Query: types of decision making in nursing

title: The Effect of Family Support on Career Decision Making, Self Efficacy and Types of Career Decision Making among Nursing Students

title: Nursing Student's Application of Nursing Management Diagnosis by Types of Decision making Cases

title: [Patients' preferences and experience regarding participation in nursing care decisions in acute hospitals an analysis of conformity of preferences and experience, and factors influencing different types of decision making]
abstract: Patients' preferences regarding their participation in nursing care decisions represent a key aspect of the concept of evidence based nursing; nonetheless, very little quantitative research has been carried out in this area. The aim of the present study was to describe the patients' preferences and experience concerning their participation in nursing care decision making processes in acute hospitals. A total of 967 patients in five hospitals in Vienna participated in this study by completing questionnaires. The results revealed that 38.5 of patients preferred the paternalistic style of decision making, 42.1 wanted to make decisions together with the nursing staff and 5.7 expressed a wish to make their own decisions. During their hospital stay, however, patients experienced paternalistic decision making to a higher degree than they wished for. Age, sex, form of treatment and subjectively experienced health condition represented person related characteristics that influenced preferences regarding the form of decision making. The results of this study underline the importance of collecting data on patients' preferences in decision making processes in order to meet the social, legal, and professional demands of patient oriented nursing care based on the most recent scientific knowledge.

title: Barriers in the Decision Making About and Performance of Continuous Sedation Until Death in Nursing Homes.
abstract: While decision making about and performance of continuous sedation involve many challenges, they appear to be particularly pervasive in nursing homes. This study aims to identify barriers to the decision making and performance of continuous sedation until death in Flemish nursing homes as experienced by the health care professionals involved.  Ten focus groups were held with 71 health care professionals including 16 palliative care physicians, 42 general practitioners, and 13 nursing home staff. Discussions were transcribed verbatim and analyzed using a constant comparative approach.  Perceived barriers concerned factors prior to and during sedation and were classified according to three types: (a) personal barriers related to knowledge and skills including the lack of clarity on what continuous sedation should be used for (linguistic ambiguity) and when and how it should be used (practical ambiguity) (b) relational barriers concerning communication and collaboration both between health care professionals and with family; (c) organizational barriers related to the organization of care in nursing homes where, for example, there is no on site physician, or where the recommended medication is not always available.  The findings suggest there are considerable challenges for sound decision making about and performance of continuous sedation until death in nursing homes. There is a need for multicomponent initiatives that provide guidance in the context of the complexity of a resident's medical situation, the family, and the specific organization of care, which would have the potential to facilitate and improve the decision making process and performance of continuous sedation in nursing homes.

title: Decision making from the perspective of nursing students.
abstract: To analyze the decision making of students from a nursing higher school and understand how they make decisions in the care process.  A qualitative study with an exploratory and descriptive approach was carried out with the case study method.  Six types of decision making were categorized by the students as follows: Decision about communication (15 record units [RU] Decision about understanding (14 RU) Decision about intervention (9 RU) Decision about timing (5 RU) Decision about targeting (4 RU) and Decision about management (0 RU) with a total of 47 RU. FINAL CONSIDERATIONS Analysis of the learning diaries showed that students make more decisions regarding communication with patients and understanding of the care situation, than with the acting decision.

title: Career Decision Making Self Efficacy and Professional Commitment Among Master Nursing Students
abstract: Developing countries face a shortage of nurses with higher education, such as those with a master's degree. However, few studies have investigated the interaction between career decision and professional commitment (PC) of nursing students, especially for postgraduates. This study performed correlation analysis for career decision making self efficacy (CDMSE) and PC of 545 nursing postgraduate students from nursing schools at 19 universities or colleges throughout mainland China, who came from different regions, and possessed different years of study and different types of degrees as well as part time job experiences. Data reliability and validity were confirmed for both Career Decision Making Self Efficacy Scale for university students (CDMSE R) and Professional Commitment Questionnaire (PCQ) We found positive correlations between factors of PC and CDMSE. The score of CDMSE was different between regions, degree types, grades, and part time job experiences. According to our results, we suggest nursing education or career advisory services should promote the PC of nursing students according to factors of their CDMSE scores.

title: The relationship between clinical decision making skills in nursing and general critical thinking abilities of senior nursing students in four types of nursing programs.
abstract: This descriptive study was undertaken to investigate the relationship between clinical decision making skills in nursing and critical thinking abilities of senior nursing students in four types of nursing education programs: generic baccalaureate, associate, and diploma the basic RN programs, along with the upper division baccalaureate (specifically RN completion) program. Fifty senior students from each type of program were conveniently selected. Clinical decision making in nursing was measured by the Nursing Performance Simulation Instrument. General critical thinking abilities were determined by the Watson Glaser Critical Thinking Appraisal. Among the basic RN programs, the higher level of general critical thinking ability was attained by generic baccalaureate seniors (mean score, 61.3) compared with the associate (50.0) and diploma (51.3) seniors. The clinical decision making scores in nursing skills were virtually identical for the three basic programs generic (32.2) associate (32.2) and diploma (32.3) That is, mean performance scores of the 2 year associate degree, 3 year diploma, and 4 year generic baccalaureate degree students on the Nursing Performance Simulation Instrument showed no statistically significant difference. The mean critical thinking score for the upper division baccalaureate seniors (61.1) was comparable to that of the generic baccalaureate seniors. Clinical decision making mean score for the upper division seniors was significantly higher (38.0) than those of the other three groups. A weak though significant positive correlation (r 0.249) between clinical decision making and critical thinking across all four types of programs was found.

title: Measuring the quality of judgement and decision making in nursing.
abstract: This paper discusses measurement of the quality of judgement and decision making in nursing research. It examines theoretical and research issues surrounding how to measure judgement accuracy as a component of evaluating decision making in nursing practice.  Judgement accuracy is discussed with reference to different methods of measurement, including comparing judgements with independent criteria and inter judge approaches. Existing research on how judgement accuracy has been measured in nursing practice is examined. Evaluation of decisions is then discussed, including consideration of the process of decision making and evaluating decision outcomes. Finally, existing research on decision making in nursing is assessed and the strengths and limitations of different types of measurement discussed.  We suggests that researchers examining the quality of judgement and decision making in nursing need to be aware of both the strengths and limitations of existing methods of measurement. We also suggest that researchers need to use a number of different methods, including normative approaches such as Bayes' Theorem and Subjective Expected Utility Theory.

title: An analysis of nursing students' decision making in teams during simulations of acute patient deterioration.
abstract: The aim of this study was to examine the decision making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions.  Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted.  A descriptive exploratory design.  Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision making and reflections on performance were audio recorded post simulation (2012) and transcribed.  Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions.  Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students' decision making in teams, in this context, highlights the importance of individual knowledge, leadership and communication.

title: Diagnostic Reasoning and Treatment Decision Making in Nursing
abstract: An exploration of the thinking processes that lead to a nursing diagnosis. Numerous examples from all clinical fields, levels of care, care settings and patient types illustrate the cognitive process and assist with decision making for diagnosis and treatment. Using a focus on cognitive skills, the text shows readers how to evaluate and improve their approach; and identify the personal and environmental factors that influence a clinical decision. It also provides an ongoing program for improving diagnostic skills.