Clinical Decision Making Essay Example

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Clinical Decision Making 6

Care of patients will always demand the making of rapid decision s in complex environments and this will require the nurses to be always equipped with decision making skills. Decision making skills will thus enable the nurses to deliver safe, effective care to the patients as well as in the long run prevention of the patients from developing complications. The information processing theory best defines the entire cycle of clinical reasoning. The processing theory describes the cognitive processing of information during decision making and it suggests that the information from the patient is normally received as input data from both the sensory and motor sources. The information is then processed in the short term memory with the pre-existing knowledge being stored in the long term memory that will now lead to the outcome which is the decision (Hoffman et al, 2009).

In the collection of information, perception as well as the collection of incoming information is a vital process in the collection and clustering of the cues hence an important step in the processing of information during clinical decision making. Collection as well as the use of the information from the patient will affect the ability of the nurse to come up with the right decision and at the right opportune moment in order to be able to meet the needs of the patient on time. Accuracy of judgment will thus enable the nurse to be able to come up with the best decisions within the shortest time possible with the decision having been founded on the ability to focus on relevant cues which will very much rely on the ability of the nurse to us the cues correctly to come up with the diagnosis of the patient’s condition. It is for this reason that the nurses should be able to have the ability of to discriminate salient from the non salient cues. Collection of the cues should also be done on a wide range of aspects and should therefore go beyond the patients presenting symptoms and illnesses while the nurse is collecting the information from the patient. The practice of decision making is based on the collection of cues. The types of cues are not normally well understood by the nurses and this makes the difference especially when it comes to application of the cues when the novice and expert nurses are compared. The way the nurses are able to use cues in the collection of information will thus always vary basing on the levels of experience that they have (Banning, 2007).

Nurses face complex situations daily, therefore there is the need for the nurses to be able to respond with accurate clinical judgment. Contrary to Hoffman (2009), Gudhe (2010) thinks that the new grandaunt nurses have all it takes to make good clinical judgment when faced with clinical situations. According to Gudhe (2010) the new nursing grandaunts have all the critical thinking skills and thus are able to meet the expectations of the nurses when it comes to the collection of cues and the making of decisions while attending to the patients. However he argues that education should be more centered towards the developing of cognitive strategies that will bring about the reduction of the errors which are encountered in the times of clinical decision making. Gudhe (2010) also goes ahead to pose the ways in which this can be implemented. In order for the trained nurses to be more effective in terms of decision making, it is relevant for the nurse educators to be able to come up with activities that will enable the students to think as they address the various clinical problems or situation. This will enable the nursing students to develop insight into their sound as well as faulty critical thinking and the making of clinical decisions. Gudhe suggest the use of online exercise as well as patient simulation as a way of improving the decision making among the nursing students (Gudhe, 2010).

Mental health triage is an area of clinical nursing practice is an area of specialty. This is because mental health triage would involve the making of complex decisions. The management of psychiatric patients should endeavor to use the clinical reasoning in the making of decisions. Most of the clinician still employs the dependence on their past experiences to come up with decisions while attending to the patients. However, in order for the nurses to be able to come up with good decisions for the patient, there is need for them to be able to use their knowledge on the theoretical models during their practice. This would include the methodologies of being able to rate urgency for this will enhance better and accurate responses towards the patients conditions. There is need for the nurses to be able also to come up with modalities and frameworks with which they are able to use while attending to the psychiatric patients since it involves complex decision making skills. Development of the evidence based decision making is what will enable the nurses to be able to come up with decisions that are timely and also beneficial to the patients. This will include the use of the clinical guidelines which will be used to constantly inform the nurses and support them while making of clinical decisions basing on the mental health triage (Sands, 2009).

Decision making by nurses with regard to the psychiatric patients has proven to be a challenge among various nurses. Although the health professionals still support seclusion as a way of management of such patients, this is however not going well with the patients themselves. The patients find this to be the source of further undue suffering since it makes them to undergo symptoms of severe distress. Most of the mental health professionals are now aware of this great challenge the management posses to the patients and thus should be able to make good clinical judgment of such patients. Due to the detrimental effects of seclusion to the patients, the nurses should therefore opt for a safer way of managing the patients. The development of a clinical decision making frame work will thus enable the nurses to be able to make sound judgment and decision with regards to the psychiatric patients. Here the nurses should be able make decision by themselves whether to seclude or o release the patients. Most of the patients would like the time duration to be reduced to below four hours when undergoing seclusion. Decision making will thus play a vital role when it comes to the management of the patients for it will enable the nurses to be able to know how to seclude the patient and also being able to attend to the needs of the patient (Hyde et al, 2009).

While making decision in the psychiatric patients, the nurses need to use the evidence based model rather than experience while making decisions. Is therefore important for the nurses to be able to use the theoretical models and framework to come up with decisions during their practice for this will bring about the better management of the psychiatric patients. Clinical reasoning thus becomes the basis of making of all decisions by the nurses while providing care for the patients (Penz & Bassendowski, 2006).


Guhde, J.(2010). Using online exercises and patient simulation to improve student’s clinical decision making, Nursing Education Perspectives, 31 (6),387-389.

Hoffman, K. A., Aitken, L.M., & Duffield, C. (2009). A comparison of novice and expert nurses’ cue collection during clinical decision-making: Verbal protocol analysis. International Journal of Nursing Studies, 46, 1335-1344.

Hyde, S., Fulbrook, P., Fenton.K., & Kilshaw, M. (2009). A clinical improvement project to develop and implement a decision-making frame work for the use of seclusion. International Journal of Mental Health Nursing, 18, 398-408.

Sands, N. (2009). An exploration of clinical decision making in mental health triage. Archives of Psychiatric Nursing, 23 (4), 298-308

The Journal of Continuing Education in Nursing ·Evidence-Based Nursing in Clinical Practice: Implications for Nurse Educators,
Penz K., and Bassendowski S.,(2006).

Banning M., (2007). A review of clinical decision making: models and current research. J. Clinical Nursing.