Decision-making is an important part of any service-providing system. In health care, there are even more aspects influenced by successful decision-making processes than in any other system. The decisions must be made regarding patients, the treatment and care-providing processes, and many other issues related to nursing. Decision-making tools are necessary to provide high-quality treatment to every patient. With the increasing quality of these instruments and the invention of new ones, it becomes progressively easier to make a particular decision. The effort takes to make a right, and quick decision is also significantly reduced. Therefore, the implementation of innovative decision-making tools may provide a significant impact on the quality of nursing and health care in general.
The Main Aspects
The critical problem that the current nursing practice is facing is that no researches are covering precisely the topic of decision-making tools. There are numerous guidelines provided by different sources that elucidate the decision-making process in general and provide frameworks in which the decision-making must be implemented. However, some sources provide tools to promote certain types of decision-making to improve the state of nursing across the globe. For example, an article by Austin, Mohottige, Sudore, Smith, and Hanson (2015) covers the topic of shared decision-making in nursing and the tools helping to promote this approach. However, once again, the question is narrowed because the authors only describe tools supporting shared decision-making in cases of serious illnesses.
Another article by Lee and Emanuel (2013) dwells on the topic of how shared decision-making provides opportunities to improve the state of the health care system while reducing costs. Indeed, decision-making tools may be a key feature to eliminate such problems as “many hands issue.” Decision-making tools provide an opportunity to monitor the treatment, while everybody involved in the process remains apparent and their decisions may be tracked to reveal the person that made a decision. It would provide a considerable reduction in time and money spent to negate the problem. At the same time, the level of quality would also rise due to increasing standards and the increasingly apparent nature of health care.
Almasalha et al. (2013) suggest another approach that incorporates methods of data mining. Although somewhat lacking in quality and precision, this method would also contribute to the development of decision-making tools. The authors conclude that “key to the successful use of diverse mining tools is the fact that the underlying data set was based on standardized language in the form of well-established nursing terminologies—NANDA-Is, NICs, NOCs and capture of this information into a standardized database architecture” (Almasalha et al., 2013, p. 7). Thus, the authors agree that there are some restrictions to this method, which means that there should probably be either more research covering data mining in decision-making or researches covering other approaches.
Finally, research by Durand et al. (2014) suggests that, apart from the benefits stated above, shared decision-making may also promote a decrease in health care inequality. Using various approaches and meta-analysis, the authors come to their main finding: “his review suggests that SDM interventions significantly improved outcomes in disadvantaged groups: increased knowledge, informed choice, participation in decision-making, decision self-efficacy, preference for collaborative decision making and reduced decisional conflict” (Durand et al., 2014, p. 8). This indicates that not only does the quality of care grow, but the working environment also improves.
All of these pieces of evidence determine two things. First, nursing science currently tends to prefer shared decision-making as one of the most efficient decision-making tools. Second, decision-making in itself provides several opportunities to increase both health care and the environment in which the nurses are carrying out their duties.
Personal Experience
My personal experience with decision-making is rather large. Although it may seem that there is no process of decision-making, it is obvious that decision-making guidelines are often incorporated in my line of duty imperceptibly. This becomes especially apparent when one is informed about the decision-making science and the steps that it suggests taking before making any particular decision.
Most of the time, the decisions regarding patients and treatment are made individually. However, there are certain cases when one is unable to make any decision on their own. This is when decision-making (more precisely – shared decision-making) comes into play. Any decision that must be made is found with much less effort when at least two or three nurses and doctors are trying to find it. For example, I had a case when a patient disagreed with my treatment plan due to his religious background. Thus, I had to decide whether I should ignore this rejection or listen to the patient and let him decide what treatment he will take. My superior physician helped me resolve the situation. Together, we decided that we should try to convince the patient to accept treatment. The negative effect was evident: there was a lot of stress for me; at the same time, I was somewhat reluctant to ask my superiors for advice. However, the positive effect of reaching an agreement with the patient outweighed everything else.
Conclusion
Thus, the decision-making science in general and the decision-making tools and approaches it provides are definite assets that may substantially contribute to the quality of health care. My nursing career will always be significantly impacted by decision-making. However, as of now, I realize that there are many more positive than negative effects to this practice.
References
Almasalha, F., Xu, D., Keenan, G. M., Khokhar, A., Yao, Y., Chen, Y., … Wilkie, D. J. (2013). Data mining nursing care plans of end of life patients: A study to improve healthcare decision making. International Journal of Nursing Knowledge, 24(1), 15-24.
Austin, C. A., Mohottige, D., Sudore, R. L., Smith, A. K., & Hanson, L. C. (2015). Tools to promote shared decision making in serious illness: A systematic review. JAMA Internal Medicine, 175(7), 1213-1221.
Durand, M., Carpenter, L., Dolan, H., Bravo, P., Mann, M., Bunn, F., … Elwin, G. (2014). Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis. PLOS One, 9.
Lee, E. O., & Emanuel E. J. (2013). Shared decision making to improve care and reduce costs. The New England Journal of Medicine, 368(1), 6-8.