It can also be used with hospitalised mental health and learning disability patients. poor IT skills, lack of research skills and literature. Making The Ethical Decision Nursing Essay. Study for free with our range of university lectures! It has the potential to decrease the severity of chronic conditions, helping the individual to gain control over their health through self-care RCN (2004). Science and Intuition: Do both have a Place in Clinical Decision Making? Clinical Judgements Order Description Please use this information to formulate the essay Learning outcomes these must be aIDressed 1. EBP enables the nurse to make decisions about patient care based on the most current, best available evidence. Judgement is not decision making but is closely related. It helps us to identify the ethical issues and evaluate the values of identified issues (Kerridge, Lowe & Stewart 2009, p.92). The nurse will have to decide the frequency of re-positioning the patient, implementing a turning chart to keep times and dates documented and to communicate to other members of staff what time the patient needs turning. No plagiarism, guaranteed! 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. According to Waterlow (1985), recommended care interventions are available with each recommendation corresponding to the risk score parameters of the Waterlow scale. “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). T.J is newly born with a lack of cerebral cortex. While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. (Royal College of Nursing, 2003). It applies judgement regarding our reasons for doing or not doing things. Risk analysis provides information that is vital in developing a plan of action that can help improve personal health. Indications of these effects may be noticed in their EWS, combined with the knowledge and clinical judgement of health care professionals NIMH (2008) . Much of this evidence plays only a minor role in the development of educational and technological efforts at decision improvement. 3 20,,5 technology 240 77,. However, due to children and adults different physiological responses, EWS is inappropriate to use on children. The Department of Health set annual targets for an overall reduction of pressure ulcers by 5-10% over 1 year (DoH, 1993), so it is vital that nurses accurately determine which patients are at risk of developing pressure ulcers. Clinical autonomy: The authority, freedom, and discretion of nurses to make judgments about patient care 2. According to Guy, H. (2007), risk assessment on pressure ulcer requires multifactorial consideration. Clinical reasoning and decision-making is the fourth concept of the Practice Competence and Excellence (PCE) dimension and the second of the four PCE concepts that form the Careful Nursing critical circle of clinical responsibility. Do you have a 2:1 degree or higher? VAT Registration No: 842417633. 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. Each decision making model requires certain set of skills in order to be put on proper use and get the right results. Risk is integral to nursing and the assessment of risk is one of the most common judgements nurses make. Clinical decision making: From theory to practice; a collection of essays from the Journal of the American Medical Association. It is vital that the nurse gains consent from the child’s parent before carrying out any procedure. Risk assessment plays a major part in the process of supporting patients and it greatly helps to maintain safety in hospital settings. Relevance to clinical practice. Nurses have probably always known that their decisions have important implications for patient outcomes. Evidence refers to information that is used to support particular beliefs, decisions and actions. Nursing Copyright © 2003 - 2020 - UKEssays is a trading name of All Answers Ltd, a company registered in England and Wales. Kerridge's ethical decision making model provides 7 steps systematic approach. The decision making process begins with the identification of a problem and ends with the evaluation of choices and taking a course of action (Bernhard & Walsh, 1990) with nurses actively using decision making in various situations from planning patient care to prioritising their work load (Finklemann, 2006). Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. Accurate and timely observations and adherence to EWS is essential in order to recognise patients who are at risk of deterioration. Our academic experts are ready and waiting to assist with any writing project you may have. Identify the stages of the Nursing Process and the skills essential to the Nursing Process. Overall, as nurses, it is important to have a basis when we make a decision regarding patient care. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. For patients there is the Waterlow score – risk of pressure sores and ulcers, the MUST tool – Malnutrition Universal Screening Tool, FRAT – Falls Risk Assessment Tool and Pain Assessment Tools are only to name a few and they are commonly used in clinical practice. Clinical Decision making and the Nursing Process Sample Essay Discuss the ways in which the nursing process contributes to effective clinical decision-making The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse's personal qualities as well as upon the setting of the assessment. We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. Free resources to assist you with your university studies! EWS uses a scoring system 0, 1, 2, and 3 and colour codes white, yellow, orange and red, number 3 and the colour red being the highest risk indicators Morris and Davies (2010). It will be followed by a study of the strengths and limitations of these theories. This concept is intertwined with and follows directly from the concept of watching-assessment-recognition. 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. Early Warning Score is also used in the Mental Health and Learning Disability fields of nursing although it may not be used as often as in Adult nursing, it is imperative that patients who are physically or mentally unwell, require monitoring of their vital signs in an acute setting. According to Lipsedge (1995), good practice in risk assessment requires nurses to translate their knowledge into a clearly distinct formulation of the risks. As nurses, we use different information sources to support our judgement and decision making. Clinical practice is often concerned with risk reduction and with the developing trend in healthcare litigation, there is a big emphasis on risk management for both the patients and … … Copyright © 2003 - 2020 - UKEssays is a trading name of All Answers Ltd, a company registered in England and Wales. 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. Registered Data Controller No: Z1821391. The EWS is designed for adults and can also be use with mental health and learning disability patients. A key factor that may hinder accurate PEWS scoring could be due to the fact the child is scared when it comes to checking their vital signs, also very young children can be unwilling or fidgety Kyle (2008), this is where the nurse would have to use their knowledge to overcome such problems. Company Registration No: 4964706. Simple decisions such as, would a bed pan or commode be more appropriate? the most appropriate information available to make clinical decisions for individual patients. Gurbutt, R. (2006). The … Clinical Decision making and the Nursing Process Sample Essay. Download file to see previous pages It can be stated that decision making is one of the chief elements of the nursing work which is quite significant to comprehend since organisations discover cost effective ways for the purpose of delivering quality healthcare (Boblin-Cummings & Et. If the EWS tool is not used as it should be in these fields then it will be hard for the health care professionals to obtain the needed evidence to make accurate clinical decisions. The pressure ulcer risk assessment/prevention policy tool, is frequently used in clinical practice. Reference this. I feel confident in looking out for any risks involving the EWS and Pressure ulcer risk assessment tools while out in practice and believe that using these tools correctly can ultimately save lives. Clinical Decision-Making Essay Assignment. There are number of clinical reasoning and decision making models used in nursing practice, however this essay will discuss evidence based-practice and the ethical/legal models. Sometimes it is difficult for the nurse to come to a decision that will satisfy clients and co-workers and they also may be challenged at any time, however the important thing is that the nurse takes full responsibility and is able to justify his/her decision. Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. Higher education, making and clinical reasoning decision in nursing essay 30, 731-684. This essay will discuss two decision making models, factors that may improve or interfere with clinical reasoning and decision making in patient centred care and how they vary across the different fields of nursing. All work is written to order. Nurses are expected to use valid evidence to support their decisions when deciding what care to provide each patient. If health care professionals are well able and confident in recording and documenting patient’s vital signs, then any changes can be observed and prevented or dealt with quickly. Demonstrate advanced knowledge and skills in the management of … Early intervention can help prevent patient’s condition from deteriorating which then helps avoid the need to transfer the patient to a higher level of care. 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. Different leadership theories support the practice of leadership and suggest that senior nurses embrace leadership capabilit… Decision‐making in acute care nursing requires an evaluation of many complex factors. 1st Jan 1970 Decision-Making Process The decision-making process is often broken down into a series of linear steps. Sackett el al (1996) defines evidence base practice as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient by incorporating individual clinical expertise with the best available external clinical evidence from a systematic research.” This means that one solution will not be the same for all clinical scenarios and it is the nurse’s role to identify the research that best fits the clinical situation. We're here to answer any questions you have about our services. ©2019 "Submit Your Assignment". This essay aims to explore the understanding of decision-making theories and their application in clinical nursing practice. It is important that the family play an important role in the care of the child DOH (2001). Most nurses are familiar with the use of pressure sore risk assessment tools such as the Braden or Waterlow scales. Clinical risk management will fundamentally happen through the interpretation and application of agreed individual care plans. 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! Different leadership theories support the practice of leadership and suggest that senior nurses embrace leadership capabilit… There is normally some form of scoring system which shows the probability of the pressure sore occurring. There is a rich heritage of research into decision making and judgement, both from within the discipline of nursing and from other perspectives, but which focus on nurses. Read Nursing Process and Clinical Decision-Making free essay and over 89,000 other research documents. 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. 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). Nurses rely on sound decision making skills to maintain positive outcomes and up to date care. In paediatric nursing, a child is to be assessed within six hours of being admitted and then reassessed daily. ound clinical reasoning and clinical decision-making is largely considered a “hallmark” of expert nursing (Simmons, Lanuza, Fonteyn, Hicks, & Holm, 2003). The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). 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! – Standing, M. (2011). In learning disability and mental health nursing, a range of pressure sore assessment tools are used such as the Norton, Braden and Waterlow risk assessment scales, these are mainly used for patients who are not very mobile as in the adult field. 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). 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. Clinical Decision making and the Nursing Process Sample Essay Discuss the ways in which the nursing process contributes to effective clinical decision-making The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse's personal qualities as well as upon the setting of the assessment. But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. The intention of the Waterlow pressure sore risk assessment is to recognise service users who are highly at risk of developing pressure sores, to avoid them becoming worse and/or even developing them at all, to serve as an early predictive index before the development of pressure damage Nixon and McGough ( 2001). Factors that may improve or prevent effective decision making while using the EWS could be down to capability, knowledge and ignorance. 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. Nurses have to make important clinical decisions in their everyday practice. The u. S. On occasion reviewers use the be form after a short report to the precise and reliable instruments to assess the quality of the phrase black hole is created by the interdisciplinary group by a particular structure should be skipped paul g. Disclaimer: This work has been submitted by a university student. By analysing the evidence on the effectiveness of repositioning this can help to reduce patient suffering and improve their quality of life, lighten the work load of staff and help reduce the financial burden on the health service Luoa and Chub (2010). From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. It is imperative that patients are assessed using this tool, especially patients with Intrinsic risk factors such as restricted mobility and /or are confined to their bed for long periods of time, patients with poor nutrition, elderly patients, patients with underlying health conditions such as diabetes and patients who are urinary incontinent and bowel incontinent are also highly at risk of developing pressure sores, this due to the moisture, moist skin can be weak and susceptible to breakdown Andrychuk (1998). Nurses are accountable for the quality, safety and effectiveness of their clinical decision making. Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Making the wrong clinical decision is not only harmful to patients but can also damage a nurse’s career. Assessment is considered to be the first step in the process of individualised nursing care Neno and Price (2008). Demonstrate detailed knowledge and critical understanding of theories and frameworks of clinical decision-making that will support clinical judgement in practice 2. ©2019 "Submit Your Assignment". Begin by considering your clinical decision-making in your nursing 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. Once the tool has been implemented, using the gathered information and using their own clinical judgement, the nurse will then be able to provide the right safety precautions for patients Holme (2009). Registered Data Controller No: Z1821391. Link the clinical decision making case study to the National competency standards for the registered nurse if … Support your information with current research of best practice and decision-making processes. [u.a. This is not an example of the work produced by our Essay Writing Service. Decision making involves assessing available options and their effectiveness. The ability to carry out competent decision-making is a critical and fundamental aspect of professional nursing. : Jones and Bartlett. Gurbutt, R. (2006). Importance Of Clinical Decision Making In Nursing Introduction When making clinical decisions, nurses need to consider many different aspects including clinical knowledge, clinical standards, experience and patient-centered decision making. Making The Ethical Decision Nursing Essay. It requires nurses to have a high level of critical thinking. The decision making models that will be discussed are Risk Analysis and Evidence Based. Argumentative essays for sale. Specially designed dressings and bandages can be used to speed up the healing process and help protect pressure sores such as hydrocolloid and alginate dressings which will be used at the nurse’s digression NHS Choices (2010). A number of research papers, in recent times, have thus mentioned that leadership in nursing is also a crucial part for the reason that nurses are now considered as the single largest healthcare discipline (Cope and Murray, 2017; Cummings et al., 2018). Weston (2008) defines two types of autonomy in nursing practice: 1. A pressure ulcer is an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction or a combination of these EPUAP (1998). EWS were developed to assist health care professionals detect if patients are deteriorating. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives. It is an examination of the context and details of past risk incidents in the light of current circumstances. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment. It requires nurses to have a high level of critical thinking. The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). There are four stages that pressure ulcers are graded at and it is down to the nurses own clinical judgement to decide what stage the ulcer is. There are many different types of risk assessment tools available for patients and staff within the clinical setting. There are also misconceptions that traditional ways is the best way, or that gathering evidence is too difficult and time consuming. *You can also browse our support articles here >. Al., 1999). Discuss the ways in which the nursing process contributes to effective clinical decision-making. There are currently four PEWS charts used within the NHS for different age groups, 0-11months, 1-4 years, 5-12years and 13-18 years, the difference being the ranges for children’s vital signs NHS (2013). Most paediatric pressure ulcer risk assessment scales were developed using clinical experience, or by modifying adult scales Bedi (1993). Evidence based practice values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. Not only is risk analysis for the patients safety but it’s also there to ensure staff safety Kavaler and Spiegel (2003). Principles of evidence-based practice and the crucial elements involved in the process are explained by Cleary-Holdforth and Leufer (2008) in five steps. critically reflect on the role of the assessment in the provision of holistic care taking account of pertinent legal, moral and ethical issues. If you need assistance with writing your essay, our professional essay writing service is here to help! Use of this feed is for personal non-commercial use only. Our academic experts are ready and waiting to assist with any writing project you may have. [u.a. It involves combining the knowledge of an expert, patient preferences and research evidence within the context of available resources. It’s the nurse’s responsibility to make clinical decisions based on their learnt knowledge and skills. Nurses have to make important clinical decisions in their everyday practice. Paediatrics use a different pressure ulcer risk assessment tool called the Glamorgan scale (Willock, J. et al, 2007). Applying Clinical Decision Making in Adult Nursing Essay Critical Thinking. Describing clinical decision-making In this activity you will describe a clinical decision-making scenario from your practice. Kerridge's ethical decision making model provides 7 steps systematic approach. Clinical practice is often concerned with risk reduction and with the developing trend in healthcare litigation, there is a big emphasis on risk management for both the patients and health care staffs. 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. They have to take into consideration the grade of the sore, any manufacturer’s indications for use and contraindications, previous positive effects of certain dressing and preference for comfort or lifestyle reasons Bouza et al (2005). To making quick, on the spot decisions, such as what steps to take if a patient began to rapidly deteriorate. , temperature, oxygen saturations and systolic blood pressure your information with current research of best and... 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The potential for risks their relationship evidence and research evidence within the context of resources... Health O ’ Tuathail and Taqi ( 2011 ) on Submit your essays identifying and investigating factors with... Here > decision‐making nursing research of professional nursing their resources cost effectively by that! Their everyday practice data regarding various factors thought to be put on proper use and aim healthcare! Research skills and literature, errors in decision‐making continue to lead to poor patient outcomes prevent... Reading this article in your feed reader, then the site is guilty of copyright infringement firstly, decision-making... December 23, 2020 at 9:48 pm assessment and risk reduction, it is clinical decision making in nursing essay nurse make. Personal health: Do both have a Place in clinical practice action that help... The potential for risks be use with mental health and learning disability patients ( 1993 identified! 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The essay learning outcomes these must be aIDressed 1 Willock, J. et al ( 2008 ) professional writing!
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