NURS 321: Leadership Module 8.02

A nurse is caring for a patient that suddenly becomes short of breath and has a decrease in oxygen saturation to 86%. The nurse places the patient on 4 L of oxygen via nasal cannula and elevates the head of the bed. What decision tree would the nurse have used in this situation?

Intuitive judgment

When making a decision about using a prn pool for added staffing, what can the nurse manager do to make the best decision?

Make a decision with all of the facts.

Always make an informed decision based on the evidence whenever possible

Question the first impression. Look underneath the initial judgment to see if something else may be going on. Getting input from others is wise, but too many conflicting opinions can make it difficult to make an accurate decision.

A nurse manager is using the decision-making model 'SWOT' to determine whether it is feasible to add another on-call team in perioperative services. What words does the acronym 'SWOT' represent?

SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. This decision-making model is typically reserved for strategic planning.

5. SWOT

Strengths, Weaknesses, Opportunities, and Threats *typically reserved for strategic planning but can be to evaluate how well an idea or option could be implemented.

Effective nurse leaders have developed critical thinking and decision-making skills that assist with collaborative leadership.

TRUE; The Marquis-Huston Critical Thinking Teaching Model describes the relationship between critical thinking and decision making; this encourages group collaboration and encourages effective interaction between leaders and their subordinates.

5 Decision Making Models

1. Intuition 2. Decision Grid 3. Decision Tree 4. Consequence Tables 5. SWOT

Why Use evidence-based data to validate decision?

After the nurse makes a decision based on intuitive action, an evaluation of the action should be made using evidence-based data to support and validate the decision that was made. It would not be beneficial to compare the action to a replica of the decision. The decision is not able to be plotted over time since it was intuitive.

A nursing staff is presently using disposable biopsy forceps in the endoscopy suite, and the nurse manager is questioning the cost-effectiveness of this practice. What would be an appropriate decision-making model to find a cost-efficient solution?

DECISION GRIDS are visual models that allow comparison of 'apples to apples'. By listing alternative options as well as different criteria, a decision grid leaves a clear comparison of alternatives. Intuitive judgment would best be used when a decision has to be made immediately using intuition. A SWOT analysis is used when strategic planning is necessary. This situation would not require a consequence grid since it is a simple comparison of cost.

Use intuitive judgment when time is of the essence.

This model calls on your ability to recognize patterns and similarities by combining common sense and your professional training and experience. Science is finding that intuition is actually more than 'knowing without knowing how' and is in fact a mental shortcut that happens so quickly you may not be able to articulate the dots your brain connected. A decision grid allows the comparison of 'apples to apples'. SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. This decision-making model is typically reserved for strategic planning. A consequence table is a balance between the decision grid and decision tree.

1. Intuition

This model calls upon your ability to recognize patterns & similarities by combining common sense with your professional training and experience.

A nurse makes a decision using intuitive judgment regarding a patient's rapid change in condition. What action should the nurse take after the decision?

Use evidence-based data to validate decision

3. Decision Tree

Visual aid that evaluates your alternatives not based on known criteria (like the decision grid) but rather based on how each option performs when subjected to situational tests.

When should you use inutuitive judgement?

time of the essence

Strengthen your confidence in your intuitive abilities by....

validating your decision by using evidence-based data after the fact

Decision-making tools such as decision trees or consequence tables are in place to prevent errors in the decision-making process.

FALSE; Human error is always a possibility during decision making, and tools can assist nurse leaders in exploring various alternatives; however, they do not prevent a person from poor or inadequate decisions.

Which of the following is a decision-making tool often used by today's nurse leaders/managers for program/unit evaluation?

FLOW CHARTS are used to develop critical pathways in the health care arena. The critical pathway shows what steps must occur in order to progress to the final step. These charts were first used by the U.S. Navy programs, originally called PERT, which stands for program evaluation and review technique. The other choices are elements of program evaluation and are not considered actual tools.

2. Decision Grid

Great visual models that allow you to compare apples to apples. Left column: options you want to chose from. Across the table": criteria by which you want to judge each option The result = clear comparison of alternatives

Why does intuition have a bad rep?

b/c it was though to lack a scientific foundation BUT it's actually a mental shortcut that happens so quickly that you may not be able to articulate the dots your brain just connected.

4. Consequence Tables

perfect combo of 3&4 Evaluate alternatives against criteria; goal is to rate how well the alternative meets the objective by plotting the consequence of implementing the option