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Why we need systematic reviews and initiatives like the Cochrane Library
Published in Debra Evans, Making Sense of Evidence-based Practice for Nursing, 2023
Information from such SRs are not clinical guidelines, although they are used to inform them (see the next chapter) and aren’t meant to be universally prescriptive. Remember in Chapter 1 we discussed clinical decision making does not only rely on evidence, but on clinical experience, patient preferences, and resources. What if the evidence for larval therapy was strong regarding how effective it was at debriding wounds but a patient said they didn’t want it? The SR of RCTs might be there, but it is against the patient’s personal preference. This is where qualitative SRs or qualitative research could be useful to enrich our understanding of patients’ preferences (Booth, 2017).
The role of decisions and judgements as part of the assessment process
Published in Helen Taylor, Ian Stuart-Hamilton, Assessing the Nursing and Care Needs of Older Adults, 2021
Various terms have been used in the literature to describe judgement and decision making, including ‘clinical judgement’3 and ‘clinical decision making’.4 Dowie5 defines clinical judgements as ‘the assessment of alternatives’, whereas a decision is defined as ‘choosing between alternatives’ (p. 8). Thompson and Dowding6 further relate these terms by describing ‘clinical judgement’ as the process and ‘clinical decision making’ as the outcome (p. 8). Cioffi7 regards judgements as the basis of clinical decisions. She uses the analogy of judgement being equivalent to a medical diagnosis, whereas a decision is the evaluation and selection of the most appropriate treatment. Judgements involve an evaluation of information about a patient. Allied with this evaluation is the making of predictions (e.g. on the basis of what is known about this patient’s ability to mobilise, how likely is it that they will fall over?).7
Consumer Health Information Technology
Published in Richard J. Holden, Rupa S. Valdez, The Patient Factor, 2021
Teresa Zayas-Cabán, P. Jon White
Clinical decision-making is one important aspect of care delivery because it involves the individual receiving care or their caregivers. Shared decision-making tools encourage and facilitate communication between clinician and patient and can document how the decision was reached (Finkelstein et al., 2012). These tools can increase consumer understanding of a condition or treatment and improve adherence to recommended management.
Do Flexible Administration Procedures Promote Individualized Clinical Assessments? An Explorative Analysis of How Clinicians Utilize the Funnel Structure of the SCID-5-AMPD Module I: LPFS
Published in Journal of Personality Assessment, 2023
Aleksander Heltne, Johan Braeken, Benjamin Hummelen, Sara Germans Selvik, Tore Buer Christensen, Muirne C. S. Paap
Even if similar results can be obtained in samples of untrained raters, it is important to acknowledge that the funnel structure of the SCID-5-AMPD-I may introduce an additional risk of confirmation bias as compared to standard fixed administration procedures in which all items are administered to all patients. When an initial impression about the patient is not only allowed to, but rather is supposed to, affect decisions about which sections of the interview to administer, there is a risk that clinicians will be more likely to selectively seek information which confirms rather than rejects this initial impression. While there are elements in the interview´s administration guidelines which could limit the impact of administration bias (e.g., the instruction to assess increasing levels until the level under assessment no longer applies), it was beyond the scope of the current study to evaluate the impact of confirmation bias on the administration and scoring of the SCID-5-AMPD-I. Given that the risk of confirmation bias in clinical decision making and diagnostic assessments has been documented in numerous studies (e.g., Crumlish & Kelly, 2009; Mendel et al., 2011; Strohmer & Shivy, 1994) and may be associated with erroneous diagnostic conclusions (Mendel et al., 2011), it is important to address this issue in future research. Before fully embracing the funnel structure of the SCID-5-AMPD-I, we therefore strongly recommend evaluating whether the instrument introduces confirmation bias.
Getting to know our patients and what matters: exploring the elicitation of patient values, preferences, and circumstances in neurological rehabilitation
Published in Disability and Rehabilitation, 2023
Catherine Vingerhoets, Jean Hay-Smith, Fiona Graham
Patient-centred care and evidence-based practice are two cornerstones of contemporary rehabilitation, with patient values, preferences, and circumstances as the common link between these healthcare models [1]. Evidence-based practice encourages clinicians to integrate scientific research, clinical expertise, and patient values (preferences and expectations) to inform clinical decision-making [2]. This approach bolsters the efficiency, quality, and effectiveness of the healthcare service [3]. Patient-centred care promotes “care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions” [4, p.234]. This approach encourages active patient participation, facilitated by positive relationships and shared decision-making with healthcare providers [5,6]. Patient-centred care that is holistic, individualised, and empowering appears to improve quality of care, health outcomes, and patient satisfaction [5]. Integrating patient values and preferences also appears to increase treatment adherence, support patient autonomy, and improve satisfaction with care, leading to better health outcomes [6–8].
The Relationship Between Lifelong Learning Perceptions of Pediatric Nurses and Self-Confidence and Anxiety in Clinical Decision-Making Processes
Published in Comprehensive Child and Adolescent Nursing, 2023
Mukaddes Demir Acar, Cemre Gul Kilinc, Osman Demir
Nursing process is a systematic approach consisting of stages, such as determining the care needs/problems of healthy/sick individuals and their families, planning and implementing necessary nursing interventions and evaluating results. Clinical decision-making is also a fundamental part of the nursing process and the patient care plan adopted by nurses as a problem solving approach. In pediatric nursing, clinical decision-making refers to the correct identification of hospitalized children’s problems and the selection of the most correct nursing-related behavior (Chen et al., 2016; Johansen & O’brien, 2016; Ozden et al., 2018). Nurses are the healthcare professionals who evaluate the data on changes in a patient’s condition, set priorities and take responsibility with the patient and the patient’s family to make the most appropriate clinical care decisions. These decisions directly affect patient care and patient safety (Al Dossary et al., 2016; Choi & Kim, 2015).