Nursing Practice and Decision Making Essay

Clinical decision making is a vital component in nursing practice which can vary from simple decisions such as advising a patient about healthy eating to more complex lifesaving decisions such as resuscitation (Holland and Roberts, 2013). These decisions do not only have consequences on nurses own personal and professional practice but they could also have detrimental effect on patient’s care and life (Holland and Roberts, 2013). This essay will examine a study case involving Sumita an eleven years old asthmatic girl who has been admitted to the ward after receiving urgent care for an acute exacerbation of her asthma in Accident and Emergency (A&E). First, this paper will discuss what evidence based practice is in order to define and present the theories and processes behind clinical decision making. Secondly, the scene of the study case will be set by giving an explanation of asthma. Eventually, the shared decision making process in Sumita’s care in the ward and her preparation for discharge will be discussed using the four nursing processes in conjunction with Tanner’s clinical judgement model (2006) which is seen as to be a more flexible process that nurse tend to use more.

Evidence based practice has been developing for more than a decade in the National Health Service (NHS). One of the most complete definitions of evidence based practice has been provided by Pape (2003) who defines it at as a ‘combination of the best research evidence, clinical experience and clients’ desires’. The emergence of NHS’ policy initiatives such as national service frameworks, clinical governance by NHS’ Trusts and the establishment of non-departmental public bodies such as the National Institute for Clinical Excellence (NICE) and the Care Quality Commission (CQC) have had a great impact on the quality of professional decision making made by nurses (Aston, Wakefiel and McGown, 2010). Additionally, the change in society and growing complexity in health and health care as well as the need to change nursing into a profession played as well a pivotal role