Evidence Based Practice: Decision Making in Nursing Practice
Background and Context
In nursing, decision-making includes an appraisal of several complex considerations. While
nursing decision-making study is widespread, decision-making mistakes appear to lead to bad
patient outcomes. A basis for further discussing decision-making in acute care nursing practise
may be established by naturalistic decision-making. In order to direct future studies to more
accurately help acute care nurse decision-making, a deeper understanding of the literature is
required. A number of essentially synonymous terms are used for decision-making in nursing:'
professional decision-making' is the most common; other terms include 'clinical judgement';'
clinical inference';' clinical logic'; and 'diagnostic reasoning'.
It is possible that nurses have already known that their actions have significant consequences
for patient outcomes. However, they are gradually being cast by policy makers and other
members of the healthcare team in the role of influential decision makers in healthcare. The
Chief Nursing Officer in the UK, for example, recently identified 10 main tasks for nurses as part
of the transformation agenda of the National Health Service and the breaking down of arbitrary
barriers between medicine and nursing (Thompson et al., 2006). It is also expected that nurses
can access, interpret and implement scientific evidence into their professional decisions and
clinical decision-making (Thompson et al., 2006). The emphasis of this paper is this constructive
interaction with research facts. When exploring the ways in which nurses interact with
research-based evidence, we would discuss why it is important to understand the context of
clinical decision making. The relationship between the accessibility and utility of information
,from multiple sources and the judgments on which such information is applied would also be
considered. Finally, we would suggest that if we want to enable nurses during clinical decision-
making to consistently engage with scientific data, we need to properly consider the
relationship between the choices that nurses make and the information that guides them.
Experiences, trial and error, intuition, rational analysis and conventional methods have become
the foundation of past experience of nurses in decision making (Polit and Beck, 2010). While
this means of knowledge sharing is accepted as necessary by Brooker and Waugh(2013), they
criticised it by mentioning the dangers to the nurse and patient that invalid information has
been communicated and may lead to prejudice. Nurses have become part of an initiative that
has evolved over the past decades with frequent revisions to national and local laws and
legislation, taking into account that patients are now specialists in their own diagnosis, which
has an impact on treatment given (Stevens,2013; Ellis ,2016). It has become more crucial,
according to Emanuel et al. (2011), that data that is synthesised into guidance is needed in
nursing due to its transformation from dictated duties to an individualised approach to
treatment. Ellis (2016) suggests that nurses should not only behave in the best interest of
patients, but should also be able to defend health care decisions. In addition, nurses have a
responsibility to understand science to ensuring that the latest information applicable to their
daily experience is extended to others to offer accurate guidance and help patients make better
choices and they are accountable for delivering the best standard of care (NMC,2018).
Furthermore, this reflects on the effective provision of services and increases the quality of life
of the patient. Healthcare workers, however, ought to be informed of the research linked to
their own clinical experience and apply it appropriately (Moule, 2018). In addition, the
, feasibility of streamlined services offered has shown that EBP and study have lowered costs as a
result of (Barker et al., 2016).
Aim of Report
The first goal of this analysis was to create a specific emphasis for this review, 'Decision making
in nursing practise.' It will show what is relevant for nurses in decision-making, variables that
influence decision-making, the consequences of mistakes and how to overcome decision-
making mistakes from studies on this topic.
This was used to construct the query used in this study, as Bettany-Saltikov (2012) describes the
use of PEO (Patient, Exposure and Outcome) to bring together a qualitative question.
Table 1: Application of PEO framework
Who is the patient and their What is the exposure? What is the intended
problems? outcome?
Dementia patients on Dementia Nurses follows the right
ventilators at the intensive guidelines in decision making.
care units
PICO is another system listed by Bettany-Saltikov (2012) as well (Population, Intervention,
Comparison Intervention and Outcome). This approach is, however, most commonly used for
quantitative analysis. For this research review, PEO was then chosen as it was more fitting when
the question was placed together.
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