Culture In The Clinical Decision-Making Process

Culture In The Clinical Decision-Making Process
The article A mixed methodological analysis of the role of culture in the clinical decision–making process is written by Hays, Prosek and McLeod
(2010). In this article, the authors indicate that counseling process in the United States becomes more complex due to the dramatic growth of racial
/ethnic minority populations. In this article, researchers try to address how culture as a factor impacts the clinical decision–making process with clients,
and a special focus on clients' cultural identities, counselors' (including counseling trainees) biases and stereotypes towards clients' cultural identities,
and cultural matches between clients and counselors are also investigated.
In order to figure out how cultural and diverse backgrounds influence
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Essay on Evidence Based Practice in Nursing
Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored
in the implementation of Evidence Based Practice. Individuals need specific care tailored to them, it is vitality important to have the correct
professional and appropriate personal care. In order to receive this we need to get the patient involved in the decision process, listen to their views and
opinions and receive the relevant, accurate, professional and medical information. Once all the information is collaborated a personal care package can
be put into practice. Evidence – Based Nursing, An introduction (2008, p.1) " At is core evidence based 'anything' is concerned with using... Show more
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This outlines the fact it is crucial to have the best external evidence including both clinical and professional inputs. It also highlights the patients' rights
preferences and their autonomy should be without doubt taken into account during the research process. The best method for treating patients for
nurses and any other medical professionals is to use Evidence Based Practice. This is because it brings together years of accurately recorded clinical
knowledge from previous cases with will be relevant in the treating of your patient. The process of using Evidence Based Practice in a patients care
plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using
this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then
need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure
effectiveness. Evidence – Based Nursing, An introduction (2008, p. 285 ) " The rapidity of change and the reorganization of nursing services within
the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on
current, high–quality research by formalizing the expectation that nurses care be Evidence Based".

The Development Of Decision Making
The Development of Decision–Making in Nursing Nursing is a profession that has traditionally attracted individuals who have a desire to help others
and have an interest in the health sciences (Ruesink, 2012). In the complex world of health care, good intentions only go so far in terms of client
safety, quality of care, and achieving the best possible outcomes, and that is why critical thinking, decision making, and evidence based practice are
crucial to the nursing profession when acting on the behalf of our clients (Fero, Witsberger, Wesmiller, Zullo, & Hoffman, 2009; Ruesink, 2012;
Thompson, Aitken, Doran, & Dowding, 2013). In this paper I will discuss and explore three decision–making models that support nursing
decision–making, how... Show more content on Helpwriting.net ...
The College of Registered Nurses of British Columbia (CRNBC), defines Clinical decision–making as: A complex and dynamic process, occurring
within a larger context and drawing from various dimensions of knowledge, in which nurses collect and organize information in order to form
conclusions and choose actions, with the intent of creating the best outcomes for clients (2014, slide 19). The nursing profession demands a high
standard of quality and safety, compelling nurses to act professionally, be accountable for their own actions, and embrace their Professional Standards
(CRNBC, 2013). The CRNBC Professional Standards requires nurses to know where to access information to support their knowledge to deliver
evidence–based, competent nursing care, as well as use decision–making tools to guide their assessments, diagnoses, and treatments (2013). For nurses
to make clinical decisions that enhance a client's health, promote realistic solutions, and reduce potential risks, decision making and critical thinking
must happen in sync (Fero et al., 2009; Standing, 2005). To support critical thinking in nursing practice, and help novice nurses compensate for the lack
of clinical experience, decision–making models have been constructed to help navigate the multi–dimensional complexities of the

Evaluation Of The Clinical Decision Making Process
Clinical reasoning can be best described by the process of collecting indications, processing, understand the problem or situation, plan and implement
interventions, asses outcomes and learn reflect on the whole process (del Bueno, 2005). Positive outcomes of this process can be determined by an
individual's preconceptions, attitude, perspective and willingness (mentally and physically) (McCarthy, 2003). In a report by the clinical excellence
commission of NSW Health they conclude that there are three explanations for negative patient outcomes in which are failure to correctly diagnose,
failure to adequately implement appropriate treatment and inability to manage complications. In this essay the author will outline a situation in which
they were involved in explaining the background of the situation, factors which influenced a clinical decision to be made whilst describing the clinical
decision making process.
On the last day of a placement block for Nursing clients with chronic conditions at an unnamed Gold Coast Hospital, I was assigned five patients with
the supervision of a registered nurse in the orthopaedics ward. With awareness of the environment, I noticed and retained times patients were coming
and going from surgery that weren't assigned to me. On completion of the shift with bag in hand, I walked past an elderly lady in her room whom I
remembered had come back from surgery approximately two hours earlier. I noticed she was quite flushed with a slight grimace on

Mistake And Mistake In Decision Making
Nursing had developed own internal links between research and professional activity in order to enhance clinical decision making. Knowledge and
decision making had been a crucial element in clinical decision making. Errors are also known to take place due to failure in decision making. Slips
and lapses, error due to action and memory are defined as failure to carry out proper action connected with decision making to achieve the objective
of the task. As a human all of us tend to make mistake and mistake is define as failure in judgemental. According to Thompson & Dowding, (2009),
slips, lapses and mistake work at different level of thinking. Slips and lapses happen as accidental, whereby on the other hand mistake involves
making judgement and decision making by processing the information. Mistakes can cause more harm than errors, however, this may not always be
the case. All three, slips, lapses and mistaken may occurred in the same incident. In medication error a simple step, clarifying can help in preventing
it from happening. This is where nurses are important to decide to do it or not, failure to do this simple's step leads to a disaster event (Handler, et. al.
2004). I realize that ... Show more content on Helpwriting.net ...
Nurses' role had been constantly becoming more and more challenging and now nurses are doing expended roles. It is high time to analyze what kind
of decision making nurses do in their clinical practice areas. In today's nursing profession nurses are urged to do clinical decisions making and it is
being establish by guidelines, policy and practices'. Today nurses are given power and autonomy to assist them on their decision making. However, this
comes with higher responsibility for the nurses and their expertise are demonstrated in their clinical decision making (Cioffi,

The Pros And Cons Of Clinical Decision-Making
Decision making is the cognitive process leading to the selection of a course of action among alternatives (Kelly &Crawford). Nurses' decision,
particularly focuses on clinical scenarios. Clinical Decision making is by deciding what information to gather, which tests to order, how to interpret and
integrate this information to draw diagnostic conclusions, and which treatments to give (Douglas L, 2015). The nurse's decision is judgments as to
whether it will be helpful to the client/patient or it will harm. I noticed that the patient's life or health are placed in our care which before we make the
conclusion of our decision, nurses must access or weigh the positives and negative impact and other considerable alternatives before we conclude our

Reflection on My Nursing Decision
Pearson (2013) clarifies "clinical decision making is essential to every aspect of care delivered to a patient" (p. 214). It is the ability to blend
information and make decisions that will later be implemented in the situation. Evidence–based decision making involves choosing from a variety of
possibilities and combining the knowledge through research and the scientific evaluation of one's practice. The purpose of this paper is to analyze my
decision of administering ativan by advocating for the patient and anticipating her change prior to confirming signs; which provided a therapeutic
response. Clinical Decision During my community placement of the cataract clinic at St. Joseph's Hospital, one patient I observed looked extremely
anxious... Show more content on Helpwriting.net ...
Rationale for Framework The CAEN Decision Making Model for Nursing Practice Framework was chosen for this analysis due to its incorporation of
foundational knowledge, thinking processes, context and decision–making processes. The model places major emphasis on the quality of relationships,
salience and pattern recognition, healing initiatives, critical reflection to analyze a situation pre and post and to value different ways of knowing. The
client along with the nurse is intertwined in the center of the framework highlighting the importance of their relationship. All critical decision making
for nursing practice is the client's lived experience of health and healing; which is essential to the inquiry process where a nurse will enter into and
become engaged in the new relationship. In this situation, being directly involved with the patient provided an opportunity to create a relationship on
the basis of providing health and healing measures (CAEN, 2008). Coming to Know the Client The first stage of this framework is coming to know the
client, which requires the nurse to understand that the personal meaning of health and healing is individualized and the context of this area is highly
subjective. Gillespie and Paterson (2009) state that "clinical decision–making processes are triggered by recognition of a cue from a patient" (p. 167).
In the case of this patient, the decision was based off a cue; a change

Clinical Decision Making
Introduction: Nursing is an exciting, challenging, satisfying and rewarding profession. Nurses are required to have a wide and an extraordinary
range of skills and talent in managing their clinical duty and responsibilities. Nurses are urged to deliver the highest achievable of quality care in a
compassionate approach. In order to achieve these nurses need to access and evaluate extensive clinical information and integrate it to improve
clinical decision making. Nurses are seen as lifelong learners, having the ability to reflect on, evaluate and modify their clinical practice based on
new knowledge and thoughts. Nurses are advised to become producers of new knowledge via nursing research (Fink, et. al. 2005). Over the last
fifteen years nursing profession had grown and developed far more advance by having policy and procedures to be endured. However, the
development of policy and procedures had placed increased pressure on nurses to be more responsible for their actions. At the same time, integrating
research into clinical decision making and research information used by nurses had remarkable increased. In healthcare industry evidenced based
approached was introduce for effective... Show more content on Helpwriting.net ...
According to Sackett, et. al. (1996), nurses do have the potential to contribute to an evidence based practice. Nurses today are believed to understand
and conduct research studies based on their own professional practice. Nursing research is a process that validates and refines existing knowledge and
creates new knowledge that directly and indirectly influences nursing practice scientifically (Burns & Grove, 2001). EBP is defined as the use of the
best clinical evidenced and such evidence characteristically comes from research conducted by nurses and other healthcare providers (Newhouse, et. al.

Assignment On The Aspects Of Clinical Decision Making
Assignment #2 Clinical Decision Making According to Mary Gillespie nurses do range of thinking process before making a decision in the
clinical settings. It is subjective and is made on the basis of data collected by various assessments (Gillespie M. , 2014). This assignment gave us
opportunity to study and analyze a case study where we witnessed the effects of clinical decision making directly on a patient's health. Through this
case scenario we see the main factors that influenced Kathy's clinical decision making are assessments, personal knowledge, previous experience,
collaborative practice, information from family, and most of all ethics. Paterson's Frame Work in this Scenario The basic knowledge of the nurse
helps her to make positive clinical decisions, in addition, a nurse remains engaged with both existing knowledge and accruing new knowledge or
skills related to the specific patient or situation (Gillespie M. , 2014). In this scenario the nurse Kathy shows various aspects of her knowledge and
ability as the base of her clinical decision making. Knowing the Self Knowing the self is about nurse not only know her skills, strengths, experience,
limitations but also believes in influence of her own personal beliefs, values, assumptions, and perceptions while this guides her in decision– making
process (Gillespie, 2014). As Kathy reflected and used her experience with her co–nurse to effectively communicate with Mrs. A's daughter who was
upset to see her mother's

Adapting A Holistic Care Package For A Patient Requires...
Complexities in Children 's and Young Peoples Nursing
Formulating a holistic care package for a patient requires children 's nurses to make clinical decisions by identifying needs, prioritising, planning and
delivering care. Nurses are expected to use current and relevant evidence in their judgement and decisions to ensure the best practise is implemented
(Thompson, C. et al. 2004). Nurses within the healthcare team must integrate scientific knowledge, patient and family perspectives, available resources
and sufficient experiential knowledge to ensure that their decisions will also be accurate and safe (Gillespie, M. & Patterson, B. 2009).
Within this assignment a scenario has been chosen to discuss the elements of clinical decision making made by nurses. To justify the decisions which
have been made, a critical appraisal of the available information will be utilized. The scenario focuses upon Joe (See Appendix), an infant who was
born prematurely at twenty–eight weeks gestation and is diagnosed with short gut syndrome and is close to being discharged. There many needs within
the scenario which have been identified, such as medication training for parents, Joe 's physiological development, travel issues but this assignment
will concentrate on managing an ileostomy, discharging Joe on TotalParenteral Nutrition (TPN) and social support for the home environment. The aim
of the nurses clinical decisions will be to prevent infection, skin breakdown and re–admission, therefore

Clinical Decision Making
The clinician decision making is the process of determining what the patient needs and when they need it. This process is subjectively done by the
healthcare provider. Clinical decision tools are an enhanced guide in giving the provider information to make a more educated decision. The use of
clinical decision support tools can help lower hospital costs, increase patient satisfaction, and improve efficiency of care. The use of clinical decision
support tools can avoid many errors and adverse events and increase the quality the care the patient is receiving. These support tools should only be
used as a guide to assist the healthcare provider in making a decision. A healthcare provider's decision should not be made solely on... Show more
Overall, Micromedex is an engaging and useful tool for myself, healthcare providers and for patient education. Dxplain is a different type of support
tool then Micromedex. It suggests a set of diseases that are associated with the clinical findings that are entered in the search box. DXplain is easy to
use especially with those who have no computer background. The diagnoses that are suggested always have a justifiable interpretation which is
significant in giving the provider education on the diagnosis. The abbreviation terminology and synonym feature is vast which makes it quick and
effortless to search. I currently work on an orthopedic med–surg unit and DXplain had limited information on Orthopedic diseases and procedures.
There is also limited information on psychiatric and dermatologic diseases. When searching for laboratory tests that are commonly completed in a
hospital setting there was no data obtained. DXplain had no path physiological knowledge which personally does not guarantee accuracy. The program
mainly focuses on the clinical symptoms but the patient personal, family, social, or employment factors are not recognized. I believe that that all
aspects should be assessed in order to make the best

Clinical Decision Support System ( Cdss )
ABSTRACT Clinical decision support system (CDSS) is a technology application that assists clinicians at the point of care to make clinical decisions
for patients with specific conditions. The healthcare is implementing many electronic tools that are aimed at improving health and health care delivery.
It is designed to make clinical decisions about patient care. Today technology plays an important role in patient care. It involves a patient, a clinician
and computer but most of the work is done by computer. CDS helps the clinician to make decisions. While interacting with the patient the clinician can
focus more on entering information on hearing to the patient and considering the information said by the patient. Implementing CDS can effect
clinician–patient communication. CDS can help clinician by providing clinical guidelines, reminders, of recommended care, prescribing and diagnostic
support. In practice this software can lead to confusion and lack of communication. This technology helps with continuity of care. The aim was to
compare the design and implementation of CDSS to compare diagnostic accuracy before and after its implementation in patient care.
INTRODUCTION: Clinical decision support is a combination of person–specific information and knowledge that is provided to the staff, patients, and
clinicians which helps to enhance health care and health. In early 1960s efforts began in health care to automate its aspects but the use of computers
and information

Clinical Decision Making Essay
Clinical decision making is a contextual, continuous, and evolving process, where data are gathered, interpreted, and evaluated in order to select an
evidence–based choice of action. An Effective Practitioner is tasked with making clinical decisions with patients and clients many times during their
health and care journey. Factors that affect decision making There are many factors involved in clinical decision making and each of the core skills has
the potential to impact effective decision making. 1.Knowing the evidence – Any clinical decision maker should rely on a knowledge base which
contains a wide array of literature review.Thanks to the digital advancements and technology, we can embed a wide variety of information in the form
of E–books, articles, journals, reference materials related to the current practice, so that we as a clinical decision makers can rely on them for decision
making process or even patients if they want information about the disease or treatment protocols, can utilise to research the evidence base, many of
the physicians as well are simply referring them a bunch of latest treatment articles or their website link in their portals to justify their... Show more
3.Knowing yourself as well as your team members completely – In many multinational organizations, there is always a special segment which
concentrates on the overall well being of their employees, be it in the form of personality development classes, art of positive thinking, cultural
peogrammes, leaves, vacation, sponsoring health insurance, ensuring employee safety, this is because any health care or other industries their biggest
investment are the employers, and the employers work and their decisions highly impact the entire organisation, that is why they make sure they know
all their team members thoroughly, and any chief decision maker should have command over himself and his attitude at his work then only he can
make clear decisions for his organization and lead it to

What Hierarchy Of Evidence Is Used When Making Decisions...
EBP Research Paper What hierarchy of evidence is used when making decisions about clinical interventions? (p. 114) There are many versions of the
hierarchical evidence levels. When deciding on basing clinical interventions on evidence, there are two specific models to look at. They both describe
levels of evidence and are depicted as pyramids. The first is the 6S model, with the "more patient–specific" information listed at the top of the pyramid
(Houser, 2015). The top of the pyramid has the least amount of information as compared to the base, it is more relevant, but it yields the least amount
of information (2015). Conversely, the more abundant information found at the bottom is less relevant to the specific intervention in question (2015).
Also, the searches conducted at the more basic levels typically take less time to yield results due to the broader relationship to the intervention in
question (2015). The 6S model of hierarchical pyramid of evidence are listed as follows from highest to lowest: Systems – this level includes "clinical
decision support system (CDSS)". This level is ranked the highest because evidence is acquired from point–of–care databases that are linked to
electronic medical records of specific patients (2015). Summaries – Evidence is taken from practice guidelines that were established by healthcare
organizations and entered into the National Guidelines Clearinghouse databases. Summaries can be appraised rapidly because they are given a

Critical Thinking
Critical Thinking Article Review Over the last thirty years, the health care system has incurred dramatic changes, resulting in new advances in
technology and medical theories. Greater demand for quality care by consumers, more knowledgeable patients, remarkable disease processes, shorter
hospitalizations, and the continuing pressure to lower health care costs are all contributing factors in the necessary changes to the nursing practice. In
order for nurses to deliver optimum care, they must develop a higher quality of thinking capability. We will review the information given in this
research paper to discuss the impact of critical thinking in the nursing profession, as well as the various strategies / techniques used in assisting... Show
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Simpson and Courtney (2002) state "an important step in problem solving and decision–making is the need to utilize critical–thinking abilities to
reframe a problem or situation." Critical thinking involves questioning all the features of a situation and analyzing solutions. The meaning of clinical
decision–making is a systematic process of assessment of a range of actions, evaluation and decision–making that will be a factor of a desired outcome
(Simpson & Courtney, 2002). Simpson and Courtney (2002) state "incorporating critical thinking skills during the clinical decision–making process
will provide clarification, a range of potential solutions appropriate to the circumstances or setting and reasoning to support the clinical decision made."
Creative thinking is described as being intuitive, being creative and visual; and discovering new ideas. Creative thinking asks questions such as why?
What if? What else? In creative thinking, a person can envision potential ideas and alternatives as an approach to problem solving. According to
Simpson and Courtney (2002), creative thinking is of its greatest value when known solutions have failed and change has not occurred. Students need
to take an active role in learning how to evaluate the information given, developing analysis skills, communication, and utilizing information in new
ways. Students need to do more that memorize facts. They need to process the information so that it can be

Essay on Nursing Process and Clinical Decision Making
Nursing Process and Clinical Decision–Making The nursing professional faces a myriad of decisions on a daily basis. The effectiveness of the
decision–making process is crucial to ensuring positive outcomes in the clinical setting. If the nursing process is misunderstood or misapplied to the
decision–making process by a failure to use critical thinking skills, the results can be catastrophic to the anticipated outcomes. Furthermore, an
immaturity in critical thinking may influence decisions because of insufficient knowledge and experience. This paper will explore the role of critical
thinking and the nursing process in making clinical decisions. Additionally, clinical maturity will be addressed as a key component of critical thinking...
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Finally, the intervention must be evaluated for effectiveness. If the intervention fails to achieve the desired outcome, then the process returns to the
fourth step and the selection process for the next intervention is initiated. (Kozier, Erb, Berman, & Burke, 2000, p.261) Closely linked to this
decision–making model is the ubiquitous nursing process. The nursing process includes data collection and documentation, analysis of the data to
determine current condition and real or potential health related issues, development of an individualized plan of care to deal with these issues,
implementation of that plan of care, and evaluation of the plan of care to determine its effectiveness and adjust the plan as needed. (Blais, Hayes,
Kozier, & Erb, 2006) Underlying both the clinical decision–making process and the nursing process is the skill of critical thinking. Critical thinking has
been described as the ability to gather and process data in such a way as to arrive at the best conclusion using the filters of prior knowledge,
experience and external resources to overcome personal emotions, biases, and assumptions. (This description was developed during NUR/300 class,
University of Phoenix, S. Colorado, March 16, 2006) Note that critical thinking is described as a

Decision Making And Clinical Reasoning Skills
I understand how to employ leadership, decision–making and clinical reasoning skills to provide optimal patient care. Pediatric care in a rural, level
III, county owned emergency room is somewhat of a precarious subject. In my hospital, we have a small pediatric floor that only admits the mildly
sick and transfers the rest of the patients. Therefore, the axiom of the emergency room is transfer as quickly as possible. When a pediatric trauma or
emergently sick child does come into our emergency room, it can quickly become a cluster and making do the best you can with what supplies you
have. I am unsure why but the consensus is to be scared to take care of children. Fear does not excuse you from a lack of education, but rather education
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The use of the warmer has decreased the amount of infants and children we have had difficulty in regulating their body temperatures. Even our local
flight team was happy to have access to the warmers while transferring a patient. Through my research and learning, it has changed the way I treat my
pediatric patients and their families. I no longer avoid these patients and I now advocate for them. I now understand these are tiny humans but their
treatment must be tailored to them much differently than their adult counterparts. I have learned that children can sense fear quicker than adults can. I
have also learned the parents are typically the best medicine. If possible, let the child stay with or in the parents lap for procedures. In addition, I have
learned that taking care of children is quite rewarding. To see them get better and know you had a part in that feels amazing. I look forward to continue
growing, learning, and expanding the knowledge to my co–workers in the field. Optimal and excellent patient care should be provided to all no matter
the age. I can demonstrate prioritization, delegation, and reflective practice to transition from novice to advance beginner nurse. After graduation
from nursing school, I began working on a medical surgical floor on night shift. I was much younger than all my coworkers were. I did not like to
ask for help. I thought I had to know and do everything for myself to prove

reflective essay
Introduction
This assignment will be a piece of reflection based on a clinical decision I have assisted in during my placement. This reflection will relate to a
situation that occurred in my clinical work where I felt that I have learnt something that is of value to my practice. The clinical decision was based
on wound dressing. I will identify what I have learned from the experience and how this relates to theory that has been researched. To help me with
this reflection I will use Gibbs (1988) model of reflection. For the purpose of confidentiality I will call the patient Mrs H. The description of events
will be in the appendix.
Feelings
I remember that when we found out about Mrs H's new wound I was feeling a mixture of confusion, ... Show more content on Helpwriting.net ...
Tissue Viability Society 2012 states that with moisture damage prevention, the most important factor is keeping the skin clean, dry at all times.
However Kray 2013 states that when the skin is too frequently cleansed with soap and water and dried, the permeability of the skin increases and the
natural barrier function of the skin is reduced. Best Practice Statement (BPS) 2012 recommends that soap & water should not be used when cleansing
following episodes of incontinence, as most soaps increase the skin's pH to an alkaline level. Cleansing with soap and water can contribute to the
development of pressure ulcers (Cooper and Gray, 2001). The moisture lesions management strategy that BPS suggests instead is to use warm water,
protect skin with barrier cream, spray or film, ensure appropriate continence aids are supplied, to increase frequency of personal care and skin
inspection and use pH balanced foam cleansers not soap. This is the advice we have given Mrs H's daughter which helped the wound to heal as quick
as it did.
Conclusion:
I have drawn two conclusions from the above reflection. The first being that clinical decision making has various factors such as pattern recognition,
critical thinking, evidence based approach and team work (Thompson, 2002). Nurses confront situations such as this relatively unprepared and react as
considerately as possible. Experience can be

Gillespie And Paterson's Clinical Decision-Making Model
The foundational knowledge within the situated clinical decision making model is the knowledge of nurses that informs their decisions. Gillespie and
Paterson (2009) divides foundational knowledge into five ways of knowing; knowing the profession, knowing self, knowing the case, knowing the
client and knowing the person. Knowing the profession is defined by Gillespie and Paterson (2009) as reflecting an "incorporation of knowledge of the
scope and standards or nursing practice, including competencies, skills, and roles of nurses, into clinical decision–making" (p. 166). Within knowing
the profession during my decision making process I relied on foundational knowledge of the CRNBC professional standards as well as the CNA
code of ethics to inform my decision. Under CRNBC professional standards of ethical practice the nurse ensures that the patient who is receiving
care is the primary concern, ensuring that the patient is receiving care in a way of preserving the patients dignity. (CRNBC Professional Standards)
"To treat someone with dignity is to treat them as being worth, in a way that is respectful of them as valued individuals" (Baillie & Gallagher, A.,
2012, p. 44). As I observed the situation I felt that the patient was not being respected as an individual. ... Show more content on Helpwriting.net ...
"Nurses intervene, and report when necessary, when others fail to respect the dignity of a person receiving care, recognizing that to be silent and
passive is to condone the behavior" (CNA Code of Ethics). During this situation I recognized the vulnerability of the patient as well as what I felt was
inappropriate behavior on behalf of the registered nurse and there for intervened because I did not agree with the situation that was

Effectiveness Of Clinical Decision Making
The effectiveness of clinical decision making is crucial in nursing practice to ensure positive outcome (Goodman, 2014). This essay will explore the
clinical and decision making process in adult nursing by analysing how nursing practice is applied in decision making considering the individual
needs of the patient. Ms LG is a 42 years old white British female with a history of dyspepsia, constipation, continuous poorly localized abdominal pain
, bloating and history of vomiting (NA2010/3010). Ms LG had chemotherapy for ovarian cancer prior to being admitted to the gastro–intestinal
oncology ward.
Ovarian cancer is a fifth most common cancer in women in the UK (NICE, 2011). Ms LG is currently in treatment phase which comes under stage 4 of
... Show more content on Helpwriting.net ...
Stage one of ovarian cancer involves just the ovaries. Stage two indicates cancer has spread outside of the ovaries however, not outside the pelvis.
Stage three indicates the cancer has spread outside of the pelvis however, not to other parts of the body and lastly, stage four indicates the cancer
has spread to other parts of the body. Ms LG is in the stage three of ovarian cancer as her cancer has metastases into her bowel. Problems &
establishing goals Ms LG has problem with her bowel as she had undergone resection of a tumour bearing ilea segment with bowel reanastamosis.
According to Bayless, Hanauer, and Bayless, (2014) a bowel reanastamosis is an operative union of two hollow or tubular structures. It is likely that
the cancer could metastasis and Ms LG could have another bowel obstruction. The nurses would therefore monitor for any signs and symptoms of
bowel obstruction. For example, vomiting is an early sign of of bowel obstruction, abdominal pain, constipation, severe bloating, decreased appetite
and diarrhoea (Moore, 2005). The nurses would have to develop a ceiling of care for Ms LG's goal if surgery was not an option in the case of more
than one metastasis.
Ceiling of care is the patient's expectation from a healthcare setting of their treatment and what is in the best interest of the patient (BMJ, 2015). As
nurses are the advocates for

Clinical Decision Making In Nursing
Clinical Decision Making I believe that the clinical decision making process associated with the actions to be taken in Jack and Jacqueline's care
were quite similar between the Canadian and the Rwandan perspectives. This is because both perspectives took on a holistic view of Jack and
Jacqueline's situation and thereby worked to develop goals that would not only address Jack's physical health, but also the emotional and mental health
of Jack, Jacqueline, and even Charles. These holistic based goals included, but were not limited to the utilization of various community supports to
foster Jack's cognitive development as well as the formation and implementation of diverse coping strategies for Jacqueline and Charles to use during
times of stress.... Show more content on Helpwriting.net ...
This is because the nurse had already provided Jack with a referral to the local hospital so that a physician could further assess his symptoms and
possibly prescribe him one or more medications that could assist in controlling his symptoms. I also believe that this goal will be easy to achieve
because despite Charles having recently begun smoking inside the family's home, he will likely be able to make the transition to smoking outdoors
without much difficulty, which will thereby prevent Jack's illness from progressing further and protect his daughters from falling ill as well.
Moreover, when reviewing which of the health practices within the care plan will need to be better accommodated to Jack and Jacqueline's health
needs, it is evident that the nurse may have to adapt how he or she works to improve upon Jacqueline and Charles' current knowledge of Down
Syndrome. As Charles has difficulty accepting Jack and his disorder, providing him with accurate information regarding his son's diagnosis may be
ineffective as he could decide that what he is being told is not important or that it is of no use to him. Therefore, the nurse must work with Charles to,
at the very least provide him with some general information about Down Syndrome. If he or she then notices that Charles has decided not to listen to
what is being conveyed, this relay of knowledge must cease. From here, all of the crucial information regarding Down Syndrome that the nurse has
gathered for both Charles and Jacqueline must only be relayed to Jacqueline. This will thereby prevent any further fuelling of Charles' rejection of Jack
while also ensuring that at least one of Jack's parents is accurately informed about his

Information Based Decision Making Essay
| Information based decision making| Unit 5002V1| | | 4/1/2015|
Task 1 (600–700 words):
A.C.1.1 – Examine the nature of data and information
Data comprises of factual information. Data are the facts from which information is derived. Data is not necessarily informative on its own but needs to
be structured, interpreted, analysed and contextualised. Once data undergoes this process, it transforms in to information. Information should be
accessible and understood by the reader without needing to be interpreted or manipulated in any way.
Knowledge is the framework for understanding information and using it to inform judgements, opinions, predictions and decisions – a pyramidal
relationship (See diagram 1)
Diagram ... Show more content on Helpwriting.net ...
Therefore, I prefer circular model (Diagram 2) of the relationship as knowledge can influence what data is collected thus generating information to
enhance knowledge that in turn can generate more data.
There are different types of data and information. These are examined in Table 1:
Type of data| Definition| Pros| Cons| Qualitative data/ information| A rich and detailed method to capture how and why people behave in certain ways
and the impact of these processes on behaviour. | Captures participant's lived experiences.Allows a deeper understanding of a topic.Smaller sample
sizes so less expensive to do.Takes researcher bias in to account – an ethical strengthCan help to provide new ideas to shape a service for people.|
Smaller sample sizes, so less generalizable to larger populations.Not possible to create statistics – which can help to shape and plan service
effectiveness and deliveryTime consumingDifficult to make comparisons within the sample.Poor re–test reliabilityResults vulnerable to researcher bias
and experience.| Quantitative data/ information| Analysis of numerical data to explain outcome, prevalence, frequency, time, cost.| Based on explicit
knowledge and this can be easy and fast to capture and analyse.Results can be generalised to larger populationsCan be repeated – therefore good test
re–test reliability and validityStatistical analyses and interpretation are

Clinical Decision Making Paper
JUDGMENT AND DECISION MAKING THEORY IN NURSING: THEORY TO PRACTICE
The demands of the current health care system provide a powerful reason for advanced clinical decision making. It is undeniably a responsible
approach to providing best possible care to patients. Nurses are required to integrate evidence–based clinical decisions as they solve problems regarding
patient care during the nursing process. Nursing knowledge, as well as patient values, expert opinions, and evidence on how best to care for the patient
are incorporated during the nurse's clinical decision making. There are a lot of decision making theories and models that are widely used in clinical
setting. Therefore this paper will discuss how decision making is used in placement

Ethical Decision Making : Medical Indications, Patient...
Health care providers are often confronted by various ethical dilemmas in their course of practice. When a person's values and beliefs conflicts with
another person's values and beliefs, an ethical dilemma occurs. An example of an ethical dilemma in a healthcare setting is when a nurse interacts with
an elderly woman who is diagnosed with terminal breast cancer and hears that she is in a lot of pain and wishes to end her sufferings. When
confronting this issue, it is beneficial to follow Jonsen's Model of case–based approach to ethical decision–making. The model consists of four
paradigms that provide a framework for analyzing a clinical ethical situation and propose a potential solution. The four paradigms are medical
indications, patient preferences, quality of life, and contextual features.
Medical Indications
The first paradigm in Jonsen's Model of case–based approach to ethical decision–making is medical indications comprising of all clinical encounters
such as diagnosis, prognosis, treatment options, and an assessment of goals of care. This section incorporates the principles of beneficence and
nonmaleficence. Beneficence means placing the best interests of the patient ahead of self–interest and nonmaleficence means to do no harm or hurt
(Edelman, Kudzma, & Mandle, 2014, p. 293).
Per the ethical dilemma provided above, the elderly woman is suffering from terminal breast cancer, which is a chronic condition and nearly impossible
to reverse. According to the Merriam

Video Consultations As Tools Of Clinical Evaluation
The current study analyses the potential of shorter video consultations as tools of clinical evaluation. It also provides evidence in the later parts of the
report of short video consultations being used to accurately diagnose clinical disorders; discusses the scenarios where shorter consultations can be
profitably used and also explores the future implications of reducing clinical evaluation time. In the current study, short video consultations are being
studied as tools of asynchronous telepsychiatry. Ever since the advent of telemedicine, telepsychiatry has taken great strides in embracing this useful
and efficient way of consulting patients. Synchronous Telepsychiatry (STP) has been used for more than thirty years to make psychiatric experts
available in areas with provider shortages. 1 It was in the year 2010, that a new study by researchers at University of California, Davis School of
Medicine established that psychiatrists could accurately assess patient's mental health by viewing stored videotaped interviews. This method known as
asynchronous telepsychiatry has now been adopted worldwide as a convenient and economical alternative to face to face consultations.2 Contemporary
literature reflects the growing need to reinvent the traditional ways of practicing medicine.3 Accurate clinical judgement is the goal of every
physician's practice. Decision making deals with the processing of information. Technological advances have allowed the current physicians to control

What Hierarchy Of Evidence Is Used When Making Decisions...
Research Worksheet Jesse Travis Midwestern University Research Worksheet Questions What hierarchy of evidence is used when making decisions
about clinical interventions? While research has long paralleled medicine, the use of strong research evidence as the basis for clinical action is more
recent (Houser, 2015). The historically accepted hierarchy of evidence separates evidence into levels of trust, from highest to lowest (Greenhalgh,
2010): 1.Systematic reviews of randomized controlled trails 2.Randomized controlled trails 3.Controlled clinical trials 4.Observational studies (cohort
studies or case–controlled studies) 5.Case studies, expert opinion, bench studies While this structure provides a starting point for the critique of
evidence strength, the prudent evaluation and, subsequent, translation into practice guidelines requires further consideration (Greenhalgh, 2010).
Research can be scrutinized into measures of quality. John Hopkins Hospital grades evidence on a high to low scale, A through C, based on criteria
including consistency of results, reproducibility of findings, sample size of study, level of study control, organizational design, and expert opinion
(Newhouse, Dearholt, Poe, Pugh, & White, 2005). Using this evaluation tool, an A score would result in a recommendation for clinical practice while
a score of C should alert the clinician to a low quality of research and should not be incorporated into practice guidelines (Newhouse et al., 2005).

The Importance Of Patient Autonomy In Clinical Management
Patient autonomy is crucial in clinical management, nursing and treatment and is especially relevant in chronically ill patients as informed consent
determines the direction of treatment. Decision–making by patients is closely related to autonomy and is based on patient preferences to help promote
patient involvement in treatment to expedite care (Wiens,1993; Halliday, 2009). Patients must be respected for being masters of their own lives.
Delmar (2013) claimed that patient autonomy is a dominant concern and could affect the fundamental values of caring, consequently affecting the
dignity of patients. Delmar (2013) studied this interplay of patient autonomy and dignity and conducted research through qualitative interviews with
patients, suggesting that patients do perceive their autonomy in decision–making as closely related to their sense of personal dignity.
Patient autonomy or decision–making forms the basis of ethics in nursing and clinical management (Delmar, 2013). However, there is a lot of
confusion about patient autonomy as there are no clear clinical directives or standards on clinician authority to create, use and revoke patient autonomy
(Hobbs and Elliot, 2009). One of the primary concerns in decision–making is patient capacity and this could be related to patient mental capacity,
emotional or cognitive status, physical and psychiatric diagnoses as well as situational and medical condition.
One of the cases or situations that may necessitate revoking patient

Applying Clinical Decision Making in Adult Nursing Essay
Applying Clinical Decision Making In Adult Nursing Ahh2036–N This assignment will critically analyse and justify the decisions based around a
fictitious patient using a clinical decision making framework highlighting its importance to nursing practice. The chosen model will demonstrate
clinical decision making skills in the care planning process. The patient's condition will be discussed in–depth explaining the pathophysiology, social,
cultural and ethical issues where appropriate in the care planning and decision making process. Any vulnerability that the patient may experience will
be discussed and dealt with in the care planning and decision making process. The supporting evidence based literature will be analysed and... Show
more content on Helpwriting.net ...
Huber (2006, p154) states that clinical decision making in nursing relates to the quality of care the patient receives and how competent the nurse is.
Over the past 30 years nursing has evolved from a task–oriented to a logical and systematic approach to care, using theories and models to guide
practice. According to Jasper (2007, p117) theories of decision making in medicine tend to favour logical, precise analytical models which are held to
be testable, unambiguous and repeatable, therefore satisfying scientific principles. These represent important ideas of certainty and rationality that are
intended to provide a sense of security and reliability. When used correctly a nursing model should give direction to nurses working in a particular
area, as it should help them understand more fully the logic behind their actions. It should also act as a guide in decision–making and so reduce
conflict within the team of nurses as a whole. This in turn should lead to continuity and consistency of the nursing care received by patients according
to Pearson et al (1999,p ). Banning (2008, p ) states knowledge for decision making is obtained from many sources and has been described as both
informative

Knowledge In The Clinical Application Environment
5–What is knowledge management in the clinical application environment and how can network technologies, wired or wireless, support knowledge
management? Come up with examples of a clinical application environment and network support to link all its necessary elements together.
There are two main classifications of knowledge, tacit and explicit. Tacit knowledge is the knowledge that is in each person, whereas, explicit
knowledge can be collected, stored, shared, retrieved, and used (Karamitri, Talias, & Bellali, 2015). It is this explicit knowledge that is at the core of
knowledge management (KM) and network technologies have a significant role in improving KM within the healthcare setting. Knowledge in the
healthcare setting is worthless ... Show more content on Helpwriting.net ...
In fact, if they were switched to VLAN it could provide an added layer of security since the devices would be accessing the internet. The devices can
access the internet either through a wireless router which is shown in the diagram or via a wired internet connection; whichever access method is
used, the connection needs to be reliable since physician's and nurse's need to depend on the CDS tool when they are taking care of patients. The
advantage of using a web–based clinical application for a CDS tool is fewer man hours are required to ensure the application is up to date. If this
application was housed on an application server in house, then the HCO would need to assign an application manager to be responsible for ensuring
the most up to date version of the CDS tool application software was available. By choosing a web–based application, updates occur as they are
available. This is just one example of how IT and clinical applications intertwine in order to enhance patient

Clinical Decision Making For Physical Therapy Assistant
Skinner, S. B., & McVey, C. (2011). Clinical decision making for the physical therapist assistant. Sudbury, MA: Jones and Bartlett.
This guide is built to help develop the essentials to caring for patients. To help people or students to make decisions to the pathway of Physical
Therapy. The book then later proceeds to talk about internships and how to score a high grade for the NPTE which is the National Exam for Physical
Therapy. A good thing about this book is that it can be used at any level ofPhysical Therapy Assistant education.
Dreeben, O. (2007). Introduction to physical therapy for physical therapist assistants. Sudbury, MA: Jones and Bartlett.
In this book we see that it consists of five parts which are The Profession, Physical Therapy Specialties, Ethical and Legal Issues, and the
Communication. Another factor is the development and evolution. Half of the textbook discusses rehab treatments and the culture of physical therapy
itself. It is also mentioned on how to choose your specialty such as neurology, pediatrics, orthopedic and more
Fetters, L., & Tilson, J. (2012). Evidence based physical therapy. Philadelphia: F.A. Davis.
This book mentions the five steps which is to focus on clinical questions, conduct a search, appraisal for the research, interrogation, and the evaluation.
An interesting chapter is the chapter of finding the real diagnosis and finding out the specific treatments for them. Another interesting chapter is
Chapter Four where the

Clinical Decision Making Model
Hello Everyone! Clinical decision–making (CDM) identify by the method including skills such as critical judgment and problem solving which is
also keystones of the effective care of patient (Wainwright, Shepard, Harman and Stephens, 2011). As Physical therapists (PTs) we make decision
every day. This decision is accepted throughout the client interview and verified during physical examination (Goodman and Snyder, 2007). The
decision making style may differ based on level of experience, knowledge, judgmental power and condition like limited time frame. Now, talking
about my CDM process in initial phase as PTs which was limited to particular area like neuro–musculoskeletal due to limited knowledge, experience
and clinical exposure. Moreover,... Show more content on Helpwriting.net ...
moreover, to decrease patient load they (physicians, admin) categorized care unit based on division as severity but instead of solving problem its
increased. Money is very serious motivator to continue to look the other way, So to reduced workload and specific treatment who actually indeed
required, Goodman's developed a new clinical algorithm in three criteria but none accepting initially this method (Crist, McVay and Marocco, 2016).
Cook county hospital have accepted first and tried this method on patients who fit in this criteria get's priority first and this model was more
reliable(70% better than regular system), convenient than experts view (Crist, McVay and Marocco, 2016). In 2005 Klein, point out five pitfalls in the
study and one of them is confirmatory bias, as physical therapist, we need to aware of bias and overcoming while diagnose the patients. For example,
ligament injury in knee joint can be conflict with meniscus injury or fracture but by using differential diagnostic test and analytic–deductive thinking
process help out for proper rule out specific condition. Training in these threats can

Clinical Decision-Making And Clinical Judgment Analysis
Although clinical decision–making and clinical judgements are closely linked, but the concepts are separate. Clinical judgement defined as "an
assessment between alternatives" whilst clinical decision–making defined as "a choice between alternatives" (Dowie, cited by Thompson and Dowding
2009). To choose the best between two alternatives requires the rationale behind decisions which can obtain by asking questions to create information
(Standing 2010). Furthermore, Levette et al's (2010, p. 515–20) define clinical reasoning as "the process by which nurses collect clues, gather
information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn
from the process".

Questions On Clinical Decision Making
Clinical Decision Making This paper will write the story of JT, clinical patient of mine. The paper will document her account of our interactions using
her eyes and voice. The story will include health assessment data, labs, and a physical assessment. Elements of JT's journey will also include her
culture, level of pain, spiritual and psychosocial stance and ethical issues that arose. The paper will then detail the patient decision making process and
strategies in a systemic manner to analyze the situation and help determine what could have been done better. The decision making process will also
attempt to identify elements where the patient care could have been improved and determine what went well and what actions or assessments made
had no basis in the guidelines or protocol. Additionally, analysis concepts will be integrated with continuous quality improvement (CQI) initiatives. An
approach for change process using the Plan–Do–Study–Act (PDSA) model will be described as it applies to this patient scenario and will include
clinical guidelines. The paper will then utilize the results from my completed self–assessment tool as well as the self–reflection and self–discovery to
analyze the process of clinical decision making. JT is a clinical patient who was born in the 1930's. By the time she was 12 years old, WW2 was in full
effect and the nation was faced with its biggest challenge yet. By the 1950's JT had graduated high school and was enrolled in College for

Freedom And Freedom : The Importance Of Clinical Freedom
Clinical freedom is the right of medical practitioners to decide and do whatever in their opinion was best for their patients. It had been common
practice that medical practitioners subject patients to treatment procedures without any evidence of their efficacy, which not only will increase
expenditures, but also may put patients to potential harm. Hampton considered clinical freedom as a myth and 'a cloak of ignorance', and believed
that medical practitioners should base their clinical practice on evidence from randomized controlled trials to guide medical decision making and set
aside dogma and biases (1). Using an example from the issue of active management of myocardial infarction, the author highlighted the importance of
managing resources effectively on clinical and economic considerations, and suggested that interventions should not only be assessed for their efficacy
in increasing likelihood of their desired effect, but also assessed with comparative trials against other alternative treatments. (1). In his conclusion,
author felt that the end of clinical freedom is not to be regretted, for its end would allow treatment to be applied only after a properly conducted clinical
trial and approved on a large scale after considering available resources and the efficacy of treatment.
This paper raises interesting questions in economics and resource management healthcare
Furthermore, the procedures would also have to be compared with other alternatives in terms of cost.

Apache V. Apache IIi System : Acute Physiology And Chronic...
APACHE stands for Acute Physiology and Chronic Health Evaluation and the first system was developed in 1981. The newest APACHE system
was developed in 1991. The APACHE III system was designed to predict an individual 's risk of dying in a hospital. It compares each individual 's
medical profile against nearly 18,000 cases in its memory before reaching a prognosis that is, on average, 95 percent accurate (Open Clinical website,
2005). This system can be used in the Intensive Care Unit setting and it can predict the patient's risk of dying in the Intensive Care Unit. This system
takes into account several variables such as, diagnosis and psychical conditions upon admission to the Intensive Care Unit, age, pre–existing medical
disorders and other variables. A physician gives the system facts, and based upon the facts the system can predict the patient's risk of passing away.
This system does not spit out an answer and healthcare workers have to follow it, it is rather a tool to help healthcare providers make a decision on
whether to discontinue "heroic" measures and it allows them to ponder these issues in a realistic way. The Clinical Decision Support System is a system
that uses patient data to generate specific advice relevant to the patient's case. Clinical DSSs are typically designed to integrate a medical knowledge
base, patient data and an inference engine to generate case specific advice. (Open Clinical website, 2006). Overall, this system can be helpful when

Systematic review paper
Systematic Review
Systematic Review
The purpose of this meta–synthesis research was to synthesize a qualitative study performed to better understand the underlying reasons why only a
fraction of cancer patients participate in cancer research trials. The attempt is to explore factors that influence participation in this type of study.
Literature in the subject indicates poorly understood process of how patients are enrolled into clinical trials. This systematic review tries to improve the
patient decision–making process in participating in cancer clinical trial and to provide Oncology nurses to treat patients with solid background utilizing
evidence based practice (Biedrzycki, 2010).
The study was conducted in hope to ... Show more content on Helpwriting.net ...
Three studies tested an educational intervention and two studies used an experimental design. 50% of the studies did not report timing of the research
in relation to the decision regarding clinical trial participation (Biedrzycki, 2010).
During meta–analysis, response rates varied by type of measure and study design, only 50% reported response rates (range = 21% – 95%,
median=71%. 29% declined participating because they had no interest and 24% declined with no reason given. One major reason people declined to
participate was because they had no access or could not use a computer. Multiple time measures were conducted in decision regret, it was noted that
responses were reduced (Biedrzycki, 2010).
The process used to pool the data together was clinical trial decision making. The main factors influencing this process consist of patient, provider, and
treatment. Two studies specifically explored decision making by the patient. Education requirements impacted decision making since understanding the
risks and benefits of clinical trials was the most important factor taken into consideration by the patient. Educational interventions were noted to have
increased patient enrollment. (Biedrzycki, 2010).
If the patient found the education from the provider to be coercive, treatment was considered a burden. Time and travel also posed an inconvenience on
the patient since it adversely affected quality of life and therefore deterred

Evidence Based Practice For Quality Healthcare Delivery...
Evidence–based practice (EBP),as characterized by the integration of clinical expertise and experience, patient values and preferences, and ideal
research evidence (DiCenso, Guyatt & Ciliska, 2014) is vital for quality healthcare delivery and improves patients' health outcomes. Several steps must
be fulfilled in order to achieve EBP in practice. To begin with, clinicians assess the patient, then question the patient on issues regarding their
preferences and values. Next, clinicians conduct research to appraise the patient's clinical case then evaluate the credibility of the sources used in the
research. Lastly, clinicians apply the information collected and integrate it with their clinical skills, patient preferences and values. The balance
between knowledge, experience, and information gathering, characterizes the process of clinical decision–making, a process through which clinicians
ascertain the right course of action. (Vincent et al., 2015). The ability to make relevant and suitable clinical decisions via this process determines the
clinician's effectiveness. Thus, the successful integration of patient values, clinical expertise, and ideal evidence in clinical decision–making, reinforces
clinician effectiveness, resulting in positive patient outcomes. This study will evaluate how registered nurses use clinical decision–making to
encompass patient values, clinical expertise, and ideal research evidence. Clinical decision–making and patient values Initially, patients

Information Between Professionals For Well Over A Decade
Introduction It has been NHS policy to actively share information between professionals for well over a decade. In England clinicians should send
copies of their clinical letters to their patients. 1 This will give patients a written record of their consultation, the discussion, the decisions made and the
reasons for making them. It will give patients the opportunity to read information that they might have misheard or may have forgotten, to reflect on
the conclusions arrived at and to discuss them with important others such as friends and carers. It recommended including patients as a partner in their
healthcare, encourage greater openness and transparency. There should be an assessment of the patient's capacity to make decisions about... Show more
An 'Easy read' is a presentation of information in a simple and easy to understand format involving short sentences and images. It is often useful for
people with Intellectual disability and for people with conditions which affect the way they process information.3 Patients have a right to see or have
copies of their records. The Code of Practice also states that it is important to recognise different communication needs of different patients such as
with disability and difficulty in communication does not remove the obligation to help people understand.4 Aims 1)Ascertain the practice of copying
clinical letters as per GMC guidelines, Royal college of Psychiatrist guidelines and code of practice from department of health. 2)To find if the
implementation of the service improvement project 'Easy read' improved the team's performance. Audit Standards 1)Department of Health (2003a)
Confidentiality: NHS Code of Practice. pp. 212. London: Department of Health. 2)Department of Health (2003b) Copying letters to patients: good
practice guidelines. 3)Royal College of Psychiatrists (2006) Good Psychiatric Practice: Confidentiality and information sharing (CR133). London:
Royal College of Psychiatrists. 4)GMC: Good medical practice (2013) Methods The setting was Salford Intellectual disability team. All clinical letters
for the month of

Clinical Decision Making : Clinical Judgment Essay
Clinical judgment Clinical judgment is the clinical reasoning, which includes clinical decision–making, critical thinking, and a global grasp of the
situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence– based
guidelines (AACN, n.d.). In the case of F.S., he was on isolation precautions due to his infection. The results from the cultures had yet to return,
therefore the infection was not identified at that current moment. The registered nurse that was assigned to F.S. went into the room several times
without wearing proper protective personal equipment. This nurse stated that if she wasn't touching the site, she was not at risk. This was a bad clinical
judgment. Unfortunately, this was not the first time this student nurse witnessed the lack of use of the personal protective equipment. What most
nurses don't seem to understand is that the risk of infection is not only towards the patient but towards the nurse as well as everyone the nurse
encounters. Contact precautions were researched and found to be associated with activities likely to reduce transmission of resistant pathogens, such as
fewer visits and better hand hygiene at the exit while exposing patients on contact precautions to less healthcare worker contact, less visitor contact, and
potentially other unintended outcomes (Morgan et al, 2013). Although it can be depressive for the patient to become isolated due to an infection, this

Culture In The Clinical Decision-Making Process

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