However, the Waterlow scale is specifically designed for adults and therefore it is not appropriate to be use on children. These tools collect data regarding various factors thought to be associated with the development of pressure sores. McKibbon (1998) recognises the importance of the patient when making decisions about their own care. “Integrating research evidence into decision making involves forming a focused clinical question in response to a recognised information need, searching for the most appropriate evidence to meet that need, critically appraising the retrieved evidence, incorporating the evidence into a strategy for action, and evaluating the effects of any decisions and actions taken.” – Thompson et al (2004). (O’Reilly, 1993) Clinical decision-making is defined as the ability to sift and synthesize information, make decisions, and appropriately implement those decisions within a clinical setting. We are accountable to the patients, clients and service users to whom we owe a duty of care. Evidence based practice values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. Clinical decision making in nursing involves applying critical thinking skills to select the best available evidence based option to control risks and address patients’ needs in the provision of high quality care that nurses are accountable for. There is normally some form of scoring system which shows the probability of the pressure sore occurring. It is important to carry out a care plan once the patient is identified to be at risk of developing a pressure sore so that occurrence of pressure damage can be prevented. The formulation should ideally reflect aspects of each individual, context and systems that may influence the potential for risks. Risk is integral to nursing and the assessment of risk is one of the most common judgements nurses make. For example, if a patient scores 15 or over on the Waterlow scale, the individual may be considered at risk of developing pressure sores and therefore the nurses will have to maintain a pressure ulcer prevention (PUP) bundle in order to keep track of the patient’s condition. Should we be concerned? 1) 'Clinical decision making is the formulation and revision of hypotheses throughout a patient encounter' The aim of this essay is to discuss and assess a given case scenario where, the chosen patient admitted with acute headache and vomiting with intermittent confusion. However, due to children and adults different physiological responses, EWS is inappropriate to use on children. What exactly are patient rights? Published: 12th Feb 2020, Clinical decision making in nursing involves applying critical thinking skills to select the best available evidence based option to control risks and address patients’ needs in the provision of high quality care that nurses are accountable for. According to Guy, H. (2007), risk assessment on pressure ulcer requires multifactorial consideration. According to Standing, M. (2011), accountability in decision making is being answerable to patients, the public, employers, NMC and the law for the consequences of our actions and having to explain, justify, and defend our decisions. It involves combining the knowledge of an expert, patient preferences and research evidence within the context of available resources. The Waterlow scale is mostly used in adult field of nursing. “Evidence based practice is an approach to health care wherein health professionals use the best evidence possible, i.e. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: Our academic writing and marking services can help you! According to Waterlow (1985), recommended care interventions are available with each recommendation corresponding to the risk score parameters of the Waterlow scale. Discuss the similarities and differences that you read for those two EBP peer reviewed articles. The NMC Code 2015 emphasises on decision making skills when it states that” make sure that peoples physical, social and psychological needs are assessed and responded to. – Standing, M. (2011). Registered Data Controller No: Z1821391. As nurses, we use different information sources to support our judgement and decision making. Free resources to assist you with your university studies! What are the assets and barriers to the use of these tools? Choose 2 EBP resources influencing the care provided to your client. We've received widespread press coverage since 2003, Your NursingAnswers.net purchase is secure and we're rated 4.4/5 on reviews.co.uk. Nurses are expected to use valid evidence to support their decisions when deciding what care to provide each patient. It can also be used with hospitalised mental health and learning disability patients. However, the Waterlow scale is specifically designed for adults and therefore it is not appropriate to be use on children. View professional sample essays here. One of the tools used in evidence based practice is the use of the early warning score system (EWS). Also, studies by McGuinty and Anderson (2008) and Williams (2004) showed that evidence based practice has reduced healthcare costs and geographic variation in delivery of care. (Royal College of Nursing, 2003). were loosely related to nursing clinical decision-making and were reviewed. You are the Registeblushing Entertain caring coercion Tom, you attain demand to mode the distinguishledge supposing to: identify the issues establish goals (what do you neglect to occur) select a mode of operation (what are you going to do) While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. Clinical Decision Making Skills Nursing Essay. Making the wrong clinical decision is not only harmful to patients but can also damage a nurse’s career. Nurses are trained to make critical decisions that can often save a life. Question 3. Decision making involves assessing available options and their effectiveness. This definition is identical to the nursing process as described by (ref ewles & simnett?) The nursing … The primary aim of pressure ulcer risk assessment tool is to help nurses identify individuals at risk of pressure ulcers and determine the degree of risk (Shakespeare 1994).Formal pressure ulcer risk assessment involves the use of a tool that assists in identifying those patients likely to develop a pressure ulcer. It applies judgement regarding our reasons for doing or not doing things. This essay will discuss two decision making models, factors that may improve or interfere with clinical reasoning and decision making … Nurses are accountable for their decisions, therefore it is crucial that they are aware of how they make these decisions Muir (2004). According to Reigle, Steven, Belcher et al (2008) and Talsma, Grady, Feetham, et al (2008), the reason why evidence based practice is consistently implemented is because it leads to the highest quality of care and best patient outcomes. These tools collect data regarding various factors thought to be associated with the development of pressure sores. Clinical decision making can be defined as, the collection of relevant patient information and accurate assessment, which results in an action being taken in the delivery of nursing care to the patient (Clark 1996). Our nursing and healthcare experts are ready and waiting to assist with any writing project you may have, from simple essay plans, through to full nursing dissertations. Decision making requires thinking skills to exercise judgement in assessing the benefits of available options and choosing a preferred option that is then acted upon. The key issue in examining risk assessment tools is how good they are at distinguishing those at risk from those who are not and if they are better or more accurate than simply relying on professional judgement (Thompson, C. & Dowding, D., 2002). Each decision making model requires certain set of skills in order to be put on proper use and get the right results. Clinical decision-making (CDM) is a dynamic activity in which the nurse builds a case in which hypotheses are accepted or rejected based on collected data, better defined by Barrows & Pickell (cited in Robinson 2002, p. 1) ‘Clinical decision making is the formulation and revision of hypotheses throughout a patient encounter’. Practicing nurses must effectively identify and solve the problems of patient diagnosis and treatment by using such a model. the patient’s heart rate, respiratory rate, temperature, oxygen saturations and systolic blood pressure. Nurses are accountable for their decisions, therefore it is crucial that they are aware of how they make these decisions Muir (2004). Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. If the child’s score is high then this means he/she is at risk of deteriorating, this gives nurses an early indication that an action has to be done. One means of doing so, paradoxically, is to identify the barriers to decision making so they can be overcome by the use of more effective decision-making tools. It is the foundation on which decisions are made and risks plans are then formulated through available national and local policies and procedures (Morgan, S.,1998). People often get patient rights and patient responsibilities confused. Nursing Process and Clinical Decision-Making The nursing professional faces a myriad of decisions on a daily basis. Clinical decision making can be defined as, the collection of relevant patient information and accurate assessment, which results in an action being taken in the delivery of nursing care to the patient (Clark 1996). Nurses exercise use their clinical judgement and decision making skills in clinical environments and have been used as exemplars for decision and judgement research since the 1960s. According to Lipsedge (1995), good practice in risk assessment requires nurses to translate their knowledge into a clearly distinct formulation of the risks. Risk assessment is a process of identifying and investigating factors associated with the increased probability of specified risk occurring. If you need assistance with writing your essay, our professional essay writing service is here to help! However, despite the good outcome of using evidence based practice in decision making with regards to patient care, there are issues such as nurses do not always make their decision based on available evidence due to lack of skills i.e. It is also concerned with the patterns of circumstances in which these factors may arise. No risk assessment tool can be 100% accurate. The EWS is designed for adults and can also be use with mental health and learning disability patients. It recognises that health care is individualised and ever changing and involves uncertainties and probabilities. This review indicates that naturalistic decision making may be applicable to decision‐making nursing research. If the child’s score is high then this means he/she is at risk of deteriorating, this gives nurses an early indication that an action has to be done. According to Lipsedge (1995), good practice in risk assessment requires nurses to translate their knowledge into a clearly distinct formulation of the risks. “Integrating research evidence into decision making involves forming a focused clinical question in response to a recognised information need, searching for the most appropriate evidence to meet that need, critically appraising the retrieved evidence, incorporating the evidence into a strategy for action, and evaluating the effects of any decisions and actions taken.” – Thompson et al (2004). Evidence-based decision making is a prescriptive approach to making choices based on ideas of how research and theory can be used to improve decision making in regards to delivery and quality of patient care. We're here to answer any questions you have about our services. Also, studies by McGuinty and Anderson (2008) and Williams (2004) showed that evidence based practice has reduced healthcare costs and geographic variation in delivery of care. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Risk assessment is a continuous process in which nurses gather information from multiple sources and other health care professionals with the focus of identifying the factors that is associated with the increased probability of risk happening. The Waterlow scale is mostly used in adult field of nursing. Published Date: 23 Mar 2015. Company Registration No: 4964706. Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. Do you have a 2:1 degree or higher? Nurses have to balance a number of elements before they make a decision, however the patient’s best interest is their main priority. Evidence based practice values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. It is based on physiological parameters taken when recording patient observation e.g. Decision making links judgement to practice by acting on it in choosing from the options available. For example, nurses must deliver care based on the best available evidence or practice and must ensure any advice given to patients are evidence based. According to Nursing and Midwifery Council (2008a, p.7), nurses are now required to use evidence based practice. Decision‐making in acute care nursing requires an evaluation of many complex factors. It is also concerned with the patterns of circumstances in which these factors may arise. It recognises that health care is individualised and ever changing and involves uncertainties and probabilities. VAT Registration No: 842417633. Nursing is the use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life whatever their disease or disability, until death. The development of a comprehensive and individualised care plan will relate to the broad range of effective treatment, rehabilitation and support services provided at the current level of clinical knowledge (Morgan, S., 1998). If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! poor IT skills, lack of research skills and literature. Essay on Nursing Process and Clinical Decision Making 1535 Words7 Pages Nursing Process and Clinical Decision-Making The nursing professional faces a myriad of decisions on a daily basis. When considering risk assessment and risk reduction, it is important that the initial assessment of risk is accurate. How do these tools affect outcomes? Clinical decision making can be defined as, the collection of relevant patient information and accurate assessment, which results in an action being taken in the delivery of … EWS were developed to assist health care professionals detect if patients are deteriorating. Registered Data Controller No: Z1821391. However, the authors Hardy & Smith further suggest being careful regarding their interchangeability when others are making use of the same activity. Using naturalistic decision making as a conceptual framework to guide research … VAT Registration No: 842417633. Reflection could improve the clinical decision-making of ICU nurses. The Nursing and Midwifery Council (NMC, 2008) states that nurses are personally accountable for their actions during practice and therefore they must be able to justify their decisions at all time. Accurate and timely observations and adherence to EWS is essential in order to recognise patients who are at risk of deterioration. Judgement is not decision making but is closely related. It involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations and preferences. Nurses are expected to use valid evidence to support their decisions when deciding what care to provide each patient. Paediatrics use a different pressure ulcer risk assessment tool called the Glamorgan scale (Willock, J. et al, 2007). Using the different types of clinical reasoning … Ultimately, Evidence base practice is the formalisation of the care process that the best clinicians have practiced for generations.”. However, due to children and adults different physiological responses, EWS is inappropriate to use on children. There are different models of decision making in nursing developed to help nurses make their decision on all aspects of nursing care and I decided to focus on risk analysis and management and evidence based decision making. Ultimately, Evidence base practice is the formalisation of the care process that the best clinicians have practiced for generations.”. This essay may contain factual inaccuracies or out of date material. Use your understanding of informatics based clinical decision making to post a discussion that answers the following questions: What clinical decision making tools have you used or seen used in nursing? Learning about developing and applying effective clinical decision making skills is vital for the wellbeing of patients and nurses’ capacity to demonstrate that decisions are justified. Should be APA style and have […] (Royal College of Nursing, 2003). For example, nurses must deliver care based on the best available evidence or practice and must ensure any advice given to patients are evidence based. A nurse may assess a patient as at risk of developing pressure sores, and then implement measures to try and reduced the likelihood of this event occurring by providing equipment such as specialist mattress. According to Guy, H. (2007), risk assessment on pressure ulcer requires multifactorial consideration. According to Reigle, Steven, Belcher et al (2008) and Talsma, Grady, Feetham, et al (2008), the reason why evidence based practice is consistently implemented is because it leads to the highest quality of care and best patient outcomes. Reference this Share this: Facebook Twitter Reddit LinkedIn WhatsApp This assignment was written by a Community Matron working in a Primary Care setting for a local GP surgery. Nursing, Clinical decision making in nursing involves applying critical thinking skills to select the best available evidence based option to control risks and address patients’ needs in the provision of high quality care that nurses are accountable for. There are also misconceptions that traditional ways is the best way, or that gathering evidence is too difficult and time consuming. Clinical decision making is also termed as clinical reasoning, clinical inference, clinical judgment as well as diagnostic reasoning. The use of early warning score (EWS) is the best practice for clinical observations (Department of Health, 2000), and this is backed up by NCEPOD (2005) who emphasised that every in-patient should have a EWS recorded. Or medical issue happen through the interpretation and application of agreed individual care plans EWS were developed to assist clinical decision making in nursing essay. 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