Importance of Clinical Decision Making by Nurses in Care of Patients in Acute Care Settings

Abstrakt

Clinical decision making is a complex process. Healthcare workers need to consider various aspects of healthcare using a vast body of knowledge while formulating a clinical decision. More recently, clinical decision making has become a collaborative process and patients are also involved as much as possible. The ultimate goal of every clinical decision making is to achieve the best health outcomes for the clients. Through review of relevant literatures, seven core skills were identified as a guide to decision making in nursing practice, i.e., pattern recognition, critical thinking, communication skills, evidence-based approaches, team work, sharing, and reflection. The graduate nurses use mainly three models of clinical decision making: hypothetic-deductive reasoning, pattern recognition, and intuition. The registered nurses and midwives are expected to practice within the relevant competency standards and decision making. Skill rehearsal through simulated environments and appropriate feedback or reflection help nurses to demonstrate cognitive pitfalls in decision making and rectify the mistakes. More guidance to novice nurses through appropriate graduate training and continuous professional development programs will be helpful to enhance clinical decision making. Evidence-based practice needs to be incorporated in clinical practice by nurses to enhance clinical decision making. In order to promote effective clinical decision making, education needs to be provided to consider and manage multiple factors influencing it, rather than focusing only on immediate decision making tasks like nursing diagnosis and interventions. Thus effective clinical decision making by nurses can improve the quality of nursing care and client’s life. Keywords: Decision making, clinical decision making, acute care nursing