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Essay Evidence Based Practice in Nursing Clinical Judgement and Decision Making in Nursing, ISBN: 9781526478368

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Evidence Based Practice: Decision Making in Nursing Practice


Background and Context


In nursing, decision-making includes an appraisal of several complex considerations. While

nursing decision-making study is widespread, decision-making mistakes appear to lead to bad

patient outcomes. A basis for further discussing decision-making in acute care nursing practise

may be established by naturalistic decision-making. In order to direct future studies to more

accurately help acute care nurse decision-making, a deeper understanding of the literature is

required. A number of essentially synonymous terms are used for decision-making in nursing:'

professional decision-making' is the most common; other terms include 'clinical judgement';'

clinical inference';' clinical logic'; and 'diagnostic reasoning'.


It is possible that nurses have already known that their actions have significant consequences

for patient outcomes. However, they are gradually being cast by policy makers and other

members of the healthcare team in the role of influential decision makers in healthcare. The

Chief Nursing Officer in the UK, for example, recently identified 10 main tasks for nurses as part

of the transformation agenda of the National Health Service and the breaking down of arbitrary

barriers between medicine and nursing (Thompson et al., 2006). It is also expected that nurses

can access, interpret and implement scientific evidence into their professional decisions and

clinical decision-making (Thompson et al., 2006). The emphasis of this paper is this constructive

interaction with research facts. When exploring the ways in which nurses interact with

research-based evidence, we would discuss why it is important to understand the context of

clinical decision making. The relationship between the accessibility and utility of information

,from multiple sources and the judgments on which such information is applied would also be

considered. Finally, we would suggest that if we want to enable nurses during clinical decision-

making to consistently engage with scientific data, we need to properly consider the

relationship between the choices that nurses make and the information that guides them.


Experiences, trial and error, intuition, rational analysis and conventional methods have become

the foundation of past experience of nurses in decision making (Polit and Beck, 2010). While

this means of knowledge sharing is accepted as necessary by Brooker and Waugh(2013), they

criticised it by mentioning the dangers to the nurse and patient that invalid information has

been communicated and may lead to prejudice. Nurses have become part of an initiative that

has evolved over the past decades with frequent revisions to national and local laws and

legislation, taking into account that patients are now specialists in their own diagnosis, which

has an impact on treatment given (Stevens,2013; Ellis ,2016). It has become more crucial,

according to Emanuel et al. (2011), that data that is synthesised into guidance is needed in

nursing due to its transformation from dictated duties to an individualised approach to

treatment. Ellis (2016) suggests that nurses should not only behave in the best interest of

patients, but should also be able to defend health care decisions. In addition, nurses have a

responsibility to understand science to ensuring that the latest information applicable to their

daily experience is extended to others to offer accurate guidance and help patients make better

choices and they are accountable for delivering the best standard of care (NMC,2018).

Furthermore, this reflects on the effective provision of services and increases the quality of life

of the patient. Healthcare workers, however, ought to be informed of the research linked to

their own clinical experience and apply it appropriately (Moule, 2018). In addition, the

, feasibility of streamlined services offered has shown that EBP and study have lowered costs as a

result of (Barker et al., 2016).


Aim of Report


The first goal of this analysis was to create a specific emphasis for this review, 'Decision making

in nursing practise.' It will show what is relevant for nurses in decision-making, variables that

influence decision-making, the consequences of mistakes and how to overcome decision-

making mistakes from studies on this topic.


This was used to construct the query used in this study, as Bettany-Saltikov (2012) describes the

use of PEO (Patient, Exposure and Outcome) to bring together a qualitative question.


Table 1: Application of PEO framework


Who is the patient and their What is the exposure? What is the intended

problems? outcome?


Dementia patients on Dementia Nurses follows the right

ventilators at the intensive guidelines in decision making.

care units


PICO is another system listed by Bettany-Saltikov (2012) as well (Population, Intervention,

Comparison Intervention and Outcome). This approach is, however, most commonly used for

quantitative analysis. For this research review, PEO was then chosen as it was more fitting when

the question was placed together.

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