Lecture notes Acute Care (SHN2004)

SHN2004 (Acute Care) Clinical Decision Making


Prioritising Care & Clinical Decision Making

Aims and Objectives
 Aim
o To enable the student to identify priorities in care and act appropriately.
 Objectives
o Discuss prioritisation of assessment and intervention
o Assess and monitor an acutely ill child
o Identify a prioritised nursing management plan appropriate to your role
o Recognise the importance of multidisciplinary team working in acute care

What is decision making?
 A process whereby appropriate alternatives are weighed up and one is ultimately
selected
 What factors need to be considered when coming up with your decision?
 Think about what influences the decisions you make in your everyday life?
 What guides and influences your decisions?
 ‘I keep six honest serving men (they taught me all I knew); Their names are What and
Why and When and How and Where and Who.’ Rudyard Kipling

Think about your decision…
 to study nursing?
o Who?
o What?
o Where?
o When?
o Why?
o How?
 On how to treat a patient?
o Who?
o What?
o Where?
o When?
o Why?
o How?
 What questions would you like answered in order to make an informed decision
o Who?
o What?
o Where?
o When?


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, SHN2004 (Acute Care) Clinical Decision Making


o When?
o Why?
o How?

Decisions you make as a nurse
 Nurses make important clinical decisions every day and these decisions have an
effect not only on the patient’s healthcare but the team around them
 As care provision becomes increasingly complex, nurses rely on sound decision-
making skills to maintain up to date care as positive outcomes
 Nurses are accountable for the decisions that they make, therefore it is imperative
that you are aware of how you came to a decision

Responsibility and Accountability
 The public
o We have accountability to ensure that the public are assured that they are
cared for by competent, caring, trustworthy and professional nurses.
 NMC
o We are accountable to our professional body and follow the standards set
out the ‘The Code’ (2015)
 An employer
o We have accountability to ensure that we work within the policies, guidelines
and procedures specified by our employers.
 The Law
o E.g. signing a contract with a particular Health Board
o Governs a great deal of the work nurses do – e.g. consent, medicine, manual
handling
o We are ultimately accountable to the law of the country in which we work.

Decision Nurses Make
 Nurses make decisions throughout the nursing process:
o Assessment
 What tools to assess?
 What is the significance of information?
 Is this acceptable?
o Diagnosis
 What is the problem/need?
o Planning (how is the issue going to be treated/resolved)
 Who
 What
 When
 How

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