Nursing Decision Making Process: The Use of Data

Introduction

Nurses have the role of ensuring that patients get quality and timely medical services, when they are offering the service, the decision they make regarding the kind of service they will offer to patient determines the quality of medical care services offered. Other than decisions that relate directly to patients, nurses are faced with numerous situations that call for decision-making, they include organizational level issues (Baker & Baker, 2011). To come up with relevance, quality and responsive decisions, nurses require having knowledge that need to be supported by information systems and technology. In recent past, the use of technology has started to take center stage in healthcare industry, particularly in the critical care arena. When collecting data manually (using data collection tools like chart-audits), there have been a number of issues that hinder the retrieval of the collected data on time as well as hindrance of the volume of data that can be collected; computer systems have come to the aid of nurses (Detmer, Richard, & Elaine, 1997). This paper analyzes how nurses use data in decision-making; it will use guiding questions to discuss the matter.

Effective nursing decision-making process in management issues

Decisions are the driving force of an organization; they give it direction and focus. The growth and competitiveness of an organization is determined by the quality as well as acceptability of decisions made by managers at all levels; in health facilities, when nurses contribute effectively to decision making, the quality of services in the facility are likely to improve. To come up with a good decision, a nurse leaders should follow five main stages; they are defining the problem, collecting data, formulating alternatives, choosing the best alternative, and implementation of the decision (Cleverly & Cameron, 2007).

How nurses are using data for decision making in your health service organization

Data can be defined as collected information about a certain situation or a certain patient; they offer some experience and give nurses background information about a certain patient or a certain situation. When nurses read the data, they get a chance to get an in-depth understanding of the condition and the situation of the patient. For example, a patient suffering from a disease type A is more likely to behave the same like another patient who had suffered the same kind of disease. When nurses have the pat information, they are able to handle the current care more careful and with much information (Cleverly & Cameron, 2007).

In some situations, there are times that cultural and societal beliefs affect the way nurses offer their services, in such situations, the nurse need to know the society that he or she is dealing with or offering services (Sadler & James, 2003). For example among the Muslim society, it is seen an omen for a lady to undress a man who is old enough to be called a father by the nurse, in such incidences, then the nurse leader may arrange the shifts that such a conflict does not arise. This can only be possible with the help of data and information about the system and the patient (Bridge & Dodds, 1975).

Some diseases run down a family; when nurses have such information, they can know the kind of behavior and the symptoms that a certain patient is likely to posses as well as how they can handle the family members. Nurses sometimes are faced with the challenge of consoling the family of a sick person or one who have just deceased, when they are undertaking this role, they need an understanding of the family, the ties there in and how they handle situations. With such information when offering the bad or sad news, the nurse will know to whom she should disclose the news and the possible effect (Wheelen & Hunger, 1998).

When making decisions, timeliness and the effectiveness of the decision is paramount, an effective decision making process should ensure that the data that was used is free from errors, its complete, and can be relied upon. Health facilities have the role of providing such mechanisms as required that can assist in the development, collecting, managing and processing relevant nursing data and information (Dowding, Spilsbury, Thompson, Brownlow & Pattenden, 2009).

Examples in clinical from my working area

One area that has seen the need for nurses to make sound decisions is the management of heart failure conditions; in developed countries, like the United States and Germany, nurses have taken the approach of specialization in certain areas so that they can be able to offer such quality services that can be termed as special to the condition. When they are specializing, they need to get a wide knowledge of the condition as well as the patient at hand (Bennet, 2008). At John Hopkins Hospital, when dealing with heart conditions, some nurses are mandated with the task of taking care of the patients. They can diagnose the patient and know when they need a doctor immediately, when they need some exercises, when they need to talk to family members, the kind of literature, lightening and the programs to watch. The above decisions can only be made sound when nurses have data about the patient (Williams, 2001).

In the United Kingdom and the United States, there has been an increasing growth of heart failures cases among the old; they result from myocardial infarction among other factors. At old age, a number of factors that can be responsible for the occurrence, the wide range of possible causes call for nurses to have different approaches and ensure that they can know the best approach for a specific patient. For example, the way nurse should handle a retired military officer who is suffering from heart failure is different from the way to handle an obese elderly. In the case of military officer, his condition may have been aggravated by the scenes he has had in battle fields, thus should be exposed to more peaceful information and those information that offer him a sense of victory in his past works (Stephen &Timothy, 2010).

In the case of the obese, there are high chances that they might feel they are suffering because they have failed themselves by not controlling their weight; they thus need professional handling to avoid any chances that they might blame themselves, a situation that might complicate the situation.

In the above two scenarios, nurses need to have the information at hand of the patient, they will be able to handle them effectively. Thirdly among the diagnosis given to a patient suffering from heart failure is exposure to some interesting scenes that make them joyful, but not over joyful, this might be movies dialogues among others. However, different people take different cases differently; an understanding of what a certain patient values and that that can give him the joy he deserves is of crucial importance. Another area that nurses need data is when disclosing some unpromising information to the family and friends of a patient. There are those people who can handle the sad news while others are so week that they cannot handle. The relationship and if possible and observance that can rate how family members feel about a patient is critical. For example it is very rare that a nurse discloses about the death of patient to his wife or mother, this is likely to be more painful and cause more harm. The most likely thing to do is to use some distance relatives or friends; the nurse then needs to have the information on who is who to the patient for such misfortunes (Gurbutt, 2006).

Examples in management from your working area

When managing a working area, nurse leaders have the main role of using data to handle different situations or to make decisions. For example, when nurses are managing, the drugs they have eat their disposal to attend to patients; nurse leaders need sound data on the demand of the medication in the facility at one particular time. When managing the drugs at the store, management ensures that they are not in excess that they can be misused but at the same time, they are adequate to handle the demand of the situation. To know the amount of medicine, apparatus and other facilities needed, nurses needs to have data on the demand of the medication in the medical facilities. For example, there may come an influx of patients that need a certain medication in large volumes, they might have been the victims of an accident who require painkillers in plenty. Nurse leaders need to understand such situation in the facility so that they can ensure they have adequate medication for the patients in the facility at any one time.

Another area that data in needed in management is when managing shifts and general human resources management within the nursing fraternity; when the nurse have quality data, they are likely to make such sound decisions that will facilitate the delivery of services. For example when allocating shifts, having the data that certain nurse is pregnant and almost due can influence the duty allocating nurse decisions on the timing of her duties as well as ensuring that when she goes for maternity leave, then the facility will be operating effectively. For instance, she may not be allocated night duties or duties that are highly busy; such information assist in ensuring that the right decisions has been made that facilitate the management of the nursing departments.

Literature review of nurses using data for decision-making

In the course of a nursing shift, nurses have to make some decisions, some that are complex while others a routine; the delivery of safe and effective nursing care is dependent on the ability of nurses to make accurate clinical assessments, which can assist in the identification of health problem and develop appropriate medical treatment. Scholars in the nursing profession have argued that the most critical role of nurses is to make accurate, timely and responsive decisions on the condition of a patient; the quality of decisions differentiates professional nurses from ancillary or technical staffs.

When making nursing decisions for children patients, nurses need to have a slight different approach than when dealing with adults, the way children express their feeling is different and may be the nurse needs to read the conditions and situations at hand to come up with the right decision. Past studies have shown that nurses use hypothetic-deductive (analytical) model of decision-making and intuitive decision-making process; sometimes the methods have failed the profession and need for a more scientific method has been demanded by prevailing conditions.

In England, the government has boosted the development of specialist nurse in heart failures, they are supported by British Heart Foundation (BHF) and Big Lottery Fund; the main aim of the project is to ensure that nurses get information and data through education and exposure that assist in making fast and informed decisions regarding the medical situation of a patient. The development of the initiatives was because of the increasing trends of poor decisions made by nurses in the medical care’s leading even to death. The management of heart failure is a complex situation that calls for the intervention of pharmacological treatments and strategies to improve patients’ functional status; this can only be attained if there are updated data about the disease and the patient. To attain this goal of collaboration, there is need to have nurse who can make sound decisions when called for.

Nursing decision have different characteristics depending with the patient involved or the patient the nurses are consulting; in general, young people with fewer complications are easy to handle and their decisions can be made more easily. It becomes complicated when dealing with the elderly or older people who have a chain co-existing conditions or diseases. For example, when dealing with cases of diabetes or renal failures, the decisions made needs to be up to date with the condition of the patient at that particular time, in such a case then, there is need to have sound data about the patient. This will assist in knowing how his situation had been handled in the past as well as how it can well be handled in the future. Data and information about a certain patient is gotten form initial interrogation or during a consultation, this data should be preserved since they might become of good use when making the decision on the kind of service that the patient will get (Abdelhak, Sara & Hanken, 2011).

An organization, whether in the medical services industry or otherwise, requires good leadership if it has to remain competitive and relevant in today is changing business world. The quality of decisions that the leader make define the direction that the organization is going to take; leaders are the think engines in an organization, they form the strategies and policies that they want their organizations operate through. If they make poor decisions then the organization is likely to fall. If they make informed and timely decisions then the organization they are leading is likely to be prosperous. When making decisions, there is need for quality data about a certain situation or regarding the circumstance at hand. After coming up with sound decision, then the management will be able to act in good time (Finkler, Ward & Baker, 2007).

Data issues that relevant to understanding care delivery outcome

When offering medical care, nurses need to have a full understanding of the condition and information at hand that can assist them makes sound decisions. When coming up with a pool of data to use, the source of the data plays a critical role as well as the quality and the nature of the data; when getting data, the nurses should ensure they come from reliable people (Nugent & Vitale, 2004). For example, if the patient is able to express him or herself, he can offer healthy information that can lead to quality data. The main issue when collecting information is on the quality and the source of the information, there are times that the patient may tune the information he or she gives to create a certain impression; when such misleading impression has been created, then the provision of quality health services is hampered. To avoid such cases, nurses should collect information from more than one person and compare them to ensure there is consistency on the other hand, if they feel that the data needs some more probing, there is no clime asking the patient to provide such people that can offer in-depth information (Thompson & Dowding, 2009).

There are sometimes that nurses may get to the ground to collect information regarding a certain disease or a certain health issue facing a community; when they are collecting the information, they use scientific methods of data collection, interpolation, analysis and inferences. Collection of data and the use of scientific means of interpolating data risk the company from statistical issues of data collection like biasness, the use of inappropriate samples, lack of effective and reliable data collection and analysis tools , as well as the lack of highly qualified personnel to conduct the exercise (Duska & Duska, 2003). When nurses have collected information, they need to document and store them in a library in such a way that they can be retrieved in the minimal time ever; when retrieving data, nurses should ensure that the process is efficient and effective. However the above does not happen always: may are the times that there is information breaks and inconsistency a factor that affects the delivery of quality services. To make sound decisions there is not shortcut, however nurses needs to have relevant data and information about the situation facing the facility as well as the patients (Huber, 2006).

Consider how nurses are defining workflow process variables for measuring nursing outcomes

After collecting information from patients, nurses have to analyze and interpolate the information them combine it with the diagnosis made to get the real condition that the patient is suffering from (Khan, 1999). In a workflow process variable analysis, the nurse gets to interpolate and relate different variables to come up with the final decisions. For example, in the case that a person has been suffering a certain disease but the weight, body temperature and appetite have not changed, then nurses need to know the right approach to such a situation since it is uncommon. They are more likely to get the advice of lab technicians who get to test the patient (Chitty & Black, 2010).

Coming up with the right decision and documenting the most important factors of the case is important; when collecting data, nurses should ensure they have documented as much relevant information as possible to assist the doctors make the right medication decision on the patient (Mantas & Hasman, 2002).

Conclusion

To provide quality and timely medical services, medical facilities need to maintain an orchestrated team; the concerned facility management has the role of developing groups within an organization to form teams that will benefit patients and the company. Nurse in their daily duties are faced with situations that calls for decision-making; some decisions may be routine while other are complex. In whichever the decision, there is need of having adequate and reliable data. “Information is power”, thus when nurses are well informed about a certain condition or patient, they are able to come up with relevant clinical and management decisions. With timely and responsive decisions, the quality of medical services will improve.

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