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Clinical Decisions: Evidence-based Decision Making Essay

Introduction

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The integration of various functions that requires decision making in the clinical field is what is referred to as EBP. Clinical skills, education, and the accumulation of clinician’s experience are what we refer to as clinical expertise. The expectations, values, personal and unique concerns are what the patient brings out as his/her encounter. To ensure that the best evidence is found and presented, best clinically researches should conducted while sound methodologies are used to ensure that best results are presented. In the knowledge of nurses, they know that their decisions are important to the patients hence, making them to make decisions that are evidenced in determining the outcome. The role of evidence decision making in the recent past, has been considered to be one of the fundamental areas by the decision makers due to its active role in the healthcare sector. It has been considered as one of the important base of policy making in the health sector as the players in this sector depend much in evidence in ensuring that professionals are getting up to date information. This impact has been felt to an extent that in the UK nurses were asked to show professional judgment and also being able to make critical clinical decisions; the Chief Nursing Officer has outlined tasks that nurses are expected to ensure that the healthcare sector has been modernized to ensure that the boundary that exists between medicine and nursing is broken down. However, nurses are expected to show their capability in making all these decisions (Sakkett, 2014).

Main Body

When one takes of Evidence-based decision making, it means basing your decisions on the combination of knowledge one has gained throughout his clinical expertise experience, the preferences of the patient and the researchers have done it from the available in different resources. In this type of decision making, one has a wide range of options that he/she can choose from including doing nothing and waiting and seeing what will happen. The choices used at the end always inform by evaluating the available information basing it in the process of clinical judgment. When it comes to making evidence-based decisions, then it is required that research evidence not to be taken according to its face value, rather critical analysis should be done to ensure that the internal and external validity of the research is known. When it comes to the Integration of research evidence in decision-making, it involves the formation of a focused clinical question to act as a response to a recognized need for information. The search of the most appropriate evidence that will be needed to meet the desired needs being able to appraise the retrieved evidence critically, ensuring the incorporation of the evidence into an actionable strategy, and finally, evaluation of the effects of the taken decisions and actions. All the steps mentioned above are very important components when it comes to the process of active evidence-based decision making (Yan, 2015).

In its nature, the way decision making is done is said to be a prescriptive approach towards the decision that are made in clinical judgment. Considering the idea of theoretical approaches and the way they are used for the improvement of real life decision-making challenges. It is important for those involved in the process of decision making first to ensure that they identify the starting point, before planning on the strategy that will enable them to attain this ideal. A question asked on how nurses view researchers based on the information of decision making by evidence. What is so surprising, is the fact that the research that has been conducted based on this topic is very little. However, there are some studies that have managed to use self-report data which is obtained from nurses and use it as a source of evidence. It’s a norm that there is a rejection of self-report to be used as the the major support in the attempt to answer the questions that are in favor of immediate observations which are clinical and also doing in-depth interviews which are meant to make us feel reflected in our actual decisions in different frequencies and also the observation of information (PICO, 2015).

Most of the theoretical models are used in the utilization of research implicitly way have recognized how important the process of making decisions is very necessary in putting the acquired information into action. Though it is regarded as an implicit way of doing things, most of the models have failed to recognize the relationship that exists between the characteristics of decisions, how to use the information, and how to process this information. An example of this is the Lomas who has proposed a coordinated research model in its implementation. It has proposed that the diffusion of knowledge can be negotiated and be applied in the research findings as they deal with patients during clinical practice. Other works done by Lomas have suggested that both types of research and decision makers have to increase their level of understanding to one another regarding thinking to ensure that both research and policy linked in a better way. The argument that those practicing clinical work is trying to make efforts that will enable them to get insights about research through initiating programs like critically training appraisals and trying to read journals that will give them information which is evidence based nursing. Those who are researchers and practitioners have frequently failed to fully comprehend which product do the decisions made meant to be applied. According to decisions taken in organizations and their policies, Lomas have suggested that the researchers always should seek to understand the structures that are within the organization for them to take decisions, they should also understand their values by expression of ideologies, interests, and beliefs. The fact proven by the fact the evidence that there are some producers of evidence existing within organizations and their source of information is from evidence-based decision making. There are other theorists who have tried to come up with a context which they turn into models that research utilizes while neglecting the micro context of those actual decisions. They consider the following factors, the type of information required, how complex that research is perceived to be, the amount of information that is available for support and challenge, and also, those principles that are present and absent meant for organizing the information (Middleton, 2014).

Some researchers have resorted to using clinical questions that are generated by clinical decisions to express the potential information needed for the whole process. The argument that should be in place is that all researchers should start to think deeper and begin the process of developing exploration of relationships that exist between the needs of information which include the information presented by questions and that information that come out of the behavior of the nurses. In addition to this, there is a need for recognition that simple mapping of the core choices to be at the heart of decision-making. This decision should involve the answering of uncertainty that that rose about given treatment, diagnosis, and prognosis. Where information may be sufficient, and the condition used are known well, then the insufficient information can be rejected at the end (Torin, 2011).

Throughout our discussion, the connection that exists between information behavior and the clinical decisions made from the researcher’s point of view are the one that we have been focusing. It is prudent that we recognize how those strategies available for the purpose of clinical decisions. Those who are the decision makers can also be allowed to alter the relationship that exists with the information. According to the cognitive continuum rule, it expresses that it is evident that it can be at a position of simplifying decisions through the removal of some of the complex inducements by individuals in the application of the search and appraisal of the behavior of those involved. Taking this as an example, there are several nurses who have expressed themselves on the importance of the structured approach as a way of collecting more information that will be used as a way of simple collection of those valuable facts that are used when confronted with situations that require critical judgment. The task of determining solution to complex diseases is one that needs the doctor to be at the top level of judgement to enure that correct decicions are taken. These group of structured facts that include history, size and Doppler reading are formed on the basis of the decisions that are taken by the management. They are always formed on the informed national decisions that are generally based on guidelines that are approved and known to be the best. In addition to this, where single are decision making is used to observe text based information which is relatively common but it is said to be uncertain about use in the medication purpose. The accounts of the nurses have clearly indicated that the sources of information used in ensuring that they are fit for the questions that rose as they were taking decisions that were entirely focused on the well-structured decisions. This will lead to a collect mix that will lead to a particular desired outcome (NRGDS, 2016).

When simplification is done then automatically we will result to the shift of the desired rational to the end of the continuum. When looking things from this point, then one can easily imagine how this particular thinking about a given decision nurses will face in their daily practice of clinical decisions then an impact will be felt on how information will behave. This proves that there are some basic elements that are based on the evidence that is brought out in the nursing process that will be used as decisions in the clinical process. Narrowing down the scoop, when we develop clinical questions that are focused the it is easy to conceptualize them as a mechanism of removing some of the hiccups that may be surrounding the choices that are to be used and therefore enable us turn our attentions to the relevancy of population, interventions, the outcomes, and the other core types of uncertainty like intervention, prognostic or diagnostic. According to Croskery, he tries to come up with some proposals that are somehow more sophisticated, and the technique which is under cognitive forcing process. The techniques used here involve the act of retraining clinicians so as to think in a manner that is different regarding the problems they face through accounting the effects that are associated with limited memory, some erroneous perspective which include ignoring of the rates of the diseases in which they are based when trying to investigate which is tied to the capacity of criticizing one’s self and other unworthy methods of selecting strategies. The results that we see at the end are heightened by the sense of meta-cognition or “thinking about thinking”. The researches have indicated that there are so many types of approaches that are missing in the nursing profession to ensure that correct decisions are taken (Penny, 2015).

CONCLUSION

In the healthcare teams, nurses are regarded one of the most group of individuals who take critical decisions. While they are recognized as an important part in decision making, it is also required that they should use best available evidence when making their judgement ad decisions. Using the model that is prescriptive to make decisions with evidence and also trying to do searching, appraising, and implementing processes that should accompany this process should be active. Those clinic practitioners who need to put research findings in their practice at a point forget that active information seeks many possible responses that are faced with uncertainties of clinical practices. The observations that done by nurses who are exercising their responsibilities has suggested that search and appraise of information should occur to all. Nurses should always try to view their colleagues to be useful and they should access sources of information more that the way they should do with research. Colleagues should always be perceived as those who have relevant information that is needed to be taken into account and the judgmental or decisions from them should be minimal making time used to be minimal. This is one of the elements in clinical decision that is necessary and it leads to high quality decisions that are more important those who are involved. The approaches that have been mentioned above have been able to explain the disconnection that exists between the traditional ways of decision taking and the modern way of doing things. All the above discussed ways of decision taking should be put into practice. Nurses and those who are on the clinical practice should always use evidence based decision making approach.

References: Clinical Decisions: Evidence-based Decision Making Essay

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Bucknall T, Kent B, Manley K, (2010). Evidence Use and Evidence Generation in Practice Development. International Practice Development in Nursing and Healthcare Blackwell Publishing Ltd: Singapore

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Torin Fed, (2011).What is Evidence-Based Practice (EBP)? Duke university medical center.

Zang Yan, (2015). Evidence Based Practice.