Concept 6 Part 1: Clinical Decision Making

Clinical Decision Making

Critical Thinking

Ability to think, understand, and reason

Differentiate facts from opinions

Approach situations objectively

Clarify concepts

Salient Cues (Salient= significant; cues= data)

Vary per patient

Indicate a chance in health status (may be positive or negative)

Differs from expected findings

Suggests delayed development

Clustering data that fits together helps determine if there is a pattern

Nurses must stay up to date with best evidence to provide the best care.

Intellect

Noticing Cues

Finding unique solutions to a problem.

Individualized Patient Care

Creative thinkers must have knowledge of the situation/problem

Creativity

The search for knowledge or facts

Examine objective information for clarification

Nurses continually use inquiry in the clinical setting

Inquiry can resolve clinical problems and issues

Leads to Improved Patient Outcomes

Inquiry

General idea, observations, or principles are analyzed to develop specific predictions.

Deductive Reasoning “Top Down”

Develops general conclusion by putting together specific cues.

Inductive Reasoning “Bottom Up”

Nurse must determine whether patient information is fact, inference, judgement, or opinion

Clinical Reasoning

Use of careful reasoning in the clinical setting

A learned skill that novice nurses must practice.

Reasoning

The action of making sense of an occurrence, experience, situation, or decision and learning from it.

Common questions used for reflection:

What worked or did not work?

What could be done differently for better outcomes?

What was done well?

Must be open minded when reflecting

Reflection

“Gut reaction”

Use of nursing knowledge, experience, and expertise for understanding without the conscious use of reasoning.

Difficult for students and new nurses

Intuition

Ethical and value based

Prioritization

Time management

Scheduling

Personal/Professional

Clinical Decision Making - Types of Decision

Identify a situation or problem

Analyze the information/alternatives

Prioritize the options

Select the best option to try

Put it into action

Evaluate the success

Clinical Decision Making - Steps to Making Decisions

Nurses use decision making as part of the problem-solving process

Need to be aware of recurring problems.

Common approaches to problem solving include: The Nursing Process, Trial and Error, Intuition, The Scientific Method

Problem Solving

is a process where nurses solve problems by applying:

Clinical reasoning

Critical thinking

Decision-making skills

What actions should the nurse take to provide care?

Clinical Judgement

Tanner’s Clinical Judgement Model

NCSBN Clinical Judgment Model Six Components

Clinical Decision Making