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Decision Making on Procedure 

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In the Covid unit rehab, a decision was made to allow nurses to take “refusal to treat” position if they were not supplied with adequate personal protective equipment (PPE). That happened after a research was carried out to reveal that healthcare staffs were being exposed to covid-19 risks and that PPEs would be helpful. The decision-making process followed specific steps to make sure that the change benefited the institution. The first step was to ensure that the outcome desired was clearly defined. All the people involved had to ensure that they understand what they wanted. The second step involved making sure that the roles of every stakeholder in the process were outlined.

The other step was to ensure that the criteria of good decisions were set. As such, this ensured that the decisions made were helpful and would serve their purpose towards the institution’s goals of safety and protecting frontline workers (Farčić et al., 2020). Alternatives were then considered to ensure that a wide variety of choices was in place to solve the problem in the best way possible. The fifth step was to ensure that the plan developed was evaluated to ensure that its effectiveness was established (Standing, 2020). The last step was to document the decisions for which the experts involved in the process settled.

Ultimately, they settled that Covid-19 rehab unit nurses were risking a huge exposure to the diseases and it was best decision that they be protected. After analyzing the possible ways and alternatives that can work, the use of PPEs was found as the best approach. The decision was effective because the cases of healthcare workers dying in the rehab unit reduced drastically. The rationale behind this outcome is that PPEs reduced the risks associated with the covid-19 to the frontline workers. The cases recorded after the decision was made were extremely few compared to the time before the choice was put into effect. Therefore, the decision was helpful to the institution and helped it to reduce new covid-19 cases among the nursing workforces.

References

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Farčić, N., Barać, I., Plužarić, J., Ilakovac, V., Pačarić, S., Gvozdanović, Z., & Lovrić, R. (2020). Personality traits of core self-evaluation as predictors on clinical decision-making in nursing profession. Plos one15(5), e0233435.

Standing, M. (2020). Clinical Judgement and Decision Making in Nursing. Sage.

REPLY 2

Decision-Making Process 

Research indicates that many patients in the United States die annually because of poor clinical decision-making. These poor decision-making processes result in medical errors, which are amongst the leading causes of death in the country. Nibbelink and Brewer (2018) aver that proper decision-making is quite essential in nursing practice. In most cases, the nurses’ decisions have the effect of influencing the whole treatment process that a patient may undergo. The other medical practitioners, such as doctors, solely depend on these decisions to determine their next actions (Watkins, 2020). Given the importance of decision-making in this field, it is quite vital to abide by the same decision once a decision has been made.

The first underpinning of change in a prior decision is having a shared vision (Nibbelink & Brewer, 2018). Whenever a nurse had an idea on changing practice, they were to share their ideas with the other nurses to convince the rest that it is the most effective procedure to undertake instead of the already established procedure within the institution. Under this requirement, the nurse who is proposing the change needs to develop strategic planning where they convince the other practitioners on the difference between the new procedure and the old one and the difference it will have on the patient. The nurses have to give a clear direction on how the new procedure will be performed and the effects on the practitioners and the patients. The nurses have to frequently communicate this vision to every affected person within the institution to help create the new practice culture.

Once the change is shared with the medical physicians, a leader is chosen to ensure that the change is successful (Chisengantambu-Winters, Robinson & Evans, 2020). The leader should have an in-depth understanding of the new procedure, and he was to drive an initiative for the organization to commit to the change as much as possible. Once every concerned medical personnel receives official communication on the change, the elected leader had the task of addressing the concerns that resistors had about the change. According to Fabrizio, change in medical procedures is often a challenging undertaking (Nibbelink & Brewer, 2018). Some physicians will always support the change in proposing the change; others will support it but with reservations, while others will oppose the change. It is upon the change’s proposer to address the issues that may arise concerning the new procedure. Ana-Elena Jensen posits that resistance to change in nursing is a normal phenomenon (Chisengantambu- Winters et al., 2020). In addressing this resistance, the leader will address the benefits of the change and address the shortcomings of the procedure currently being applied in the institution (Campbell, Massey, Broadbent & Clarke, 2019).

Once the resistance is addressed, the new procedure is placed under clinical trial for three months. The results were recorded and presented to the management of the institution for assessment. Once the management proves that the proposed change is more effective than the one currently implemented, it will adopt the change as the new practice. After that, the concerned medical practitioners will the taken through the new practice frequently so that the same can become a culture in the institution. In my current institution, the nurses proposed a change in the dialysis procedure. In the past, the institution adopted Peritoneal Dialysis, which some medical practitioners did not approve of. A team of nurses proposed a change to Hemodialysis treatment. The change underwent all the processes of decision making, and the institution finally adopted it. The new procedure has been quite effective in reducing emergency medical issues that arise during dialysis.

References

Campbell, K., Massey, D., Broadbent, M., & Clarke, K. A. (2019). Factors influencing clinical decision making used by mental health nurses to provide provisional diagnosis: A scoping review. International journal of mental health nursing28(2), 407-424.

Chisengantambu-Winters, C., Robinson, G. M., & Evans, N. (2020). Developing a decision-making dependency (DMD) model for nurse managers. Heliyon6(1), e03128.

Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing27(5-6), 917-928.

Watkins, S. (2020). Effective decision-making: applying the theories to nursing practice. British Journal of Nursing29(2), 98-101.

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