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Lecture notes Acute Care (SHN2004)
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Prioritising Care & Clinical Decision Making
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SHN2004 (Acute Care) Clinical Decision MakingPrioritising Care & Clinical Decision Making
Aims and Objectives
Aim
o To enable the student to identify priorities in care and act appropriately.
Objectives
o Discuss prioritisation of assessment and intervention
o Assess and monitor an acutely ill child
o Identify a prioritised nursing management plan appropriate to your role
o Recognise the importance of multidisciplinary team working in acute care
What is decision making?
A process whereby appropriate alternatives are weighed up and one is ultimately
selected
What factors need to be considered when coming up with your decision?
Think about what influences the decisions you make in your everyday life?
What guides and influences your decisions?
‘I keep six honest serving men (they taught me all I knew); Their names are What and
Why and When and How and Where and Who.’ Rudyard Kipling
Think about your decision…
to study nursing?
o Who?
o What?
o Where?
o When?
o Why?
o How?
On how to treat a patient?
o Who?
o What?
o Where?
o When?
o Why?
o How?
What questions would you like answered in order to make an informed decision
o Who?
o What?
o Where?
o When?
1
, SHN2004 (Acute Care) Clinical Decision Making
o When?
o Why?
o How?
Decisions you make as a nurse
Nurses make important clinical decisions every day and these decisions have an
effect not only on the patient’s healthcare but the team around them
As care provision becomes increasingly complex, nurses rely on sound decision-
making skills to maintain up to date care as positive outcomes
Nurses are accountable for the decisions that they make, therefore it is imperative
that you are aware of how you came to a decision
Responsibility and Accountability
The public
o We have accountability to ensure that the public are assured that they are
cared for by competent, caring, trustworthy and professional nurses.
NMC
o We are accountable to our professional body and follow the standards set
out the ‘The Code’ (2015)
An employer
o We have accountability to ensure that we work within the policies, guidelines
and procedures specified by our employers.
The Law
o E.g. signing a contract with a particular Health Board
o Governs a great deal of the work nurses do – e.g. consent, medicine, manual
handling
o We are ultimately accountable to the law of the country in which we work.
Decision Nurses Make
Nurses make decisions throughout the nursing process:
o Assessment
What tools to assess?
What is the significance of information?
Is this acceptable?
o Diagnosis
What is the problem/need?
o Planning (how is the issue going to be treated/resolved)
Who
What
When
How
2
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