Conceptualizations of clinical decision-making: a scoping review in geriatric emergency medicine

Gamborg, Maria Louise; Mehlsen, Mimi; Paltved, Charlotte; Tramm, Gitte; Musaeus, Peter

doi:10.1186/s12873-020-00367-2

Cited by 9 publications

(5 citation statements)

References 95 publications

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“…Of particular note is the potential for a tendency to misinterpret information in favour of previous beliefs, patterns that could be mistaken, and subtle cues often missed by less experienced clinicians (Nagtegaal et al, 2019 ). Previous research suggests biases may be common in the care of older patients who are often given low priority for nursing care when resources are limited (Emme, 2020 ; Evripidou et al, 2021 ; Gamborg et al, 2020 ; Suhonen et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…While urgency, severity or acuteness of illness are often considered by nurses to be the most important criteria for setting priorities, nurses also prioritize care using patient groups, specific diseases, age and the perceived good that care might bring for patients in different clinical settings (Suhonen et al, 2018 ). Older patients, or those not expected to recover, are often given low priority for nursing care when resources are stretched (Emme, 2020 ; Evripidou et al, 2021 ; Gamborg et al, 2020 ; Suhonen et al, 2018 ), despite evidence suggesting prioritizing older patients and high‐intensity interventions can be most effective to avoid harm (Strassner et al, 2020 ). Solutions to address missed nursing care require complex interventions that are flexible, proactive and context specific, focus on what nurses can modify, and build multidisciplinary alliances (Palese et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Nurses' harm prevention practices during admission of an older person to the hospital: A multi‐method qualitative study

Redley

Douglas

Hoon

et al. 2022

Journal of Advanced Nursing

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Background Nurses' harm prevention practices during the admission of older persons to hospital have important consequences for patient safety, preventable patient harm and length of hospital stay. Novel solutions are needed to assist nurses to balance complexity, high workload burden and patient safety during admission processes. Aim Explore the nurses' experiences of harm prevention practices during the admission of an older person to the hospital. Design A multi‐method qualitative study informed by frameworks of behaviour change and human‐centred co‐design. Methods The purposive sample included 44 nurses, 5 clinicians from other disciplines and 3 consumers recruited from five general medicine wards across three hospitals of a large public health service in metropolitan Melbourne, Australia. Data were collected over 12 h of naturalistic observations of nurses during eight patient admissions, and during four participatory human‐centred co‐design workshops between August 2019 and January 2020. Observation, field notes and workshop artefact data were integrated for qualitative content and thematic analysis. Results Analysis revealed a 5‐step journey map, with a temporal logic, that captured nurses' experiences, as well as the enablers and barriers to harm prevention practices when admitting an older person to the hospital. The consensus was reached on three priority features to assist nurses to implement harm prevention practices when they admit an older person to the hospital: (1) prioritize important care; (2) tailor care to the individual and (3) see the big picture for the patient. Conclusion The novel research approach identified five steps in nurses' activities and harm prevention practices during admission of an older person to the hospital, and key features for a solution to assist nurses to keep patients safe. The findings provide the foundation for further research to develop interventions to assist nurses to manage high workloads during this complex activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nurses' harm prevention practices during admission of an older person to the hospital: A multi‐method qualitative study

Redley

Douglas

Hoon

et al. 2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…Correct diagnosis and treatment depend on obtaining complete, reliable data from the patient through a global assessment, which includes history-taking, clinical examination, radiographs, and laboratory tests [6]. Clinical decision-making is an important part of medical education, and has been taught using a variety of methods, including computational strategies, cognitive training, and even sociology [7]- [9].…”

Section: A Serious Games For Clinical Decision Makingmentioning

confidence: 99%

Dental Case, a Brazilian Serious Game for Supporting Decision-making in the Dental Clinic: A Case Study

Huanca,

Garrido,

Teixeira

et al. 2023

EJDENT

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Background: Games are intrinsic to society and are used to represent a wide variety of human activities. Contemporary society has been digitalized, and the habit of playing games has naturally migrated to the digital environment. The use of digital games in education, where they are known as serious games, has given rise to the introduction of new educational approaches for dental students and dentists, which complement traditional approaches. A brief conceptual outline of games can help broaden our understanding thereof in social and educational contexts. Objective: To report the designing and development of a serious game for decision-making in clinical case management in the field of dentistry, for use as a complementary teaching tool. Method: The method used was a case study to describe the development of the content and narrative of a Brazilian serious game for decision-making in the dental clinic, called Dental Case. A player in Dental Case takes on the role of a dentist during a consultation, with the mission of completing the steps of anamnesis, clinical examination, complementary examination, diagnosis, and treatment. The clinical cases presented in the game were designed to resemble real-life decision-making situations in the dental clinic of a primary healthcare setting. The content developed was reviewed and validated by specialists, from both a technical and pedagogical point of view, and then included in the game software by an information technology (IT) team. Results: Dental Case was developed from a set of clinical cases. The game targets dental professionals and students, and its goal is to lend support to the teaching of decision-making in the different stages of clinical care. The game is freely available on the web, and on the Play Store and Apple Store mobile application platforms. Conclusions: The resources made available by Dental Case constitute a new complementary pedagogical approach, and a tool for the application of educational technologies in dentistry, which can contribute to expanding the scale and reach of educational activities. Future research is warranted to investigate the effectiveness of Dental Case in promoting learning and should include an evaluation of its performance by its users.

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“…Assessing CDM in emergency nurses is very challenging because of several related factors such as time and how clinical decisions are made (Gamborg et al, 2020). On the other hand, factors influencing emergency nurses' CDM such as personal values, professional attitudes, and accountability are also important barriers in the care of patients in need of forensic nursing skills (Hosseini et al, 2018).…”

mentioning

confidence: 99%

Clinical Decision Making in Forensic Nursing

Farzadfar,

Jafaraghaee,

Karkhah

et al. 2023

Journal of Forensic Nursing

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Background Appropriate clinical decision making (CDM) is very important for emergency nurses when working with forensic patients with violence-related injuries and can improve patient outcomes. Therefore, it is essential for emergency nurses to have the basic skills to make the right clinical decisions when working with forensic patients. Aim The aim of this study was to evaluate the CDM of emergency nurses when caring for forensic patients. Methods This study was conducted using a cross-sectional design. Nurses working in the seven emergency departments of Rasht hospitals, Guilan Province, Iran, were recruited to take part in the study. Data collection was performed via census sampling from September to November 2019. Data were collected via a two-part questionnaire developed by the researcher(s) that addressed (a) demographic characteristics and (b) simulated scenarios that assessed their CDM in caring for forensic patients. Findings One hundred ninety-two emergency nurses participated in this study. The mean score of CDM in forensic nursing was moderate (56.46; 95% CI [54.49, 58.43]). Of the participants, 60.42% of the emergency nurses had moderate CDM knowledge related to forensic nursing, whereas only 2.8% had desirable knowledge of CDM. There was a statistically significant relationship between CDM in forensic nursing and the history of encountering forensic patients (p = 0.008). Conclusion CDM scores regarding emergency nurses' knowledge of forensic nursing were moderate. Knowledge of and CDM in forensic nursing is very important and provides high-quality safe care for forensic patients. Implications for Clinical Forensic Nursing Practice This study highlights the importance of additional education and professional development in forensic nursing, for emergency nurses, and should be considered further by nursing administrators and nursing educators.

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Conceptualizations of clinical decision-making: a scoping review in geriatric emergency medicine

Cited by 9 publications

References 95 publications

Nurses' harm prevention practices during admission of an older person to the hospital: A multi‐method qualitative study

Nurses' harm prevention practices during admission of an older person to the hospital: A multi‐method qualitative study

Dental Case, a Brazilian Serious Game for Supporting Decision-making in the Dental Clinic: A Case Study

Clinical Decision Making in Forensic Nursing

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