Clinical Decision Making – Clinical Judgment (Nursing)

by Christy Davidson

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    00:00 Welcome back everyone.

    00:02 Today's video is an important topic for both individual contributors as individual health care providers and organizations.

    00:10 Clinical decision making.

    00:13 Clinical decision making is a contextual, continuous and evolving process where data are gathered, interpreted and evaluated in order to select an evidence-based choice of action.

    00:25 Common elements of clinical decision making include: Identifying a goal.

    00:33 Second, establishing needs.

    00:30 What is the purpose of the decision? Who's gonna be affected? Identifying options Which choices are possible? Making a plan Which action should be taken? Then, taking action, this is where you actually do it.

    00:51 And finally, evaluating results.

    00:53 How did it work out? Now, there are three stages to clinical decision making.

    00:58 First, brainstorming.

    01:00 Brainstorming should focus more on quantity of ideas rather than quality in the beginning.

    01:06 Nothing is off the table.

    01:07 Really think about everything, what are all of the possibilities? Second, mapping.

    01:13 Mapping often begins with a central problem or an issue such as infection control and you place that at the beginning point of the diagram.

    01:21 Now, as ideas for dealing with the problem are suggested, and you come up with more ideas, they are added to the diagram.

    01:28 And then finally, prioritizing.

    01:30 The reality is that, regardless of the value of multiple ideas, some prioritization is generally needed to determine the first action or the best alternative from a number of suggestions.

    01:42 Now, bigger than just one person making a clinical decision, organizations also have to have clinical decision making processes as well.

    01:49 The health care organization really should clearly articulate their organizational values.

    01:54 and the team members incorporate these values when making decisions.

    01:58 The organization also ensures that nurses and physicians from the bedside to the board room, all participate in all levels of decision making.

    02:06 The organization also provides team members with support for and access to ongoing inter-professional education and development programs, focusing on strategies that ensure collaborative decision making.

    02:19 Program content includes mutual goal setting, negotiation, the salutation, complete management, systems thinking and performance improvement.

    02:28 The organization also has operational structures in place that ensure that perspectives, the patients and their families are also incorporated into the decisions affecting patient care.

    02:40 Health care organizations also establish systems such as structured forums, involving appropriate departments and healthcare professionals to facilitate data driven decisions.

    02:50 They also establish deliberate decision making processes that ensure respect for the rights of every individual.

    02:56 They incorporate all key perspectives and designate clear accountability.

    03:02 And finally, organizations have fair and effective processes in place at all levels to objectively evaluate the results of decisions including delayed decisions and indecisions.

    03:13 So remember, nurses share accountability for effective decision making by acquiring the necessary skills, mastering relevant content, assessing situations accurately, sharing fact-based information, communicating opinions clearly and inquiring actively.

    03:31 What do we learn today? First, clinical decision making involves the common elements of identifying a goal, establishing needs, identifying options, making a plan, taking action and evaluating results.

    03:46 To begin the clinical decision-making process, be sure to start with brainstorming.

    03:50 Next, map out all of the possibilites.

    03:53 And then finally, prioritize your action.

    03:56 Now, at a higher level, organizations should also have a structure in place for decision making.

    04:02 And finally, nurses, as an important part of the health care team, should play a vital role in an organization's decision-making process as well.

    04:11 I hope you've enjoyed this video on clinical decision making.

    04:14 Thank you so much for watching.

    About the Lecture

    The lecture Clinical Decision Making – Clinical Judgment (Nursing) by Christy Davidson is from the course Professionalism (Nursing).

    Included Quiz Questions

    1. Clinical decision making
    2. Analytical reasoning
    3. Deductive problem solving
    4. Interpretive analysis
    1. Identify goals, establish needs, make a plan, and take action.
    2. Recognize initial challenges, identify key stakeholders, and formulate cost of implementation.
    3. Create a mission statement, encourage the decision-making process, and develop an evaluation methodology.
    4. State the purpose, build a team, motivate for success, and implement the plan.
    1. The quantity of ideas
    2. The quality of ideas
    3. The realistic nature of ideas
    4. The creativity of ideas
    1. Mapping
    2. Graphic depiction
    3. Pictorial representation
    4. Scaling
    1. Prioritizing
    2. Formulating
    3. Processing
    4. Operationalizing
    1. That organizational values are clearly articulated so that team members can incorporate these values in making decisions
    2. That management uses transparency, consistency, and mission-driven language to articulate how decisions are made
    3. That a cost-benefit analysis of how decisions are made within the organization supports the organizational values
    4. That there is a clear chain of command and structure for making decisions within the organization
    1. Administer oxygen via a nonrebreather mask.
    2. Administer oral acetaminophen.
    3. Administer 0.9% normal saline intravenously.
    4. Administer norepinephrine intravenously.
    1. A client reporting angina
    2. A client ready to be discharged
    3. A client reporting a headache
    4. A client requesting a heating pad

    Author of lecture Clinical Decision Making – Clinical Judgment (Nursing)

     Christy Davidson

    Christy Davidson

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