This unit is focused on writing essay on nursing practitioner, discussing theories and models related to nursing practice and examine which theory can be applied in PEP including following aspect
- Provide brief introduction related to decision making theories in nursing
- Demonstrate three decision making theories that are used in nursing practices
Decision making theories in nursing practices plays n crucial role for the practitioner is determining the best way to treat patients. Every patient in health care organisation is from different cultural background, beliefs and values. The differences in service users make difficult of nurses to mange equal care practices for all. Further, the report will outline three different theories that is cognitive continuum, expected utility and social judgement theories which support decision making of nurses. Thus, to make discussion effective one theory will apply to decision making in nursing practice in preparation for post-exposure prophylaxis (PEP).
Cognitive continuum theory
Cognitive continuum theory is proposed by Hammond, because according to this scholar cognition is the best practice which can support inclusion service of nurses. The author found out this theory to overcome the limitation of intuitive humanist model and systematic-positivist. In accordance to this theory, it is important for the nurses to make effective clinical and cognitive decision for healthcare practices. However, as per Cognitive continuum, it is important for the practitioners to work collaboratively with health care teams in order to support modern health care plans and procedure, The plan and policies of nursing are related to interpersonal working because it helps in reducing medical errors which arise due to lack of knowledge and information (Felder and Mayrhofer, 2017). The CCT theory of nursing practice is related to decision making process of health practitioner which regards to human judgement. Further, the theory considered as effective because it helps in focusing on both type of decision that is interpersonal health care teams and individuals nurses. The theory is three dimensional which comprise, cognitive mode, time to process and structure of task. Following theses elements of theory assist the partitioner in making effective decision with regard to changes. Its offers and effective management plan to nurse especially for the emergency cases which requires responsible and quick decision.
CCT theory is related to paradigm for clinical decision making and its related to analytical process where two or more people groups group together for one clinical purpose. It offers theoretical framework of make decision which helps in differentiating intuitive approaches and analytical thinking. As per (Bombardini and Trebbi, 2012), it has been analysed that CCT theory is known as effective decision making process because it is focused on team working. IT states that clinical setting lacks familiarity which leads to miscommunication and communication gap. However, it assists the nurses in setting collaborative working which helps in overcoming each other weakness. It is an effective plan because there are nurses who lack pharmacology knowledge, quick decision making etc. which are assisted in cognitive approach of working. Apart from interpersonal working, CCT approach is helpful for the individual nurses in managing effective decision post-exposure prophylaxis because the theory supports inclusion and helps the practitioner in deriving unique way of involving service users in order to deliver safe and quality patient care services. The major advantage of implementing use of this theory is in decision making of nurses where it helps in reducing medical and clinical errors (Kam, Chismar and Thomas, 2014). Thus, from the analysis it can be said that the theory can be effective for post-exposure prophylaxis. PEP is an critical medication situation where nurses needs to be focused on pharma knowledge and confide of individuals when dealing patients. Moreover, it will be beneficial as it is related to interpersonal team working in health care organisation. Hence, it is important for the person to develop knowledge over cognitive continuum practises as it is related to enhancing one's knowledge over medical services which are patient centred. Involving effectively with patient to which post-exposure prophylaxis is being given is the most effective plan which is supported by cognitive approach of this theory.
For instance, if in case the team of 5 health practitioner are allotted work in team for managing decision for the patient who has been exposed to HIV and within 72 hours he needs to be given PEP, in this case the focus practitioner will be on protecting the person by collaborating efforts like one will focus on knowledge constraints in order to manage preventive and cautious measure. One person will be focused on time management and other three will focus on giving treatment by motivating patients. The collaborative efforts of nurses demonstrate working and decision making via Cognitive continuum theory
As per (The use of cognitive continuum theory and patient scenarios to explore nurse prescribers' pharmacological knowledge and decision-making, 2008), article where the scholar conducted interview for using CCT to explore decision making and pharmacological knowledge of nurses. Nevertheless, the study denotes that majority of participants were unable to answer question for the case studies and proposed scenario, Few individuals were very confident to their solution to problems whereas there were respondents who stated that at the time of critical decision making the individuals refer patient to general practitioner. Thus, from the study, it has been evaluated that social and institutional factors plays an important role decision making of health care practitioner but it is important for the care workers to hold knowledge over pharmacological concepts and needs to have confident when dealing with service users in critical situation. Thus, from this learning, it can be concluded that CCT theory is effective only when the practitioners in cognitive team have coherent idea over medical and clinical setting of health acre organisation.
(Dhami and Thomson, 2012), has discussed about four components of model which states that the approach helps the practitioner in making analytical and intuitive thinking at the time of making decisions. Further, the approach is focused on combination of efforts of nurses in order to make quick ad effective decision. Third phase of theory is based on quasi rational decision making and forth is based on dynamic cognition. The key term so CCT theory are analysis, where the nurses are able to follow consistence and conscious process in health care organisation. It enables high cognitive control and awareness about every specific service user and their education (Starmer, 2010). The special of functions and responsibility in this theory helps the practitioners is setting high cognitive control over clinical and medical setting when working interpersonal teams. Further, the theory is related to coherence, where it focuses on decision making and responsible person of the change. Apparently, it is important for their practitioner to ensure that the final decision made for clinical setting and medication of service need to be proper and specific.
Expected Utility theory
Expected utility theory is proposed by John von Neumann and Oscar Morgenstern, where the author discussed about the prediction and uncertain environment of health care setting. In this the author focused on changing medical intervention with patients. In this, it is the responsibility of practitioner to derive the behaviour of people in different and critical medical situations like post-exposure prophylaxis.. It s related to choices made by nurses in uncertain and emergency situations. In this the author discussed about the decision making of nurses where it is important for the nurses to analyse all the possible outcomes of situation before implementing decision to situation. However, ion accordance to theory it can be argued that medical changes and practices are based on assumption, experience and knowledge. Therefore, when taking any choice for medical setting for patient the practitioner frames all the possible expectation and results which can occur It is the most possible approach to health care organisation which comes with risk and life threatening issues. (Moscati, 2017), has suggested that expected utility theory is beneficial for the nurses to prevent infection and risk to patient with medication because the theory is focused on making pre assumption of health outcomes. Thus, theory can be effective for nurse for its PEP because it is related to prior detailing of medication and clinical setting before relating its to patient.
This theory defines to deal with analysis situation where person make decision without knowing what result are out formed the decisions and those decisions are comes immediately. In nursing practise decisions are take certainty because some patients don't time to take decisions about the patients faster (Johansen and O'brien, 2016). Those types of decision are depended on the agents risk aversion and the utility of other agents. In nursing department they take search decisions according to their patients like some patient are more injuries in that situation they are no thinking much and start conversation one more thinking in the nursing practice they are 24 hours available to having treatments of the peoples (Levy, 2016). This also defined like theory which estimates utility of an action- where there is uncertainty about the outcome. In PEP nursing practice are defined the theory is defined the to take major decision in their profession in certain situation. It also tells about the practices to recover patients in their fields and also help to the person who are in danger situation. Mainly this is decision theory which are held in major situations. For instance, when the nurses are providing PEP treatment to patient where the focus of individual is on 72 hours of exposure. Further, the individual will just assume possible health outcomes after giving PEP which can be assured because of uncertain medical situation. However, assuming health outcomes will the focus of nurses when decision making with the helps of expected utility theory.
This theory help in nursing department to take major decisions and also define the values of the nursing staff. This theory also defined the nurse are the only who take care the patients also take minor decision in certain situation it also helps to understand the all the patients details about the situations. Limitation helps to understand the nursing practices is defined they only take decision in their fields and their patients each department have their own nursing staff appointed in the hospital all the take care of patients and take decision in major situation. They are only one who are closer to patients sand help to define their situation (Alligood, 2017)n. Limitation are in nursing practice they only take decision in their department and their under patients.
Advantages of this theory help to take decision in critical situation its beneficial for the patients and also beneficial in their career. This theory also give advantage in patients treatments like they recover fast and also the critical decision are help to save patient life and also help treatment (Cunningham and et.al., 2014). This theory helps to understand the preparing of personal experience like those decision are help to improve confidence to take certain decisions in the medical department and nursing department capable to take major decision in their fields (Paterson and et.al., 2016).
Apart from this, this theory has less disadvantage but some time nursing departments critical decisions are risk in the hospitals patients are not handled those treatments and they are died ll those blames' arr goes to the nursing department who take decision in major situation. It difficult but its true in nursing department. One more disadvantage to this theory in nursing department each decisions are only demands on the situation on when factors are not in the hospital or they are in hospital and nurses ignore them and they take decisions. In this situation major effects goes to patient health.
Social Judgement theory
Social judgement theory is proposed by self-persuasion theory proposed by Carolyn Sherif, Muzafer Sherif, and Carl Hovlan. The theory offers the most effective plan to practitioners because in with the help of this theory the nurses are able to make medical judgements. The theory is beneficial for PEP experience because it is important for the practitioner to make me quick judgement to emergency situation in order to prevent risk of uncertain medical situation. Apparently, it is related to judgement which arise in risky situation like inevitable error, abundance of fallible cues etc. Like PEP which is given to patient in emergency situation with 72 hours. In accordance to this situation it can be said that it is important for the nurses to make quick decision in order to prevent the risk of lapse. The nursing decision making accordance to social judgement theory varies from patient to patients and also with changes in clinical setting (Dowding and Thompson, 2017). As per social theory, it has been analysed that the medical judgement are instant and for making decision this theory support easy analysis. Accordance, to this procedure the individuals holds knowledge and experience of every medical situation and risks therefore as and when the situation arise the person is able to process instance solution to it by coordinating with past learning, knowledge and experience. It is considered as effective for PEP because it is c
Other type of Samples: -Questions related to business law