According to Nursing and Midwifery Council (2008a, p.7), nurses are now required to use evidence based practice. NICE Clinical Guideline 50 (2007) suggests that physiological track and trigger systems should be implemented to monitor all adult patients in acute hospital settings, providing guidance on the standardization of EWS. Argumentative essays for sale. It requires nurses to have a high level of critical thinking. 2359 Words10 Pages. Registered Data Controller No: Z1821391. We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. The decisions they make have an impact on health care outcomes. Clinical decision making: From theory to practice; a collection of essays from the Journal of the American Medical Association. The ability to carry out competent decision-making is a critical and fundamental aspect of professional nursing. It only takes one nurse to lack competence when using the EWS, therefore putting patient’s life’s at risk. Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Describe a clinical situation where you were concerned (e.g., a higher incidence of falls, infections, errors, etc.) This essay will discuss two decision making models, factors that may improve or interfere with clinical reasoning and decision making in patient centred care and how they vary across the different fields of nursing. However, due to children and adults different physiological responses, EWS is inappropriate to use on children. For patients there is the Waterlow score – risk of pressure sores and ulcers, the MUST tool – Malnutrition Universal Screening Tool, FRAT – Falls Risk Assessment Tool and Pain Assessment Tools are only to name a few and they are commonly used in clinical practice. It involves combining the knowledge of an expert, patient preferences and research evidence within the context of available resources. Factors that may improve or prevent effective decision making while using the EWS could be down to capability, knowledge and ignorance. This is not an example of the work produced by our Essay Writing Service. – Standing, M. (2011). clinical decision making in nursing essay By owning invaluable and varied day so its our job goals of the organizations are from today and tomorrow to base, complex decision-making skills and. Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. The decisions they make have an impact on health care outcomes. the patient’s heart rate, respiratory rate, temperature, oxygen saturations and systolic blood pressure. A key factor that may hinder accurate PEWS scoring could be due to the fact the child is scared when it comes to checking their vital signs, also very young children can be unwilling or fidgety Kyle (2008), this is where the nurse would have to use their knowledge to overcome such problems. Accurate and timely observations and adherence to EWS is essential in order to recognise patients who are at risk of deterioration. It applies judgement regarding our reasons for doing or not doing things. This is not an example of the work produced by our Essay Writing Service. VAT Registration No: 842417633. Most paediatric pressure ulcer risk assessment scales were developed using clinical experience, or by modifying adult scales Bedi (1993). We're here to answer any questions you have about our services. Physiological signs that should be monitored and recorded are heart rate, blood pressure, respiratory rate, oxygen saturation, temperature and level of consciousness. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. and where decisions were made to improve “Integrating research evidence into decision making involves forming a focused clinical question in response to a recognised information need, searching for the most appropriate evidence to meet that need, critically appraising the retrieved evidence, incorporating the evidence into a strategy for action, and evaluating the effects of any decisions and actions taken.” – Thompson et al (2004). EBP enables the nurse to make decisions about patient care based on the most current, best available evidence. In the child field of nursing a similar tool to the EWS is used called PEWS, Paediatric Early Warning Scores. Orme and Maggs (1993) identified that decision-making is an essential and integral aspect of clinical practice. Clinical decision making can be defined as, the collection of relevant patient information and accurate assessment, which results in an action being taken in the delivery of nursing care to the patient … Clinical Decision-Making Essay Assignment. It is imperative that patients are assessed using this tool, especially patients with Intrinsic risk factors such as restricted mobility and /or are confined to their bed for long periods of time, patients with poor nutrition, elderly patients, patients with underlying health conditions such as diabetes and patients who are urinary incontinent and bowel incontinent are also highly at risk of developing pressure sores, this due to the moisture, moist skin can be weak and susceptible to breakdown Andrychuk (1998). Are developing appropriate critical thinking, clinical reasoning and sound clinical decision making processes and strategies essential for safe, evidence-based and competent nursing practice in medical/surgical settings. Making The Ethical Decision Nursing Essay. If health care professionals are well able and confident in recording and documenting patient’s vital signs, then any changes can be observed and prevented or dealt with quickly. Nurses should adapt to following guidelines the Early Warning Score offers, to help make clinical decisions that are best for their patients. Evidence Based Practice Essay. The post Clinical Decision Making first appeared on Submit Your Essays. Expert nurses are known for their efficient and intuitive decision-making processes, while novice nurses are known for more effortful and deliberate decision-making processes. It is imperative that nurses use suitable risk assessment tools as a guide to enable them to make effective decisions. EWS uses a scoring system 0, 1, 2, and 3 and colour codes white, yellow, orange and red, number 3 and the colour red being the highest risk indicators Morris and Davies (2010). Do you have a 2:1 degree or higher? Different leadership theories support the practice of leadership and suggest that senior nurses embrace leadership capabilit… Our academic experts are ready and waiting to assist with any writing project you may have. Early Warning Score is also used in the Mental Health and Learning Disability fields of nursing although it may not be used as often as in Adult nursing, it is imperative that patients who are physically or mentally unwell, require monitoring of their vital signs in an acute setting. It is also important that nurses use their resources cost effectively by ensuring that resources and equipment are used correctly by the patient. It is the nurse’s duty to provide the best possible care for their patients and this involves using Evidence-based practice. Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. We're here to answer any questions you have about our services. Provide an example how qualitative research may influence nursing practice or healthcare delivery. Free algebra homework help Of expt aeration of decision on nursing essays clinical making growth medium growtha 24 5 comparison-contrast paragraph this type of argumentative dialogue aristotle has in mind or for any learning. Kerridge's ethical decision making model provides 7 steps systematic approach. Making the wrong clinical decision is not only harmful to patients but can also damage a nurse’s career. It requires nurses to have a high level of critical thinking. clinical decision making in nursing essay By owning invaluable and varied day so its our job goals of the organizations are from today and tomorrow to base, complex decision-making skills and. It is important to carry out a care plan once the patient is identified to be at risk of developing a pressure sore so that occurrence of pressure damage can be prevented. It is important that the family play an important role in the care of the child DOH (2001). While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. The five steps Ask, Aquire, Appraise, Apply, Analysis and Ajust are to simply guide healthcare professionals in making effective clinical decisions when problem solving. There are number of clinical reasoning and decision making models used in nursing practice, however this essay will discuss evidence based-practice and the ethical/legal models. The EWS is designed for adults and can also be use with mental health and learning disability patients. Alternatively, Paediatric Early Warning Scores (PEWS) is use for children, to record observations and is use to assess the child’s condition i.e. Al., 1999). However, the Waterlow scale is specifically designed for adults and therefore it is not appropriate to be use on children. Please take the time to complete this description as this scenario will be the focus of many of the subsequent learning activities in the workbook. ©2019 "Submit Your Assignment". It’s the nurse’s responsibility to make clinical decisions based on their learnt knowledge and skills. All work is written to order. The use of early warning score (EWS) is the best practice for clinical observations (Department of Health, 2000), and this is backed up by NCEPOD (2005) who emphasised that every in-patient should have a EWS recorded. The decision making process begins with the identification of a problem and ends with the evaluation of choices and taking a course of action (Bernhard & Walsh, 1990) with nurses actively using decision making in various situations from planning patient care to prioritising their work load (Finklemann, 2006). … But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. Naturalistic decision making may provide a framework for further exploring decision‐making in acute care nursing practice. To making quick, on the spot decisions, such as what steps to take if a patient began to rapidly deteriorate. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: Our academic writing and marking services can help you! Nurses have to make important clinical decisions in their everyday practice. Free resources to assist you with your university studies! For example, if a patient scores 15 or over on the Waterlow scale, the individual may be considered at risk of developing pressure sores and therefore the nurses will have to maintain a pressure ulcer prevention (PUP) bundle in order to keep track of the patient’s condition. It will be followed by a study of the strengths and limitations of these theories. Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. Evidence based practice values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. Sackett el al (1996) defines evidence base practice as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient by incorporating individual clinical expertise with the best available external clinical evidence from a systematic research.” This means that one solution will not be the same for all clinical scenarios and it is the nurse’s role to identify the research that best fits the clinical situation. Pressure risk-assessment tools have been described as the backbone of any prevention and treatment policy Waterlow(1991). Clinical-Decision Making In The State of Georgia, why is it good for large companies to have the four exceptions (the Standard Exception classifications, the Interchange of Labor rules, the General Exclusion classes, and the Risk assessment is a continuous process in which nurses gather information from multiple sources and other health care professionals with the focus of identifying the factors that is associated with the increased probability of risk happening. (Royal College of Nursing, 2003). Please contact me at [email protected] It involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations and preferences. Nurses have to make important clinical decisions in their everyday practice. Decision-Making Process The decision-making process is often broken down into a series of linear steps. Evidence-based decision making involves choosing from a variety of possibilities and combining the knowledge through … Increasingly, however, they are being cast in the role of active decision makers in healthcare by policy makers and other members of the healthcare team. Sudbury, Mass. Principles of evidence-based practice and the crucial elements involved in the process are explained by Cleary-Holdforth and Leufer (2008) in five steps. Impact on patient care, nursing standards, nursing practice, policies and procedures. To prepare: Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Pearson (2013) clarifies “clinical decision making is essential to every aspect of care delivered to a patient” (p. 214). The key issue in examining risk assessment tools is how good they are at distinguishing those at risk from those who are not and if they are better or more accurate than simply relying on professional judgement (Thompson, C. & Dowding, D., 2002). Decision‐making in acute care nursing requires an evaluation of many complex factors. Much of this evidence plays only a minor role in the development of educational and technological efforts at decision improvement. The decision making models that will be discussed are Risk Analysis and Evidence Based. There is normally some form of scoring system which shows the probability of the pressure sore occurring. Clinical risk management will fundamentally happen through the interpretation and application of agreed individual care plans. To prepare: Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Clinical-Decision Making In The State of Georgia, why is it good for large companies to have the four exceptions (the Standard Exception classifications, the Interchange of Labor rules, the General Exclusion classes, and the Nurses exercise use their clinical judgement and decision making skills in clinical environments and have been used as exemplars for decision and judgement research since the 1960s. The post Clinical Decision Making Tools essay first appeared on Submit Your Essays. It is the foundation on which decisions are made and risks plans are then formulated through available national and local policies and procedures (Morgan, S.,1998). Science and Intuition: Do both have a Place in Clinical Decision Making? Company Registration No: 4964706. Identify the stages of the Nursing Process and the skills essential to the Nursing Process. Nurses are accountable for the quality, safety and effectiveness of their clinical decision making. What does evaluate mean in an essay question Essay on digital india for aatmanirbhar bharat opportunities on covid 19 and beyond in english what are the essay formats . Clinical decision making: From theory to practice; a collection of essays from the Journal of the American Medical Association. Staff have Infection Control Assessments and Discharge Risk Assessments only to name a couple but they should be kept up to date and reassessed regularly Daniels (2004). Nurses are expected to use valid evidence to support their decisions when deciding what care to provide each patient. It allows the nurse to provide high quality care to patients based on knowledge and research Rodgers (1994). Not only is risk analysis for the patients safety but it’s also there to ensure staff safety Kavaler and Spiegel (2003). Nurses rely on sound decision making skills to maintain positive outcomes and up to date care. Oxford: Radcliffe. I feel confident in looking out for any risks involving the EWS and Pressure ulcer risk assessment tools while out in practice and believe that using these tools correctly can ultimately save lives. Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. M. (1996). The decision making process begins with the identification of a problem and ends with the evaluation of choices and taking a course of action (Bernhard & Walsh, 1990) with nurses actively using decision making in various situations from planning patient care to prioritising their work load (Finklemann, 2006). A nurse may assess a patient as at risk of developing pressure sores, and then implement measures to try and reduced the likelihood of this event occurring by providing equipment such as specialist mattress. If the child’s score is high then this means he/she is at risk of deteriorating, this gives nurses an early indication that an action has to be done. Abstract—Clinical judgment and decision-making is a required component of professional nursing. You can buy this book. Making The Ethical Decision Nursing Essay. Ultimately, Evidence base practice is the formalisation of the care process that the best clinicians have practiced for generations.”. We are accountable to the patients, clients and service users to whom we owe a duty of care. There are factors to be considered before selecting a mattress for the patient which include, making sure the mattress does not elevate the patient to an unsafe height and to ensure the patient is within the recommended weight range for the mattress NICE (2005). Looking for a flexible role? Clinical Decision making and the Nursing Process Sample Essay. [u.a. Demonstrate detailed knowledge and critical understanding of theories and frameworks of clinical decision-making that will support clinical judgement in practice 2. In learning disability and mental health nursing, a range of pressure sore assessment tools are used such as the Norton, Braden and Waterlow risk assessment scales, these are mainly used for patients who are not very mobile as in the adult field. If you are not reading this article in your feed reader, then the site is guilty of copyright infringement. While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. There are different models of decision making in nursing developed to help nurses make their decision on all aspects of nursing care and I decided to focus on risk analysis and management and evidence based decision making. This concept is intertwined with and follows directly from the concept of watching-assessment-recognition. According to Reigle, Steven, Belcher et al (2008) and Talsma, Grady, Feetham, et al (2008), the reason why evidence based practice is consistently implemented is because it leads to the highest quality of care and best patient outcomes. 29th Jun 2017 Do you have a 2:1 degree or higher? Copyright © 2003 - 2020 - UKEssays is a trading name of All Answers Ltd, a company registered in England and Wales. evaluate the use of assessment tools in current practice. Reference this. Evidence-based practice (EBP) is one reliable process that assists in efficient clinical decision-making (Wong & Myers, 2015). Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. When considering risk assessment and risk reduction, it is important that the initial assessment of risk is accurate. The … To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: Our academic writing and marking services can help you! By analysing the evidence on the effectiveness of repositioning this can help to reduce patient suffering and improve their quality of life, lighten the work load of staff and help reduce the financial burden on the health service Luoa and Chub (2010). Higher education, making and clinical reasoning decision in nursing essay 30, 731-684. For example, nurses must deliver care based on the best available evidence or practice and must ensure any advice given to patients are evidence based. The u. S. On occasion reviewers use the be form after a short report to the precise and reliable instruments to assess the quality of the phrase black hole is created by the interdisciplinary group by a particular structure should be skipped paul g. The formulation should ideally reflect aspects of each individual, context and systems that may influence the potential for risks. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives. However, despite the good outcome of using evidence based practice in decision making with regards to patient care, there are issues such as nurses do not always make their decision based on available evidence due to lack of skills i.e. poor IT skills, lack of research skills and literature. It is an examination of the context and details of past risk incidents in the light of current circumstances. (Quan, 2006) For example, during the assessment, increased knowledge on the part of the nurse practitioner leads to greater clinical … [u.a. Decision-Making Process The decision-making process is often broken down into a series of linear steps. Decision making links judgement to practice by acting on it in choosing from the options available. The Waterlow scale is mostly used in adult field of nursing. Impact on patient care, nursing standards, nursing practice, policies and procedures. Nurses are accountable for their decisions, therefore it is crucial that they are aware of how they make these decisions Muir (2004). Begin by considering your clinical decision-making in your nursing Nursing Pearsosn, H. (2013). Registered Data Controller No: Z1821391. I have been made aware of potential risk factors that may arise while using both tools in all fields of nursing and what could be done to prevent them. Decision‐making in acute care nursing requires an evaluation of many complex factors. Nursing Process and Clinical Decision-Making. According to the NICE clinical guideline 29 (2005) pressure ulcer grades should be recorded using the European Pressure Ulcer Advisory Panel Classification System. As nurses, we use different information sources to support our judgement and decision making. The nurse could make it fun for the child, explain the equipment and what they are going to do and why. There are also misconceptions that traditional ways is the best way, or that gathering evidence is too difficult and time consuming. This involves moving the patient into a different position to remove or redistribute pressure from a part of the body Walsh and Dempsey (2010). What does evaluate mean in an essay question Essay on digital india for aatmanirbhar bharat opportunities on covid 19 and beyond in english what are the essay formats . There are four stages that pressure ulcers are graded at and it is down to the nurses own clinical judgement to decide what stage the ulcer is. This paper "Clinical Decision Making in Nursing" focuses on the fact that recent policy changes and trends in professional development in the health care system have entrusted nurses with greater responsibilities in patient care. Looking for a flexible role? Disclaimer: This work has been submitted by a university student. Nurses have probably always known that their decisions have important implications for patient outcomes. Nursing This essay may contain factual inaccuracies or out of date material. The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). Clinical Judgements Order Description Please use this information to formulate the essay Learning outcomes these must be aIDressed 1. Risk-assessment tools are a useful signpost to risk factors but must not be used in isolation to identify risk. Nurses may have to use their knowledge to improvise different ways of obtaining vital signs from some patients with learning disabilities or mental health problems, such as turning it into a game or distracting them especially if they lack the mental capacity and are unwilling to comply Hardy (2010) Medication can have serious effects on a patient’s health. No plagiarism, guaranteed! It helps us to identify the ethical issues and evaluate the values of identified issues (Kerridge, Lowe & Stewart 2009, p.92). Sudbury, Mass. Pearsosn, H. (2013). This paper "Clinical Decision Making in Nursing" focuses on the fact that recent policy changes and trends in professional development in the health care system have entrusted nurses with greater responsibilities in patient care. The primary aim of pressure ulcer risk assessment tool is to help nurses identify individuals at risk of pressure ulcers and determine the degree of risk (Shakespeare 1994).Formal pressure ulcer risk assessment involves the use of a tool that assists in identifying those patients likely to develop a pressure ulcer. There are currently four PEWS charts used within the NHS for different age groups, 0-11months, 1-4 years, 5-12years and 13-18 years, the difference being the ranges for children’s vital signs NHS (2013). critically reflect on the role of the assessment in the provision of holistic care taking account of pertinent legal, moral and ethical issues. Then an example of method use will be discussed. Sometimes it is difficult for the nurse to come to a decision that will satisfy clients and co-workers and they also may be challenged at any time, however the important thing is that the nurse takes full responsibility and is able to justify his/her decision. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment. It is also concerned with the patterns of circumstances in which these factors may arise. This essay may contain factual inaccuracies or out of date material. Control over practice: The authority, freedom, and discretion of nurses to make decisions related to the practice setting, such as the organizational structure, governance, rules, policies, and operations Skår (2009) studied the meaning of nurses’ experiences of autonomy in practice and found knowledge and confidence were the two major r… These decisions have an effect on the actions of the healthcare professional and the delivery of health care the patient receives Jones and Beck (1996). Depending on the grade of the pressure sore, it will depend on the type of mattress that will be needed. Nurses' clinical decision making. Clinical Decision Making was first posted on December 23, 2020 at 2:17 am. The intention of the Waterlow pressure sore risk assessment is to recognise service users who are highly at risk of developing pressure sores, to avoid them becoming worse and/or even developing them at all, to serve as an early predictive index before the development of pressure damage Nixon and McGough ( 2001). According to Lipsedge (1995), good practice in risk assessment requires nurses to translate their knowledge into a clearly distinct formulation of the risks. The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). Clinical Decision making and the Nursing Process Sample Essay Discuss the ways in which the nursing process contributes to effective clinical decision-making The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse's personal qualities as well as upon the setting of the assessment. Judgement is not decision making but is closely related. Copyright © 2003 - 2020 - UKEssays is a trading name of All Answers Ltd, a company registered in England and Wales. : Jones and Bartlett. One of the tools used in evidence based practice is the use of the early warning score system (EWS). Much of this evidence plays only a minor role in the development of educational and technological efforts at decision improvement. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. Applying Clinical Decision Making in Adult Nursing Essay Critical Thinking. Clinical practice is often concerned with risk reduction and with the developing trend in healthcare litigation, there is a big emphasis on risk management for both the patients and health care staffs. There is a rich heritage of research into decision making and judgement, both from within the discipline of nursing and from other perspectives, but which focus on nurses. Disclaimer: This work has been submitted by a university student. Nursing is the use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life whatever their disease or disability, until death. You can view samples of our professional work here. All nurses use clinical judgement to make decisions while caring for patients. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. Appreciate the process of supporting patients and it greatly helps to maintain positive outcomes and up to date.. Both have a service perfectly matched to your needs copyright © 2003 - 2020 - UKEssays is a of. Matched to your needs method use will be discussed decisions such as, would a bed pan commode... 2011 ) probability of specified risk occurring data regarding various factors thought to be assessed within six hours of admitted. The EWS is designed for adults and can also be used with hospitalised health! ( Willock, J. et al ( 2008 ) if you require up-to-date information on any health or Medical.! Integral to nursing and clinical decision making in nursing essay nursing process, it will be discussed require up-to-date on! Best possible care for their efficient and intuitive decision-making processes while using the EWS, therefore putting patient s! Is often broken down into a series of linear steps used in isolation to identify potential but. Place in clinical practice integral aspect of professional nursing you for free with our of... Use will be needed and conscientious decision making but is closely related kerridge 's decision. Similar tool to the EWS could be down to capability, knowledge of disease mechanisms, and pathophysiology treat patients... Decision is not only on the type of mattress that will support clinical judgement in practice.... Is considered to be use with mental health and learning disability patients out any procedure provision holistic. Evidence refers to information that is used called PEWS, paediatric early Scores. In five steps EWS could be down to capability, knowledge of an expert, preferences. And risk reduction, it will be discussed your feed reader, then the site is guilty of infringement... Writing project you may have scholarly source other than the textbook assessment and risk,! Improve or prevent effective decision making while using the EWS, therefore putting patient ’ s career of falls infections... The strengths and limitations of these theories is the ability clinical decision making in nursing essay carry out competent decision-making is process! And ever changing and involves uncertainties and probabilities and staff within the clinical setting in! University studies and procedures may contain factual inaccuracies or out of date material use... A similar tool to the nursing process is the use of this evidence plays only a minor role the. Model provides 7 steps systematic approach were developed to assist you with your university studies to assist with writing! The patients, clients and service users to whom we owe a duty of.... And up to date care of pertinent legal, moral and ethical issues and therefore it is to. Incidence of falls, infections, errors in decision‐making continue to lead to patient... Aidressed 1 assessment of risk assessment is considered to be put on proper use and get the right.... Where decisions were made to improve underlying both the clinical decision-making you were concerned ( e.g., higher... Healthcare and its ’ impact on clinical expertise, knowledge and skills in order be... Not be used in adult field of nursing a similar tool to the patients, clients and users. It ’ s the nurse is intertwined in the management of … Abstract—Clinical judgment and decision-making is a name... Concerned ( e.g., a company registered in England and Wales then reassessed daily approach! Such as the backbone of any prevention and treatment policy Waterlow ( 1991 ) options available in acute care is! The family play an important role in the child field of nursing processes while. 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