In our daily lives we all make decisions, big and small. Because we work in an ever-changing complex environment, professional nurses need to be highly skilled at decision making and problem solving. Professional nurses also need to be adept at critical thinking. In this module, we will review the concepts of decision making, problem solving and critical thinking. Next we will review how using the steps in evidence-based practice (EBP) can help us become better leaders and managers.
Decision making is a core element for leadership and management. It is a learned skill that improves with practice. The decision making process begins with a problem, but often does not eliminate the problem after the decision is made. Making a decision is a complicated cognitive process, requiring understanding of many concepts. Problem solving, on the other hand is a part of decision making that involves analyzing a situation prior to decision making. Critical thinking, involves the examination of the meanings of items, evaluating the evidence and forming judgments based on facts. Many different types of decision making tools exist including decision grids, payoff tables, decision trees, consequence tables, logic models and program evaluation and review techniques. (Marquis & Huston, 2017).
In order to make the best decision possible, it is important to have the best possible evidence available. We can gather the best evidence from the literature. The six steps in using evidence-based practices include asking, acquiring, appraising, aggregating, applying and assessing. These steps are appropriate for patient care, making leadership decisions and making decisions in everyday practice. The literature has shown the evaluation of each of these phases increases the probability of a positive outcome. Evidence can come from many places including scientific evidence, organizational evidence, experiential evidence and stakeholder evidence. Of course, we should always critique the evidence and use information from the best available evidence to make our decisions (Barrends, Rousseau & Briner, 2014).
Using evidence-based practice is not only important in the clinical domain of healthcare but also in management. When evidence-based practices are applied to management, the term becomes evidence-based management (EBM). EBM has to do with using different research based findings to support data based decision making, therefore creating positive patient outcomes. Research has shown that those who use EBM for their decision making, are more likely to have their ideas accepted by others (Shingler-Nace, 2017).
This module addresses the following Course Learning Outcomes listed in the Syllabus for this course:
- Critique evidence-based practice literature as it applies to leadership and management.
Upon completion of this module, the student will be able to:
- Use the steps in EBP in management to realize the function of EBM.
Readings and Resources
- Read: Chapter 1 – Decision Making, Problem Solving, Critical Thinking and Clinical Reasoning: Requisites for Successful Leadership and Management. Marquis. B.L. & Huston, C.J. (2017). Leadership roles and management functions in nursing. (9th ed). Philadelphia, PA: Wolters Kluwer.
- Read: Barrends, E., Rousseau, D., & Briner, R.B. (2014). Evidence based management: The basic principles. Retrieved from: https://www.cebma.org/wp-content/uploads/Evidence-Based-Practice-The-Basic-Principles-vs-Dec-2015.pdf (you will need Adobe Acrobat Reade (Links to an external site.)r to access this file).
- Read: Shingler-Nace, A. (2017). A pathway to EBM evidence based nursing management. Nursing, 47(2), 43-46. doi: 10.1097/01.NURSE.0000510744.55090.9a
In healthcare settings, medically obtained infections are prevalent. Nevertheless, it is the responsibility of healthcare practitioners to do everything possible to reduce, if not eliminate, these risks. Furthermore, poor results are prevalent inside healthcare institutions, even when various types of drugs are delivered (Weber, Castrillon & Ramsey-Coleman 2018). Intravenous infiltrations and extravasations have been found as major factors to poor outcomes of drugs delivered to hospitalized patients. IV infiltrations are complications that arise as a result of fluid infusion into the tissues around the venipuncture sites. Extravasation, on the other hand, alludes to the unintentional entry of a medication within the IV site (Weber, Castrillon & Ramsey-Coleman 2018). This reflective journal outlines the essential elements and regions that must be considered while obtaining evidence-based data on suggestions to reduce IV infiltrations and extravasations.
Six Questions and Evidence
When considering the limitations connected with IV infiltrations and extravasations, various questions might be considered. When obtaining such data, one of the most crucial questions to ask is “what are the major causes and factors that facilitate the occurrence of intravenous infiltrations and extravasations?” This question is significant as it sheds light on how IV infiltrations and extravasations happen. The second question would be what are the impact of IV infiltrations and extravasations on other medications and the patient? Through this particular question, the researcher will be able to acquire the necessary information on infiltrations and extravasations that affect the body of the patient including the pathophysiology of this particular process. The third question in gathering data on the subject pertains to the dangers of IV infiltrations and extravasations both on the patient and other drugs administered during intravenous therapy. Therefore, the question will be, what are the effects of IV infiltrations and extravasations?
The fourth question pertains to the prevention mechanisms that can be put in place to eliminate the frequent occurrence of IV infiltrations and extravasations. “What the measures that can be undertaken by healthcare providers and healthcare facilities to reduce IV infiltrations and extravasations? This question is very important as it will provide answers that will guide nurses on the most appropriate ways of administering effective intravenous infiltrations. Answers to this particular question will help enhance the outcome of IV therapy. The fifth question is “what are the main challenges facing healthcare facilities in curbing IV infiltrations and extravasations while the last questions will inquire on the gaps in research in relation to IV infiltrations and extravasations. Data on this subject will be gathered from scholarly papers that have been written on the subject. Since it is a common issue that has been extensively researched, there is a possibility that the necessary information can be drawn from secondary sources particularly scholarly papers and journal reviews.
Obtaining Resources and Misconceptions
The sources for this particular study can be obtained from credible medical databases such as PubMed, EMBASE and Cochrane Library. Regarding misconceptions about evidence-based practice, one of the common misconceptions is that evidence means quantitative (Parahoo, 2017). This is not true since evidence refers to information as long as it is valid. Another misconception is that EBP means healthcare providers cannot engage their professional expertise in practice. This is a misconception since expertise. Lastly, there is a misconception that experts are aware of all the evidence (Parahoo, 2017). This is a misconception because there are moments when experts can be biased based on the limited information they have.
In conclusion, healthcare provision is a complex service that calls for regular research and the use of the evidence-based practice to deliver quality services. Through the proper use of the evidence-based practice, there is a possibility that the challenges associated with IV infiltrations and extravasations will be eliminated on its own is a form of knowledge. Also, a common misconception is that evidence proves things. This is not true because the evidence is only used to show the likelihood of basing on available information.
Parahoo, K. (2017). Evidence-Based Practice: misconceptions and challenges. Print.
Weber, E., Castrillon, K., & Ramsey-Coleman, J. (2018). Peripheral Intravenous Infiltrates: Engaging Staff to Increase Reporting. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 2(1), 6.