Making Decisions in Nursing Practice

Decision-Making Factors

Nursing and decision-making is a very complex process on which patient comfort and health depend. To make quality choices, the nurse must consider many factors that will ensure ethical and skilled treating care. Among the most significant determinants are the personal preparedness of the staff, successful teamwork, sustainability of management practices, and effective communication. Only a combination of these elements will contribute to quality administration (Sanerma et al., 2020).As care managers, the nurses require knowledge, skills, and attitudes that will enable them to carry out their work to achieve effective results. Therefore, in constant communication with the population, they must know the basic approaches and principles of care to ensure an individualized approach to everyone. Thus, the nurse should always strive to develop individual skills and deepen knowledge.

Decision-Making in Relation to Client Centered Care

The client-centered care approach dictates the specific conditions of interaction with target patients and determines the nature of decision-making. The patient-nurse relationship in an individualized care plan includes a variety of factors that must be taken into account. For instance, it is crucial for nurses to consider a patient’s personal background and their religious beliefs alongside other cultural criteria to provide the most effective care, both from a clinical and a moral standpoint. If there are barriers to treatment interventions, they are addressed so that a patient receives individualized attention, leading to greater efficiency and satisfaction (Sanerma et al., 2020). To improve the quality of nursing care, the introduction of dedicated funding programs is to be considered. The timely replenishment of the resource base helps eliminate challenges related to patients’ problems, no matter what they struggle with.

Intentional Learning and Decision-Making

Intentional learning is one more aspect that plays an essential role in decision-making. It has been estimated that the lack of theoretical background can affect the quality of interaction with patients. Intentional learning, in this case, can become a driver to strengthen a health professional’s decision-making skills and deepen the understanding of how to operate with sufficient evidence for credible and ethically correct nursing practice. In addition to that, intentional learning is associated with medical workers’ increased abilities of self-reflection. As a result, nurses can elaborate a clear model of professional development and identify the areas for improvement (Epp et al., 2018). This, in turn, helps to approach decision-making more responsibly as health professionals become aware of their limitations to make unconditionally accurate predictions and nursing diagnoses.

Processes of Making Decisions in Nursing

Speaking about the processes and approaches to decision-making, there are various them based on different analytical techniques. Accordingly, there is a large volume of theoretical and practical bases that professionals can use to improve their skills in analytical decision-making. This process is deemed reliable and efficient due to the logical comparison of specific data and their objective assessment. In other words, no personal beliefs and opinions are involved. This will help the specialist to choose a solution that will help the patient (Nibbelink and Brewer, 2018). Additionally, a clear analysis of previous information will allow nurses to choose the right patient care. As a result, the percentage of satisfied sufferers increases, and work efficiency increases.

On the contrary, another process that is important to mention is based on intuitive practice. It is the technique of identifying specific causal relationships based on individual experiences and similarities. However, it is not suitable for those with little work experience. It is explained by the fact that inexperienced workers do not have sufficient practical background to draw conclusions based on intuition and to refer to personal views on care outcomes. Although, nurses who have significant experience successfully use intuitive practice (Nibbelink and Brewer, 2018). Therefore, they have a higher percentage of happy and healthy patients and are satisfied with their work. As a result, it is necessary to develop intuitive skills for the younger generation of nurses to provide excellent conditions for patients.

Moreover, there is a crucial concept that unites the approaches mentioned – it is called naturalistic decision-making. This framework is based on stimulating rapid responses to different situations, including emergencies. For instance, one can initially research and analyze the optimal set of actions under certain emergency situations and then simulate the decision-making process several times. As a result, when the emergency situation occurs, the action plan would already be easily ‘available’ intuitively (Nibbelink and Brewer, 2018). Such training is important as medical employees often face situations when much depends on the speed of making the right decision, up to a patient’s life. Therefore, this is a valuable practice for one to learn how to operate under different conditions and be able to address potential challenges quickly.

Decision-Making in Relation to Clinical Reasoning and Critical Thinking

Furthermore, any issue related to patient care requires professional judgment in line with clear rationales for a specific solution. In this regard, decision-making is associated with clinical reasoning, where every possible aspect of care is employed. Clinical reasoning corresponds to various manifestations of decision-making. As a result, relevant tasks are successfully solved due to the search for adequate justifications based on clinically useful features of each case. The concept of critical thinking is another approach that intersects with decision-making in nursing. This practice is rather an individual one than a group one. Still, it is valuable since its basis is a ‘purposeful self-regulatory judgment that results in interpretation, analysis, evaluation, and inference’ (Macauley et al., 2017)

Decision-making can be complicated by circumstances that require a quick response, a combination of theoretical and practical skills, and other conditions. Critical thinking helps nurses quickly find an approach to each case by assessing such situations adequately.

Decision-Making and Leadership

When it comes to the leadership aspect of decision-making, it is estimated that the primary purpose of a competent leader is to stimulate colleagues’ productive work. Simply communicating relevant tasks to them and ensuring that these are completed timely is not enough. Moreover, for effective decision-making, working at different levels should be taken into account. For instance, it has been stated that many leadership promotion programs focus primarily on organizational management (Salvage and White, 2019).This means that, at the clinic level, relevant proposals to improve work performance and stimulate employee initiative are accepted. As a result, this approach increases employee productivity and efficiency in patient care.

At the same time, leadership in local environments addresses issues that concern decision-making at a more general level. An example of that is local campaigns that are aimed at educating nurse leaders, thereby creating a background for productive leadership at the organizational level. In a global context, leadership concepts are conveyed by international agencies, such as the World Health Organization (WHO), which purpose is to promote policy decisions and then disseminate them to lower levels. Ultimately, decision-making is one of the fundamental concepts to drive through actionable leadership practices in all environments (Giddens, 2018). Therefore, the application of leadership not only at the global level but also at the local level contributes to the rapid spread of these approaches and positive results.

Use of Technology in Decision-Making

While discussing effective communication, which is an important aspect of productive decision-making, one should also mention the tools used to interact with different stakeholders in the care process. In this regard, different remote communication tools are considered, for instance, social media can deliver information to target patients timely and clearly. This practice is particularly valuable in the current context of the COVID-19 pandemic, since due to social constraints communication with patients is often remote (McDonald et al., 2018). Nevertheless, regardless of the technology available, one has to acknowledge that patients have the right to understandable and accessible explanations of diagnoses and care courses.

Quality Improvement and Error Prevention Practices

Creating an effective and error-free nursing process in a multitasking and dynamic work environment is a challenge to implement in nursing practice. In this regard, medication management and creating an environment for patient safety is significant topic. An effective plan of care that includes strategies to prevent errors and hazards inherently involves ‘preparing, calculating, checking, and administering medications’ as well as educating patients about their medications (Kavanagh, 2017). In addition, to meet all cultural competencies, nurses must consider the principles mentioned above of client-centered care and promote participation and empathy as essential aspects of skilled nursing, including psychological support. Such an environment promotes healing and increases the productivity of the patient-physician interaction.

Core Competencies

In terms of quality improvement, a wide range of competencies is needed to improve individual nursing skills and address various nursing tasks. Quality improvement, which is the ongoing development of professional capacity and conditions to optimize the nursing process, is one of six core competencies (Phillips et al., 2018). These are quality improvement, client-centered care, collaboration and teamwork, safety, evidence-based practice, and informatics (technology) Combining these requirements is a powerful approach to creating a safe care environment where the target audience’s concerns are addressed through appropriate interventions and effective intra-team communication mechanisms. It is important to note that these factors alone cannot fully ensure quality patient care. The mattering factor is integrity, that is, the totality of all elements.

Team Collaboration as Part of Decision-Making

Team collaboration is particularly essential to an effective decision-making process. Colleagues’ help can be valuable for the individual who can actively listen to others and accept their support. Positive consequences of collaboration in nursing include improvements in patient safety, patient satisfaction, patient care, and decreases in error rates, patient mortality, patient length of stay, and healthcare staff turnover rates (Emich, 2018). Furthermore, health promotion among the population is one of the critical advantages of working in a nursing team. As a member of the group, one has an opportunity to participate in collective assistance programs that aim at engaging with target communities and integrating modern care approaches. Individual solutions may be biased while teamwork reduces the risk of misjudgment of challenges and facilitates.

Conclusion

To sum up, various aspects of the decision-making process within the healthcare sphere have just been discusses. We have analyzed how such factors as intentional learning, critical thinking, clinical reasoning, collaboration within a team can help to improve the decisions that healthcare professionals deliver. Additionally, the importance of a good decision-making process with a personal approach to achieving client-centered care has been considered. Moreover, different decision-making processes and approaches, which included analytic, intuitive, and naturalistic models, have been examined. Furthermore, the role of technology from the perspective of communication with clients and colleagues has been viewed. Finally, the practices that help to improve the quality of care and prevent errors have been presented.

References

Emich, C. (2018). Conceptualizing collaboration in nursing. Nursing Forum, 53(4), 567-573.

Epp, S., Reekie, M., Denison, J., de Bosch Kemper, N., Willson, M., & Marck, P. (2021). Radical transformation: Embracing constructivism and pedagogy for an innovative nursing curriculum. Journal of Professional Nursing, 37(5), 804-809.

Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing, 34(2), 117-121.

Kavanagh, C. (2017). Medication governance: Preventing errors and promoting patient safety. British Journal of Nursing, 26(3), 159-165.

Macauley, K., Brudvig, T. J., Kadakia, M., & Bonneville, M. (2017). Systematic review of assessments that evaluate clinical decision making, clinical reasoning, and critical thinking changes after simulation participation. Journal of Physical Therapy Education, 31(4), 64-75.

McDonald, E. W., Boulton, J. L., & Davis, J. L. (2018). E-learning and nursing assessment skills and knowledge – An integrative review. Nurse Education Today, 66, 166-174.

Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917-928.

Phillips, J. M., Stalter, A. M., Winegardner, S., Wiggs, C., & Jauch, A. (2018). Systems thinking and incivility in nursing practice: An integrative review. Nursing Forum, 53(3), 286-298.

Salvage, J., & White, J. (2019). Nursing leadership and health policy: Everybody’s business. International Nursing Review, 66(2), 147-150.

Sanerma, P., Miettinen, S., Paavilainen, E., & Åstedt-Kurki, P. (2020). A client-centered approach in home care for older persons–an integrative review. Scandinavian Journal of Primary Health Care, 38(4), 369-380.

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