Clinical Decision Making Lilik (2)

8/12/2019 Clinical Decision Making Lilik (2)

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Lilik S

Clinical Decision Making


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PRINCIPLES of PATIENT CARE

Decisions making

Evidence based nursing

Practice guidelines

Assessing the outcome of care

Delivering cost-effective & benefit medical

care

Accountability Continued learning

Research and teaching


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Decision-making

is solving a problem using a systematic

approach of sequenced steps, selecting

an alternative approach, and putting theapproach into action.


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An organizational decision

relates to organizational purpose:

futurity,impact, philosophy or ethics,

uniqueness.


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A personal decision

relates to professional autonomy.


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Manager behavior

Applies decision-making theory and the

problem-solving process in achieving the

mission of the nursing agency.


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Pitfalls of decision making

Inadequate fact finding

Time constraints

Poor communication Failure to follow decision-making steps


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Steps in problem-solving

Systematically collect, organize, and

analyze data related to a specific problem

or need.

Make a plan of action.

Implement the plan.

Evaluate the results.


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Normative model

1. Define and analyze the problem

2. Identify all available alternatives

3. Evaluate the pros and cons of eachalternative

4. Rank the alternatives

5. Select the alternative that maximizes

satisfaction6. Implement

7. Follow up


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VERIFIKASI

Diagnosis Planning, etc

inducto

deducto

hypoteticoverivicative

PARADIGMA PROSES DIAGNOSIS

MEMPELAJARI PENDERITA

DATA DASARMANIFESTASI MASALAH

KELAINANSTRUKTUR & FUNGSI

SINTESIS DIGNOSIS

PERUBAHANMORFOLOGI, SELULER & KIMIA

PATOANATOMIPATOFISIOLOGI

PATOGENESIS

ETIOLOGI

DATA DASAR

MEMPELAJARI PENYAKIT


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Scientific Problem Solving Approach

S.P.S.A.

PROBLEM IDENTIFICATION

EVALUATION DATA COLLECTION

IMPLEMENTATION DATA ANALYSIS

PRIORITY SETTING HYPOTHESIS

FORMULATION

PROBLEM SOLVING HYPOTHESIS

ALTERNATIVE TESTING

CLINICAL PROCESS

HEALTH PROBLEM

FOLLOW-UP ANAMNESA/ P.D./

LAB. / MED-RECORD

IMPLEMENTATION DATA &

INFORMATION

ANALYSIS

TREATMENT DIAGNOSISPRIORITY SETTING SYNTHESIS

TREATMENT DIAGNOSIS

ALTERNATIVES PLANNING


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Making critical decisions

requires critical judgment

the use of knowledge and experience

to diagnose patients and plan their

treatment.


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Critical Decision Making

The ability to anticipate

The ability to prioritize

The ability to problem-solve Relies heavily on knowledge base

An ability to learn from past mistakes


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Bledsoe et al., Essentials of

Paramedic Care: Division 1I

2006 by Pearson

Education, Inc. UpperSaddle River, NJ

Critical thinking is not an action

but a way of life.


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Acuity

The severity or acuteness of your patients

condition


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Protocol

A standard that includes general and specific

principles for managing certain patient

conditions


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Standing Orders

Treatments you can perform before contacting

the medical direction physician for permission


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Algorithm

Schematic flow chart that outlines appropriate

care for specific signs and symptoms


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Paramedics Critical

Thinking Skills (1 of 2)

Knowing anatomy, physiology, and

pathophysiology

Focusing on large amounts of data Organizing information

Identifying and dealing with medical

ambiguity


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Paramedics Critical

Thinking Skills (2 of 2)

Differentiating between relevant

and irrelevant data

Analyzing and comparing similarsituations

Explaining decisions and constructing

logical arguments


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terimakasih

Clinical Decision Making Lilik (2)

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