Generating And Assessing Evidence For Practice In Nursing Decision Making

Importance of nursing decision making process

Discuss About The Generating Assessing Evidence For Practice.

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Nursing process and clinical decision making are crucial parts in the organization because these impact the entire activity of the organization (Munteannd, pp. 2). The profession of nursing faces the numerous decisions on the daily basis. It is necessary to have the effectiveness in the decision making process to make sure the positive outcomes in the clinical setting. The misunderstood decision making process of nurses can lead the organization into anticipated outcomes. Moreover, immaturity in clinical thinking might impact the decisions due to ineffective experience and knowledge (Banning 2008, pp 178). Nursing decision making process is the skill of critical thinking. Critical thinking is the process that shows the ability to accumulate and process data in a way to arrive the effective conclusions. This assignment will reflect the role of critical thinking and the process of nursing in making clinical decisions. The involvement of the decision making model is necessary in guiding the decision making process. That is why it is vital to know about the nurses’ decision making model and theories in aiding the learning and development of decision making skills. Three theories will be described in this assignment to describe the importance of decision making models and theories. One theory of them will be opted and analyzed in the context of how nurses make decisions in their practice. Furthermore, the pros and cons of the theory will be critically examined. Along with that the complexities, contradictions and inconsistencies associated with the theory will be discussed in this assignment with supporting counter argument. At last, the essay will provide the practical applications of intuition theory which will be considered as the most appropriate nursing decision making theory.

Social judgment theory is considered as the framework that studies human judgment. It is a Meta theory that defines the research on cognitive perspective which shows how someone reacts on the situations (Asemah and Nwammuo, 2017, pp. 76). It assists to simplify the principles of psychophysical judgmental and the social judgement. It is majorly focused on the internal process of the personal judgment of the person in order to make the relations between employees. It has advantages as well as disadvantages in the context of nursing decision making which will be discussed. The advantage of social judgement theory is based on the idea. It has been analyzed that the consequences of the persuasive message on the specific issues is dependent on the way that the receiver analyses the situation of the message. The nurses can take the decision by applying social judgment theory because it suggests that formative research should be made as the campaign message (Bambini, Washburn &Perkins 2009. pp.80). The major pros of this theory is that it is practical utility, testable, predicts and intuitive appeal. Social judgement theory also represents how people contrast their personal positions on concerns to the position of others. It has been found that the social attitudes are not increasing especially in the term of specific issues where the attitude is extreme (Chau, Wong, Chow and Fung, 2014, pp.1).It means that person is not agreed with the less extreme stands relative to his position even though the similar direction (Polit& Beck 2008). The major agenda of this theory is creation, judgment process and critics. It assists nurses to take decision after evaluating that why two people may perceive the single message differently. The weakness of social judgment theory is that it is not likely to happen with clear message and along with that this theory can impact persuasion. Another drawback of this theory is that it ignores the other factors that can influence the persuasion.

Role of critical thinking in making clinical decisions

Information processing theory is the approach of understanding the thinking of the human. George A. Miller was the founder of this theory who has provided the major two ideas for this theory that are fundamental to cognitive psychology and the information processing framework (Moos, n.d., pp.4). Nurses of the healthcare are considered as the key decision makers. The decision of the nurses is expected from the authority of the healthcare team and the people that they will take best available evidence in their judgements and decisions. As per this theory human is able to store the objective data which will be coded as the symbols and this majorly focuses on three memory store such as sensory memory, cognitive process, long term memory and work process memory (Moos, n.d., pp.4). Symbols refer the group which comprise as the pattern in the brains thus memory is stored in chunks. It has been analysed that these patterned groups of symbol are linked with external stimuli. The most benefit point of this theory is that people identify the patterns in the time of re-occurring of similar stimuli that pretends to fit the experience of person. Communication and the clarity is the strength of this theory that stimulates nurses to take appropriate decision in the context of welfare of the people (Wong & Cummings 2009, pp.524). This model is systematic that facilitates nurses to elucidate how they reached at the decisions and what factors are considered in the process. The cognitive processing can be seen in clear way by using this theory. The drawback of this theory is that it consumes a lot of time of nurses to take decisions. It only influences external events such as verbal agreements, pictures and diagrams. It has been found that the nurses have to depend too much on the computer as an analogy for how human thinks. The complexity of neural networks is not represented due to sequential depiction of information processing.

Intuition theory is considered as the human ability for knowing without adequate causes. It is a process of identification of the truths without rational thinking (Senanayake, 2017, pp.5). There are numerous definitions of intuitions. In this model, the decision maker deliberately integrates recall knowledge that comes from education. This theory provides the information based on the beliefs, justification is not required under this theory (Lisko&O’dell, 2010, pp. 106).  The spirit of intuition has the ability to identify the cues which is helpful to increase the experience in the management of patients in the field of nursing. Intuition theory facilitates nurses to take decision quickly without considering any analytical model which may confuse them. The huge benefit part of this theory is that it helps to take the quality decision making. Intuition is able to trust on past experience to reach at the judgement without considering the procedures of analytical (Light hall &Vazquez-Guillamet 2017, p. 156). By experiencing the same incident in the past, nurses can evaluate the current condition and take decision as per the requirement of time. There is another merit of this theory that it lies in the linked applications of emotions, it’s considered as the holistic approach for the situations and the ability to recognize the amending scenarios which assist it to expand the process of decision making by accumulating both experience and memory. Intuitive theory can be used within the organization when goals are unclear and organization faces the major issues. The weakness of this theory is that nurse should be experienced to apply this theory in decision making process. It has been stated byJefford, Fahy and Sundin (2011), that nurses are entirely reliable on intuition have information builds which are only appropriate in specific contexts entailing that unexpected outcomes might be attained if intuitions is put for unnecessary context. Moreover, the theory of intuition is condemned for ignoring analytical principles.

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Overview of social judgment theory and pros and cons

As per discussion above, it is cleared that intuition theory is the supreme decision making theory for the nursing practice. This theory is being chosen because it is based on probabilistic programs and it is effective theory which can influence the decision making process (Senanayake, 2017, pp.5). It supports prediction that is why it can be considered as the ideal for the profession of nursing. This theory allows nurses to predict about future on the basis of present. There are various kinds of nursing procedures which may be applied in nursing care and the involvement of this theory is necessary for the patient to get better. It has been analysed that nurse are not required to use analytical reasoning in creating clinical decisions which is helpful to save the time. It is worth noting that the decision making process has the theory’s preferences. There are major two thought processes in the case of nursing care for patients in various situations. The first kind of thinking of nurse in the context of decision making is analytical and rational which focus on observable data. On the other hand, the second kind of thinking is an unconscious process that happens holistically and rapidly and rooted in emotions. After that the later procedures is deemed as intuition. It has been argued by Thompson et al. (2008), that intuition is the legitimate and important element of decision making. Intuition theory permits the nurse to utilize counterfactual inferences in decision making. For instance, there is a child patient who is malnourished. In such case, the nurse would ask question from mother about the knowledge about nutrition. The nurse would tell about the role of government in a school feeding program for poor children. The nurse would ask about the daily activity of the child. These questions would be helpful for her to evaluate the case to figure out the condition of the patient. It can be done that the patient would not be in the hospital and would be active at other place such as school and home. By taking help of such intuition, the nurse would be able to make the decisions in the context of malnourishment by providing knowledge about information on malnutrition and how to avoid it. By taking help of nutrition, the nurse would be able to define about the entire issues the patients are faced with. Furthermore, the nurse would be able to describe those factors which are not included in the issues of malnutrition like gender because malnutrition does not impact any specific gender. There are many reasons of malnutrition such as bad eating habits along with the lack of food which might hugely be referred as environmental factors (Thompson et al. 2008, pp.3). Apart from that there are number of ways in which nurses utilizes the intuition theory in making decisions in their nursing practices. There might be numerous factors but the fact is that they may be similar since how each patient of the healthcare is influenced by the emotional and cognitive factors. The role of intuition theory in such scenarios is big because it assists nurses to evaluate the condition of the patient take action as on same so that they come up with right strategies.

Overview of information processing theory and pros and cons

The major complexity of the social judgement theory is that it ignores the message content. It has been found that there are various evidences that show several messages are variables such as evidence or quality of argument which may affect persuasion (Asemah and Nwammuo, 2017, pp.77). Social judgment theory does not take into account any variable messages as other theories do. For instance, a variable message that reduces the in the latitude of rejection may not be rejected due to its strong argument for its position. It is not sure that the patient makes a judgement about the situation of the influential message. It is not necessary that the message is judged before attitude amends takes place. The process can be reversed and the persuasive messages might be accepted by listeners. It can be possible that the listener may react like that, ‘the message or information has the nature of persuasive’. It should have been near to my attitude.’ The differentiation in the understanding can be the major reason of wrong interpretation which may influence the nursing decision making’. This complexities and inconsistencies in the nature of this theory are high in comparison of other theories.

The contradictions of intuition theory are not as higher as other theories. There are various decisions made are linear in nature that includes the process of knowledge and action. It is considered as the linear process of thinking. It has been cleared in this theory that the importance of experience is huge to understand the emotions and the situation of the patient. Intuition could not be defined in rational manner but it put huge impact on the outcomes of the patient (Senanayake2017, pp.8).

 It has been found that major complexities of this theory is that it cannot understand the specific requirements of the patients and by taking help of intuition theory, nurses start to assume that the problem is limited and for making this kind of thinking, they do not go beyond the issue. However, intuition is generally represented as the capability to act appropriately without balancing alternatives (Harteis and Billett, 2013, pp.1). For instance, there was junior nurse who look after one patient who had issue of high blood pressure and the communication between them was open. A junior nurse found that the patient had severe heart ache which could not be controlled by him and she started to provide the treatment and sent him for testing. This information was being sent to senior nurse who had 20 years experience in nursing. She observed that junior nurse could not understand that the patient was experiencing a heart attack. After getting reports of patient, it was clear that he was having a heart attack. It has been concluded by junior nurse that senior nurse was not to identify the concern of the patient due to intuition theory and sent him for right test. It is cleared to analyse that the senior nurse recognized the concern but it has been countered that the intuition theory is applicable for them who has huge experience. Heart related test was conducted of the patient but the patient was the victim of diabetes and due to intuition she did not provide any precautions regarding diabetes which may lead him in severe disease. It shows that the intuition theory bound the thinking of the nurses which may influence her decision making (Ροβ?θης 2015, pp. 1).

Overview of intuition theory and its benefits

Information processing theory enables to increase the understanding of the process of how nurses will react on the specific situation and further develop nursing theories. This theory is necessary to develop the research into nurse patient communication. They are expected from the authority of the healthcare team and the people that they will take best available evidence in their judgements and decisions (Dickison e al. 2016, pp. 5). The expansion of nursing theory might recognize effective response of nurse to particular patient interactions with insinuation for nursing care and the outcomes of patient. The communication with nurses of patients influences the outcomes such as adherence, anxiety and satisfaction with care. The counter agreement for this theory is that is it possible that patient understand the solution and the discussion about the concern which he or she raised up? This theory generally applies in the system of the company by using the model of the computer to describe how the brain works. For instance, nurse describe about the precautions and the diet chart in effective way by using the computer. It is not vital for every patient to understand about the way in which nurse communicates. It is the big complexity in this process. The inconsistency has been found in this theory in comparison of others. The difference is significant because all memory processes within the information processing model happen at the same level of awareness (Ammenwerth et al. 2011, pp. 27). For instance, the interaction with a child, it has been found that the acknowledgement of him is different from his father. The expression while communicating him was different but the way in which he opts to behave in the entire process is based in a conscious choice and it is done due to his awareness. As consequences, the action of consciously identifying social context would be contradictory to the major principles of information processing theory if it happened in the time of processing of stimulus in the sensory memory store.

Conclusion

In the limelight of above discussion, it has been concluded that the role of nursing in health care organization is vital that is why their decision making process impact the entire activity of the organization. The involvement of the decision making model is necessary in guiding the decision making process. That is why it is vital to know that the nurses’ decision making model and theories in facilitating the learning and development process within the organization. The three theories have been highlighted in this assignment such as social judgment theory, information process theory and intuition theory. All theories have merits and demerits which have been discussed in this assignment.  It has been found that the major focus of social judgement theory is on the internal process of the personal judgment of the person in terms to the relations within a communicated message. Information processing theory has explained in this assignment which shows that the communication is the strong evidence for this theory and human are able to store the objective data which will be coded as the symbols. Intuition theory has applied in the nursing decision making with various examples. The huge benefit part of this theory is that it aids to take the quality decision making. Intuition is able to trust on past experience to reach at the judgement without considering the procedures of analytical. The complexities, contradictions and inconsistencies between the theories have been described in this assignment by taking support of counter argument for each theory. it has been found that after having the complexities in intuition theory, it is integral as it permits inference in the time of making decisions which can be defined and have certainty hence objecting in providing the quality of judgements. Intuitions enable nurse to recognize the concerns or issues of patients and hence give the correct and suitable intervention programs to them.

References

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Asemah, E.S. and Nwammuo, A.N., 2017. Implications of social judgement theory for persuasive advertising campaigns. Journal of Research in National Development, 15(1), pp. 75-82.

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Dickison, P., Luo, X., Kim, D., Woo, A., Muntean, W. and Bergstrom, B., 2016. Assessing higher-order cognitive constructs by using an information-processing framework. Journal of Applied Testing Technology, 17(1), pp.1-19.

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