2201NRS Clinical Decision Making in Nursing

Running Head: 2201nrs Written Assignment: Assessment 1 - Structured Essay
2201NRS WRITTEN ASSIGNMENT: ASSESSMENT 1 -
STRUCTURED ESSAY

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2201nrs Written Assignment: Assessment 1 - Structured Essay
Table of Contents
Introduction................................................................................................................................3
Part A.........................................................................................................................................3
Part B..........................................................................................................................................4
Conclusion..................................................................................................................................6
Reference list..............................................................................................................................8

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2201nrs Written Assignment: Assessment 1 - Structured Essay
Introduction
Proper clinical decision making (CDM) helps to increase competence of nursing
practice and helps to provide high-quality care. In this essay, the influence of a key factor in
CDM has been discussed in the context of the work environment. Moreover, one discussion
is done about one health information technology that is used in supporting patients.
Part A
There are different factors that influence CDM, which include lack of knowledge of
procedures, experience, resources, and others. Lack of knowledge about procedures is a key
factor that influences CDM for nurses involved in monitoring patients. This factor is created
due to various issues in the workplace. This includes lack of training of nurses, considering
knowledge provision as a low priority task and due to scarcity of knowledge-sharing
platform.
Lack of knowledge of nurses impacts on the confidence level of nurses and creates a
barrier in collecting information from patients while monitoring them. Lack of knowledge of
nurses inhibits the capability of nurses to make innovative decisions and the flow of ideas
gets limited. The monitoring process gets affected due to knowledge gaps and desired patient
outcomes cannot be achieved.
In the clinical reasoning cycle, knowledge is essential for achieving different steps
like process information and problem identification. As opined by Levett-Jones et al. (2010),
knowledge is essential while interpreting subjective or objective cues. Analysis of data is
essential in the step of processing information, which can be done through the help of
knowledge and skills. Moreover, during the step of expertise and knowledge must be used to
make a proper diagnosis of the problem. Improper diagnosis can impact the treatment process
of patients. Hence, the lack of knowledge also hampers the clinical reasoning cycle.

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2201nrs Written Assignment: Assessment 1 - Structured Essay
Lack of knowledge about different procedures creates a dilemma in practice because
awareness about personal and professional accountability is low (Bucknall et al. 2016). A
nurse with good knowledge is able to make a proper judgment by assessing the cues.
Inadequate knowledge about a specific medical condition decreases the capability of a nurse
to make proper decisions. This causes a delay in the treatment process of an individual.
Moreover, Campbell, Massey, Broadbent & Clarke (2019) argued that nursing knowledge is
evolving and regular knowledge gathering is essential to make proper decisions. Lack of
regular knowledge-gathering creates a gap and different updated techniques of nursing
practices cannot be learned. Hence, it can be stated that a lack of knowledge decreases the
professional status and decision-making ability of a nurse.
Part B
The technological revolution is helping the healthcare sector to assess and monitor the
health condition of patients easily. According to Klecun, Zhou, Kankanhalli, Wee, & Hibberd
(2019), this industry is providing better care to patients through using Healthcare Information
Technologies (HITs). HIT refers to technological devices that allow nurses to store, share and
evaluate health information of patients and these devices can increase the accuracy of
treatment given. Common HITs include Electronic Health Record (EHR), Medical Practice
Management System, and Remote Patient Monitoring, E-prescribe software, Patient Portal,
Master Patient Index (MPI), Medical Billing Software and others. These technologies have
different features that can support nurses to perform their responsibilities within a healthcare
setting.
Electronic Health Record (EHR) is commonly used by nurses to record medical
information of patients. In the early days, nurses used to record all vital signs on paper.
However, after the technological revolution, it has become possible to fill up a form on EHR
to record information related to the health of patients. As mentioned by Nesheva (2019)

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2201nrs Written Assignment: Assessment 1 - Structured Essay
stored information on this device can be managed and consulted by authorized physicians.
Moreover, it helps to summarize different types of health information of patients that have
been collected from different sources.
It allows nurses to share information with patients with other team members and it
helps to make the right decisions based on the present condition. Ko, Wagner & Spetz (2018)
have stated that EHR can be accessed easily by using a computer or mobile device. The use
of EHR allows the efficiency of care giving and it saves time on medication.
The technology of EHR impacts positively in better patient’s assessment processes
because it helps to provide accurate and complete information about patients. Moreover,
Ko, Wagner & Spetz (2018) stated that it helps in quick access to patient records that
facilitate efficient care in a timely process. This technology positively supports the sharing
process of electronic information in a secure way with other clinicians or patients. Thus, the
diagnosis process gets facilitated and reduction of medical errors can be seen. More accurate
decisions can be taken through this technology because it helps in integrating information
about patients from different sources. Privacy and security of patients can be maintained as it
helps to maintain the confidentiality of data. On the other hand, nurses can maintain work-
life balance and improve their productivity as this technology helps in bringing peace in the
procedures.
The technology of EHR has some potentially negative impacts on patient assessment
and care. This includes overdependence on technology and loss of own decision-making
skills. Jacobs et al. (2019) stated that overdependence on technology is a serious issue and
breakdown of technology can impact the productivity of an organization. Moreover, changes
in the power structure can occur in the workplace. For example, a doctor may lose autonomy
to make decisions about a patient. This is because EHR blocks ordering certain tests and
medications.

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2201nrs Written Assignment: Assessment 1 - Structured Essay
EHR supports care coordination and team-based care. According to Chan, Kharrazi,
Parikh & Ford (2016), this device helps to share medical information among medical care
team members, so that they can discuss and make the appropriate decision at the right time.
Coordination between medical team members increases and it allows each member to be
involved in the process of clinical decision-making. EHR provides sophisticated data
analytics that helps in clinical decision-making. On the other hand, Rathert, Porter, Mittler &
Fleig-Palmer (2019) have contradicted that EHR is reducing the rate of medical error through
its unique features of detecting dosing error, giving allergy and drug interaction alert to
nurses. Clinically important as well as relevant links are there in the EHR system that
influences physicians to compare and contrast the most recent information regarding the
suspected disease during making clinical decisions. It means that this feature of EHR is
allowing healthcare professionals to make decisions after analyzing the problem set of a
patient with reference to current relevant information. As contradicted by Kruse et al. (2017),
the pretest probability calculator and the clinically scoring tools of EHR technology help a
physician to select the particular medical information of a patient that can guide to diagnose
the disease fast.
However, some features EHR are preventing the health care sector to make clinical
decisions accurately within the minimum time. For example, Jacobs et al. (2019) have stated
that poor usability and a time-consuming process of data entry through EHR can be
considered as barriers to making appropriate clinical decisions at the right time in the right
situation.
Conclusion
From the entire discussion of this essay, it can be concluded that without sufficient
knowledge nurses may face difficulties in processing information. On the other hand, it has

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2201nrs Written Assignment: Assessment 1 - Structured Essay
been understood that HIT has both positive and negative sides. It is the duty of healthcare
professionals to use the benefits of HIT to improve the quality of care.

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2201nrs Written Assignment: Assessment 1 - Structured Essay
Reference list
Bucknall, T. K., Forbes, H., Phillips, N. M., Hewitt, N. A., Cooper, S., Bogossian, F., &
First2Act Investigators. (2016). An analysis of nursing students’ decision‐making in
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Campbell, K., Massey, D., Broadbent, M., & Clarke, K. A. (2019). Factors influencing
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2201nrs Written Assignment: Assessment 1 - Structured Essay
Jacobs, M., Boersma, L. J., Swart, R., Mannens, R., Reymen, B., Körver, F., ... & Dekker, A.
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