Clinical Decision Making

Lilik S
 Decisions making
 Evidence based nursing
 Practice guidelines
 Assessing the outcome of care
 Delivering cost-effective & benefit medical
care
 Accountability
 Continued learning
 Research and teaching
 Decision-making
…is solving a problem using a systematic
approach of sequenced steps, selecting
an alternative approach, and putting the
approach into action.
…relates to organizational purpose:
futurity,impact, philosophy or ethics,
uniqueness.
…relates to professional autonomy.
 Applies decision-making theory and the
problem-solving process in achieving the
mission of the nursing agency.
 Inadequate fact finding
 Time constraints
 Poor communication
 Failure to follow decision-making steps
 Systematically collect, organize, and analyze
data related to a specific problem or need.
 Make a plan of action.
 Implement the plan.
 Evaluate the results.
 Normative model
1. Define and analyze the problem
2. Identify all available alternatives
3. Evaluate the pros and cons of each
alternative
4. Rank the alternatives
5. Select the alternative that maximizes
satisfaction
6. Implement
7. Follow up
 inducto

verivicative hypotetico VERIFIKASI

Diagnosis Planning, etc

deducto
S.P.S.A. CLINICAL PROCESS

PROBLEM IDENTIFICATION HEALTH PROBLEM

EVALUATION DATA COLLECTION FOLLOW-UP ANAMNESA/ P.D./

LAB. / MED-RECORD

IMPLEMENTATION DATA ANALYSIS IMPLEMENTATION DATA &

INFORMATION
ANALYSIS

PRIORITY SETTING HYPOTHESIS TREATMENT DIAGNOSIS

FORMULATION PRIORITY SETTING
SYNTHESIS

PROBLEM SOLVING HYPOTHESIS

ALTERNATIVE TESTING
TREATMENT DIAGNOSIS
ALTERNATIVES PLANNING
 Making critical decisions
requires critical judgment—
the use of knowledge and experience
to diagnose patients and plan their
treatment.
 The ability to anticipate
 The ability to prioritize
 The ability to problem-solve
 Relies heavily on knowledge base
 An ability to learn from past mistakes
Critical thinking is not an action
but a way of life.

Bledsoe et al., Essentials of Paramedic Care:

Division 1I
© 2006 by Pearson Education, Inc. Upper
Saddle River, NJ
 The severity or acuteness of your patient’s
condition
 A standard that includes general and specific
principles for managing certain patient
conditions
 Treatments you can perform before contacting
the medical direction physician for permission
 Schematic flow chart that outlines appropriate
care for specific signs and symptoms
 Knowing anatomy, physiology, and
pathophysiology
 Focusing on large amounts of data
 Organizing information
 Identifying and dealing with medical
ambiguity
 Differentiating between relevant
and irrelevant data
 Analyzing and comparing similar
situations
 Explaining decisions and constructing
logical arguments
 terimakasih