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Ä deLaune and Ladner (2006) ³ considering


and selecting interventions from a repertoire
of actions that facilitate the achievement a
desired outcome´
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- -dentify the need for a decision
-- etermine the goal or outcome
--- -dentify alternatives or actions along with the
benefits and consequences of each action
- ecide which action to implement
 valuate the decision
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Ä ecision Making is made up of 


 
  
 

  

 


ðaul (1992) ³thinking about your thinking while


you¶re thinking in order to make your thinking
better´

-gnatavicius (2001) ³ purposeful, outcome-


directed thinking that is based on a body of
scientific knowledge derived from research
and other courses of evidence´
 

rhe critical thinker


asks  !
"  about a
situation to arrive
at the best
decision
 

our basic skills of Critical rhinking

A Critical reading
B Critical listening
C Critical writing
 Critical speaking
    

ðesut and Herman (1999) watching and


observing ourselves as we perform a task or
make a decision about a particular situation
We have two selves, the active self and the
reflective self      # 
    

 $
rhe reflective self acts as observer and
offers suggestions about the activities
    

Ôurse educators assists students to become


better reflective thinkers through the use of a
clinical journal
  

-ntuition and intuitive thinking ³ innate feeling


that nurses develop that helps them to act in
a certain situations´ (Gardner, 2003)

-t has also been described as a gut feeling that


something is wrong -ntuitive thinking may
result from unconscious assessment and
analysis of data based on an individual¶s past
experience
ð% &

ðroblem solving is an active process that starts


with a problem and ends with a solution
ð% &

rhe problem-solving process


a -dentify the problem
b Gather and analyze
c Generate alternatives and select actions
d -mplement the selected action
e valuate the action
ð% &

-t has similarities with nursing process but the


difference is «« one is used with the
patient in mind and the other is used
anytime, anywhere
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Ä ecision Making Grid


Ä ðrogram valuation and Review rechnique
(ðRr)
Ä ecision rree
Ä Ganntt Chart
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(


-t may help to separate multiple factors that


surround a situation

Useful when trying to decide between two choices

etermine the priorities when developing a grid


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(

ð
)  #
 " *ð)+

Useful in determining the timing of decisions

rhe flowchart provides a visual picture


depicting the sequence of tasks that must
take place to complete a project
ð
)  # " *ð)+
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Useful in making alternatives visible


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Useful in making alternatives visible


˜ 

ecision makers use to illustrate a project from


beginning to end
  
'

Computer technology has many


uses to support information
system for nurses

Many nurses today are using ðA


(use medication administration
and accessing the literature,
information on pathophysiology,
nursing care plans, and nursing
diagnosis)
˜|  

roday¶s leadership and management styles


include people in the decision-making
process who will be most affected by the
decision

ecisions affecting patient care should be


made by those groups implementing the
decisions
˜|  

rhe effectiveness of groups depends greatly


on the group¶s members, the size of the
group and the personalities of group
members More ideas are generated with
groups, the acceptance of the decision is
likely to occur, and groups can be a medium
of communication
˜|  

Major disadvantages

rime involved, more costly and can lead


to conflict
 " ˜
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 " ˜| 


 

Ôominal Group rechnique

elphi rechnique

Consensus Building

Group rhink

 "

rhe word nominal refers to the nonverbal


aspect of the approach

teps :
Ä irst step ± no discussion rhe group
members write out their ideas or responses
to the issue or question

 "

teps :
econd step ± presentation of the ideas to the group
members along with the advantages and
disadvantages -deas are presented on a flip board
or chart

rhird step ± offers an opportunity for discussion to


clarify and evaluate ideas

 "

teps :

ourth step ± private voting of ideas


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-t differentiates from the nominal technique in


that group members are not meeting face
to face instead questionnaires are
distributed and then summarized

rhe process continues on as many times so as


to reach a consensus among the group
 ,


All group members can live with and fully


support the decision regardless whether
they agree or not
˜ 

rhe goal is for everyone to agree 100% Group


think discourages questioning and
divergent thinking -t hinders creativity and
usually leads to inferior decisions
˜

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± Group members develop an illusion of
invulnerability
± tereotyping others
± Group members reassure one another that their
interpretation of the data and their perspective on
the matter are correct regardless of the evidence
showing otherwise
˜

&
 
 
Appoint group members to roles that evaluate how
group decision making occurs

ncourage all group members to think independently


and verbalize their individual ideas

Allow the group some time to gather further data and


reflect on the data already collected
G)  | 
 

Limitations to ffective ecision Making

Ä Jumping to conclusions without examining the


situation thoroughly
Ä ailing to obtain all of the necessary information
Ä Choosing decisions that are too broad, too
complicated or lack of definition
Ä ailing to choose and communicate a rational
decision
Ä ailing to intervene and evaluate the decision or
solution appropriately«
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trategies to strengthen the nurses¶ role in the
decision making for patient care

Ä mpowering the patient in a manner that will


ultimately promote a more positive outcome
Ä Comfort with decision making improves with
experience
Ä Have all the needed information to make a decision
Ä Anticipate questions and outcomes
Ä rurn decisions with poor outcome into learning
experiences«

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