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Clinical Decision Making Theories in Nursing Practices

Introduction

In this paper would discuss the decision-making theories in the nursing practices for the preparation of PEP.  In the department of the nursing, there are said to be many of the decision-making theories that can be used. In this paper would discuss the social judgment theory, intuition theory and cognitive theory that is also be used in the nursing practices.  Nursing opinion and decision-making are said to be the necessary constituent of specialized nursing practices and very complex. So can say that the specialist nurses are recognized for well-organized and intuitive processes of the decision-making, at the same time as beginner nurses are recognized for extra effortful and on purpose processes of the decision-making (Parker-Tomlin Boschen Morrissey & Glendon 2017).

 In spite of enchanting longer to formulate any kind of the decisions, the beginner has the problem with effectual decision-making practices. The intent of this document is to appraisal the factor that contributes to nursing practices in the decision-making. This was attained by evaluation over literature bent by searches. This piece of writing uses a variety of technologies of information collection, an assortment from examination to well-controlled testing, even though the preponderance of learning were investigative in the environment (Smith 2013).

So all of the factors are said to be partial decision-making were classified as a person or ecological factors. The individual factors detain only one of its kinds to decision-maker and built-in factors, for example, the experience, prompt recognition, and theory update. By difference, ecological factors imprison elements adjacent to the task of the decision. In the middle of this issue were task difficulty, time force, and disruption (Bennett & Hauser 2013).

Intuition Theory

The Intuition theory is a frequently used feature in practicing of the nursing. Because the confirmation base practice of the nursing is the well-known practice nowadays, the intuition practice is said to be concealed and rather diminish. Even though it is complicated to describe because of its characteristics, intuition theory is a necessary division of effectual scientific decision-making. This is also said to be the research is an inductive qualitative contented analysis that is likely to focus on a nurse, and make use of intuition information and knowledge. The Benner’s from beginner to specialist theory and also the Carper’s primary Patterns of significant in the theoretical framework of the nursing theory of this research. The theory of the Benner’s discusses 5 phase of professional nurses department, while the Carper’s theory of the intuition focuses on dissimilar ways of meaningful in nursing occupation.

On the other hand, outstanding to elevated excellence and correctness of judgments in the intuitive, they believe researchers in its opportunity to balance, some of the characteristics that the decision-making capability of an individual is connected to the power of the intuitive decision-making(Chau C. Y. Wong & Fung 2014).

The Intuition is accurately definite as “attendance”, “able to be seen”, “obvious “and “imminent”. In the additional word, it is the person aptitude for meaningful or responsibility without sufficient cause also, is a method to the gratitude of the reality with no balanced thinking. So we can say that the studies long-established the continuation of perception, and establish its production from the forwarding cortex of intelligence. Additional examination with by means of Electrocardiography heart rate unpredictability and Electroencephalography completed that the human brain can forecast some particularly dangerous and intimidating proceedings in the prospect; in this container the intelligence and spirit have the interactional association for in receipt of, dispensation and decode the automatic post (Smith Alford Hibbing et al. 2017).

So in this case, the nursing has focused on confirmation base put into practice; therefore, positivist method reason abandons the unspoken or intuition information. Be short of notice to all approach of meaningful with the exclusive focus on “balanced” is an obstruction to improve thinker aptitude of nursing practices. In this stare, it is also stated intuition is a major constituent of the decision-making in the fields of nursing, at the same time appropriate decision-making and choice are the most important typescript of a well-informed and practiced nurse(Parker-Tomlin Boschen Morrissey et al. 2017).

The Intuition also has an important role to be familiar with the most excellent nursing principle events dropping rate of patient’s health conditions in the disaster undecided circumstances and make a diagnosis the weakening of vital signs of the patient. On the other hand, because of short of evidence, the notion of intuition is not understandable fully in nursing, it is mostly based on nurses’ experience without any rationale, cannot be explained (Dhami & Thomson 2012).

Pros And Cons

Advantages

The intent is to describe intuition, meaningful, and decision-making in the nursing. In adding up, this research describes the shock of information and knowledge on intuition and medical decision making connected to beginner nurse and specialist nurse. So we can say that the judgment and alternative are whole on “unbiased” and “intuition” move toward. The balance is assessing by a lot of research, but intuition has recognized as a dubious technique.

Disadvantages

There are various disadvantages of the intuitive decision-making example in the clinical experience there could be the common element that may not have the clearer understanding. However, in clinical situations, the nurses may not have interpret patient cues and there may not be pattern recognition because there can be less experience.

Social Judgment Theory

The social standard comes up to forecast that movement providing message true normative data about extensive health that has misperceived behaviors will decrease the whole flanked by indistinct awareness against definite put into practice and as a result decrease behaviors depend on overstated norm. So in this case, the determining assessment of communication intended to efficiently express true standard knowledgeable through social judgment theory be supposed to measure the limitations of the leeway of receipt, no promise, and negative response for that information (Chau C. Y. Wong & Fung 2014).

The considerate knowledge requirements of the student be a very important step in preparation for the release of effectual learning. To evaluate the shock of such interference is not forever simple and a lot of methods depends on the behavior that is a self-reported or straightforward change in information, which association to achievement is not for all time clear. By means of analysis of the conjoint, inside the social judgment theory theoretical framework, this learning exemplify a work of fiction income of investigative nurses’ employ of nursing information when making a hypovolemic diagnosis upset in a sequence of replicated belongings obtainable via PC. The learning examines modify in data practice previous to and after a customary literature.

This learning establishes that the freedom was considerably dissimilar from one more in believability. Social judgment theory forecast that a movement stands on a standard lessening in the freedom of no commitment resolve be probable to be effectual. A sequence of mail by means of the factual norm, that is likely to cut down within the liberty of no commitment that was the division of a movement. The opening in professed against real consumption and the dissimilarity in apparent numeral was condensed, at the same time as self-reports of expenditure of five drinks augmented considerably (Smith Alford Hibbing et al.2017).

The consequences demonstrate that information the nurses make use of are not linear and the usefulness for choice judgment resulting from scientific data is not dispersed evenly. The learning also recommends that a number of nursing information, for instance, the Glasgow Coma is not healthy unspoken and included in scientific and nursing practices in the judgment. The revise has an insinuation for persons scheming and evaluates enlightening intervention and those study the use of data, nursing judgment and choice making (Bennet & Hauser 2013).

So nurses can say that the Social judgment theory maintains that a place of persons on a subject depends on 3 belongings. Primary, the secure, or the favored location on the subject. In the car instance, the fasten be the people present means of transportation. Subsequent, their location based on option, confidential as satisfactory, discarded, or evasive. In the car instance, the simplest option was not captivating the car but visualize the variety of option in the theme such as the politics. In conclusion, the third constituent of someone’s location on a subject based on their individual involvement of the ego. So nurses can say that the social judgment theory is also likely to have an impact on the nursing practices (Chau C. Y. Wong & Fung 2014).

Pros And Cons

Advantages

The good thing was that the nurse is caring and helping in nature. The good thing was that the nurses help other nurses to perform the duties well. However, when the shift changed the next coming nurse was guided but sometimes not properly, therefore, such a nurse would become anxious about the working and not adjusting herself to the environment. This is because the nurse not brief satisfactorily. The things, which told in hurry, become problematic for the person due to lack of or poor understanding of the instructions. Therefore it is important that the nurse should pay special attention to the activities. The things only work when they give importance and attention. Safety is the dimension of quality. It is important for the families and the healthcare. There is a need to develop the culture of high professionalism.

Disadvantages

There are various disadvantages of the attitude change as the audience interprets or judges the message by themselves. People can evaluate incoming information.

Cognitive Continuum Theory

With the advancement in the Cognitive continuum theory, the whole theory of behavior is changed. Now the nursing department has the little bit of objection with the early theory of the behaviors that are much relied on the feeling and emotions of a person but now nurses are more focus on the other side of the behaviors that is cognitive. The Cognitive continuum theory added irrational thoughts technique and the way of cognitive schemas and the list of other many things that they use to understand the target behavior practices of their clients that is to be solved (Tomlin 2017).

In addition, according to a Cognitive continuum theory, the focus on the task is very much affected by the cognitive issues related to the anxiety. On the other side, the Cognitive continuum theory may also mean that the task is to be performed by the person is significant for him, so it can cause the performance of the person to increase in the practices of the decision-making. In other words, we can say that it is not necessary that the negative internal state always results in the bad performance. Nurses can say that there are many practices of mindfulness decision-making are available in the nursing (Deringer Dronskowski Pan George & Muller 2016).

As nurses know that, the decision making with the help of the Cognitive continuum theory is the way to relief and wellbeing o the patient in the nursing, without any change in the attention of the person. It is more like the awareness of the present moment of the person, the person who is more aware of his inner self and surroundings because pertains to decision-making are non-directional. It is true that the cognitive abilities of a person also influence his personality. This depends on the mental approach of the person that he perceives positive or negative things from it. Moreover, there are other contemporary theories that the essay will analyze on their application to the improvement of the performance and reward strategies, which are cognitive evaluation theories. The Cognitive continuum theory is a kind of invention and the practice that is said to be very helpful in the department of the nursing (Parker-Tomlin Boschen Morrissey & Glendon 2017).

Pros And Cons

Advantages

The use of this theory is very wide, these are also be used for the training of nursing. This practice allows the nurses to do their peak performance. The umbrella term for these methods of behaviors is known as self-regulation that contains many techniques like goal setting, self-talk in the decision-making process. The other most influential theory is social Cognitive continuum theory that is very much related to this behavior cognitive theory. All of these practices have the controlling effect on the behaviors, decision of the nurses because this assumption is likely to help the nurses to go for the best practices of the decision-making.

Disadvantages

Due to lack of the staffing and hurry to change in the shift leads to the human error in the medication. This is highly a risk and the results may become fatal in this regard. This behavior is not appropriate, as it can be a fatal mistake for the patients and for the nursing. There is also a need to check for the root cause and identify the action plans for implementation of the solution in this field. There is also a lack of quality in the medication. No one is focusing to check either the patient receives the medication, which is really prescribed it, or not. Due to this reason, the quality practice is decreasing and the risk is increasing. Therefore, the need for safety and quality urges in this field.

Applied Theory In Nursing Practice

            As far as decision making in nursing is concerned, all decision making theories are quite relevant and effective for different given circumstances. But as per above discussion, it can be said that the cognitive continuum theory would be the most suitable, considerable and reliable theory to select for the nursing decision making process. This theory looks to be more compatible than any other theory with regards to decision-making. The good thing about this theory is that it deals with the cognitive process of behaviors, which is an important aspect to keep in mind while making nursing decisions. (Frankel, 2008)That is why nurses would prefer to use the cognitive continuum theory in the decision-making process for the nursing practices in a given working environment. For example, during the nurses’ placement in the hospital, a Mr. Smith, a 35-year-old who sustained a left femur fracture as a result of car accident.  The patient condition seems clinically worst; he was so irritable, anxious. He states that as a result of painhe can’t relax. One of the nurses used analytic cognitive processes while managing patients pain, he may be in pain so kept him in the comfortable position and vital signs were taken which were Temp-38C, pulse-94 beat/m, resp-28b/min, BP-140/90mmhg and pain score 9/10.  And nurse has collaborated his physical conditions and all the medical reports; the nurse identified patient is in pain and needs some pain management so that, Intravenous analgesics morphine STAT gave immediately. (Kim, 2012) After few minutes, patients verbalize, looks comfortable, vital signs were stable within age-appropriate ranges and pain score is 1/10, by observing patient’s conditions can say medicine lowers the pain (Fedo 2014). It can effectively identify the target behavior practices of the relevant client and evidence-based care. In addition, it looks at the issues being developed for the cognitive behavior of a person. It can have a great controlling effect with more accurate results (Pettigrew 2015).

Complexities, Contradictions & Inconsistencies Between The Theories

According to the research conducted by Bennet & Hauser 2013,In the contemporary system of the healthcare, quickly increasing complexity, the mounting countless of conduct alternative, and explosion data stream that frequently does not efficiently arrive at the facade lines hold back the aptitude to decide optimal conduct decisions in excess of time. This framework of the artificial intelligence serves two possible functions that are said to be an imitation surroundings to exploring a variety of policies in the healthcare, reimbursement methodologies, and on the foundation for artificial intelligence in the field of the nursing can also be used for the purpose of the decision making(Bennet & Hauser 2013).

According to the research conducted by Chau, C. Y. Wong, & Fung, (2014) it is reviewed that the origin of the dynamical of estimation division in the genuine world is an attractive theme corporeal scientists might assist to appreciate. Too correctly replica the dynamics, the hypothesis is completely well matched with the answer by social judgment on minute estimation modifies. Here nurses bring in a general replica of estimation configuration with all the same agent depends on the well- recognized communal decision theory in society through making bigger an alike model planned in the article for the social judgment theory (Chau, C. Y. Wong, & Fung 2014).

Worldwide, all the countries are facing similar problems in the healthcare sector. The introduction of new technologies and techniques is introducing even more challenges and all the older challenges are in the spotlight to be discussed and understood. The powerful and smart economies in the health sector are provided with the chance to bring change and development and revolutionize the complete healthcare sector.

The opinions of the agents will ultimately come together approximately great and reasonable opinion form 3 phases in a parameter of the two-dimensional space that portrays the infinitesimal estimation comeback of the manager. The model of the dynamics can be understood the qualitatively by mean-field psychoanalysis. Additionally highly, first-order stage change in estimation allocation is experiential by developing the scheme beneath a sluggish change in the parameters of the system, appearance that mix together equilibrium in community vision can take place still in an entirely associated social network for the decision-making practices (Chau, C. Y. Wong, & Fung 2014).

According to the research conducted by Dhami & Thomson, (2012), it is reviewed that the significance of the Cognitive Continuum Theory for study decision-making judgment and analysis. As far as the Cognitive Continuum Theory is a concern, there are manifold methods of cognition that lie down on a range between character and psychoanalysis. Cognitive Continuum Theory is the common manner of cognition. The more of the Cognitive tasks vary in their ability to persuade instinct, analysis, and presentation is dependent on the communication between task possessions and mode of the Cognitive Continuum Theory (Dhami & Thomson 2012).

Using the Cognitive Continuum Theory, nurses can also be recognized tasks require the dissimilar mode of consideration, and be familiar with when analysis in the Cognitive Continuum Theory. This may also likely to break psychoanalysis and instinct. Researchers can make use of Cognitive Continuum Theory to level out a number of recognized anomalies in the planned literature of the management and to offer a more sophisticated framework of the theoretical in this situation for the decision-making practices (Dhami & Thomson 2012).

According to the research conducted by Smith, Alford, Hibbing, Martin, & Hatemi, (2017), it is reviewed that the at first urbanized to give details about the artistic variation in ethical judgment, ethical basics theory turn out to be extensively adopted as a hypothesis of political philosophy. The Intuitive Ethics political attitude is entrenched in assessment produce by inborn mental modules evolve to resolve communal quandary. If it is accurate, ethical basics are comparatively steady traits dispositional, modify in ethical brass tacks be supposed to methodically forecast consequent change in following, and, at the smallest amount in separation, ethical basics be genetic(Smith, Alford, Hibbing, Martin, & Hatemi 2017).

Nurses are also likely to experiment with these hypotheses and discover considerable unpredictability in individual-level ethical tacks crossways the time, and modest confirmation that changes the description for change in the following attitude. Nurses can also discover little confirmation that Intuition ethical basics are transmissible. These answer raise question concerning the prospect of Intuition theory and the ethical concern related to it in the decision making the process as a theory of ideology (Smith, Alford, Hibbing, Martin, & Hatemi 2017).

Conclusion

Summing up the discussion we can say that the social judgment theory, intuition theory and cognitive theory that is also be used in the nursing practices. This is also said to be the research is an inductive qualitative contented analysis that is likely to focus on a nurse, and make use of intuition information and knowledge. On the other hand, outstanding to elevated excellence and correctness of judgments in the intuitive, they believe researchers in its opportunity to balanced, some of the characters that the decision-making capability. So, in this case, the nursing has focused on confirmation base put into practice; therefore, positivist method reason abandons the unspoken or intuition information. To evaluate the shock of such interference is not forever simple and a lot of methods depends on the behavior that is a self-reported or straightforward change in information.

The opening in professed against real consumption and the dissimilarity in apparent numeral was condensed, at the same time as self-reports of expenditure of augmented considerably. The Cognitive continuum theory added irrational thoughts technique and the way of cognitive schemas and the list of other many things that they use to understand the target behavior practices of their clients that is to be solved. The Cognitive continuum theory may also mean that the task is to be performed by the person is significant for him, so it can cause the performance of the person to increase in the practices of the decision-making. To correctly replica the dynamics, the hypothesis is completely well matched with answers by social judgment on minute estimation modifies. Using the Cognitive Continuum Theory, organization researchers can also be recognized tasks require a dissimilar mode of consideration, and be familiar with when analysis in the Cognitive Continuum Theory. The Intuitive Ethics political attitude is entrenched in assessment produce by inborn mental modules evolve to resolve communal quandary. So we can say that all of the theories of the judgment are likely to have an effect on the nursing decision making, but cognitive continuum theory would be more suitable and viable for the decision making process concerned with nursing.

References
  • Bennett, C., & Hauser, K. 2013, Artificial Intelligence Framework for Simulating Clinical Decision-Making: A Markov Decision Process Approach.
  • Chau, H. F., C. Y. Wong, F. K., & Fung, C. H. F. 2014, Social Judgment Theory-Based Model on Opinion Formation, Polarization and Evolution.
  • Deringer, V. L, Dronskowski, R., Pan, U. E., & Muller, P. 2016, Intermolecular contacts in bromomalonic aldehyde-intuition, experiment, and theory.Irrelevant
  • Dhami, M. K., & Thomson, M. E. 2012, On the Relevance of Cognitive Continuum Theory and Quasi rationality for Understanding Management Judgment and Decision Making. European Management Journal.Irrelevant
  • John Fedo, 2014, ‘Nurses’ Decision Making and Pain Management Outcomes’, University of Connecticut Digital Commons @ UConn, UCONN LIBRARY, 1-21-2014.Insufficient information
  • Nursing, T. a.–M. 2015, Toward a Theory of Intuitive Decision–Making in Nursing.Incorrect information
  • Parker-Tomlin, Boschen, Morrissey, & Glendon. 2017, Cognitive continuum theory in interprofessional healthcare: A critical analysis.Insufficient information
  • Pettigrew, R. 2015, Risk, rationality, and expected utility theory. Canadian Journal of Philosophy, 798-826.Insufficient information
  • 2013, Using a theory to understand triage decision making. 21 (2).insufficient information
  • Smith, K. B., Alford, J. R., Hibbing, J. R., Martin, N. G., & Hatemi, P. K. (2017). Intuitive Ethics and Political Orientations: Testing Moral Foundations as a Theory of Political Ideology. American Journal of Political Science, 424–437.Irrelevant reference
  • Tomlin, M. P. 2017, Cognitive continuum theory in interprofessional healthcare: A critical analysis. Journal of interprofessional care, 446-454.Insufficient information

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