Applying Clinical Decision Making in Adult Nursing Essay

Standing (2011), defines clinical decision-making as a complex process that involves observation, gathering information, critical thinking, evaluating evidence, applying necessary knowledge, reflection and problem-solving skills. Every day nurses make important clinical decisions and these decisions have important implications for patient outcomes and deserve serious consideration. Therefore, it is important for nurses to have a better insight of the decision-making process, be able to deliver holistic care and meet essential and complex physical and mental health needs of the patient.

(Polit & Beck, 2010). As nursing is person-centred and relies on a multidisciplinary team approach it has to take into account the care setting, patient predilections, clinical judgement and best available evidence. (Holland & Rees, 2010).

Care delivery models are an integral component for delivering patient care. With the collaboration of other members of the healthcare team, the Registered nurse is able to fully optimize his/her skill sets to provide to best quality care. As discussed consistency and coordinated care are the key. Studies must be conducted and evidence base practice must be implemented in order to find the model that is suitable for a particular unit. How models are implemented in an organization can be highly variable. Completion of this assignment has enlightened me on the profound impact that care models have in the flow of a unit. Newer models

I believe that the clinical decision making process associated with the actions to be taken in Jack and Jacqueline’s care were quite similar between the Canadian and the Rwandan perspectives. This is because both perspectives took on a holistic view of Jack and Jacqueline’s situation and thereby worked to develop goals that would not only address Jack’s physical health, but also the emotional and mental health of Jack, Jacqueline, and even Charles. These holistic based goals included, but were not limited to the utilization of various community supports to foster Jack’s cognitive development as well as the formation and implementation of diverse coping strategies for Jacqueline and Charles to use during times of stress.

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

When considering a change in practice we need to firstly understand why we need to make a change? Secondly when making a change, we need to justify a decision. This can be achieved by exploring the components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient

Guidelines in our nursing practice must be accompanied by knowledge, critical thinking, and clinical reasoning based on scientific rationale (why’s), (things that are learned) in order to be effective, in the areas of quality and safe patient care. Nursing implications; are also important, the nursing-related consequences of something (a disease, a medication, a procedure), but the things which may occur which are up to the nurse to understand about the medication the nursing-related consequences of something (a medication, a procedure).

A nurse is expertised in assessing patients by collecting and analyzing information about their patients’ physical and mental conditions along with their responses to evaluated conditions while simultaneously acknowledging the extraneous factors the patients’ experience such as physiological, social, spiritual, lifestyle, and psychological. Also, they are found responsible for making making clinical judgments—identifying their patients' symptoms and responses as well as their ongoing needs based on potential problems or complications. Additionally, nurses contribute to the crucial planning involved which means Creating detailed and accessible care plans (that include assessment information and clinical judgments) by setting achievable goals and outcomes that can be measured and charted over a span of time. Lastly, implementing care plans for their patients while ensuring that those plans are not disrupted by evaluating care plans continuously monitoring the status of patients and determining whether or not their care is effective or needs to be

Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).

In order for Barbara to return home a variety of decisions had to be made. The aim of these important decisions being to promote positive patient outcomes (Benner, Hughes and Sutphen, 2008). Standing (2014) reports that learning skills and knowledge used within nursing should not be secondary to developing decision making skills, and that in theory decisions should be

In my voluntary work as a first aider, I often need to make critical decisions based on assessing both seen and unseen signs and symptoms regarding someone health, while in the clinic I need to consider longer-term judgments about someone's wellness. The ongoing structured training I have undertaken and adhering to guidelines means that I can make these decisions in s consistent, fair and repeatable manner, which keeps everyone safe. Having an understanding of evaluating the short-term or long-term outcomes according to established or agreed criteria, is crucial to decisions based on assessing evidence.

The development of the nurse’s ability to clinically reason and take appropriate and timely action can, in time, become an instinctive and automatic process. Reflective practice by the nursing professional will highlight the areas in which further improvement is needed. Essentially, it is the responsibility of the individual nurse to identify the need to develop this ability, and the skill to effectively communicate the patient’s condition to the other members of the healthcare team to produce positive patient outcomes.

The application of theories into nursing practice has profound advantages for nurses as well as the profession as a whole. Many of today’s evidence-based practice and nursing concepts and fundamentals are stemmed from nursing theories that were developed by many nurse scholars and researchers. A wide range of nursing theories have been used throughout the history of the profession as the basis of professional nursing practice and it helps nurses perform superior care for their patients and better serve the community by incorporating evidence-based practice which has been tested and validated in studies. By acknowledging the importance of these frameworks and their use in clinical practice, nurses are given the opportunity to fine-tune their nursing judgment and decision-making skills. Furthermore, nurses are empowered to apply these theories into their daily practice as it helps them build new knowledge and ensures that their nursing interventions are supported by research. To demonstrate how nursing theories impact evidence-based practice, this paper will discuss two research articles in which Mishel’s uncertainty in illness theory has been used as the basis for the study. It will then be followed by a brief analysis of the utility of this framework within daily nursing practice as well as my personal thoughts regarding Mishel’s uncertainty theory. One research article by Almgren, Lennerling, Lundmark, and Forsberg (2017) utilized Mishel’s theory in a study to

The importance of nursing theory to practice of nursing should not be overlooked or underrated. That is because, it’s understanding and application are essential in enhancing patient 's care, improving communication between nurses, providing education’ and guidance in research, (Robert T. Croyle (2005). It is equally important to know that currently, there are many theories that guide the practice of nursing. Two of the most prominent ones will be compared and will form the subject of this this discussion.

Nursing is a complicated profession requiring a broad knowledge base, discipline, and a deep desire to understand and interpret scientific data with a goal of obtaining the best possible patient outcomes. This can be very difficult to achieve, requiring the nurse to process a variety of information, prioritize, and problem solve at a critical level (Wilkinson, Treas, Barnett, Smith, 2016). The nursing process is a scientific approach, utilized by nurses to systematically improve patient care by following five steps: assessment, diagnosis, planning, implementation, and evaluation (Wilkinson et al., 2016). A good nurse is someone who understands these phases, continues to build on them, and uses the information to create the best possible, individualized, healthcare plan for the patient. It is a mastery of art to find a way to include all of these concepts with so many diverse medical diagnoses. Having a structural way, such as the nursing process, paves a strong foundation for the nurse to maintain a patient centered approach to implement exceptional nursing care (Goncalves, Spiri, Ortolan, 2017).