Introduction
Nurses are in direct conduct with the patient and are expected to give health care. In order to provide competent and confident decisions, the nurse requires relevant data for decision making. Sherrod, McKesson & Mumford (2010) have defined decision making based on data as “a systematic process of collecting, analyzing, and synthesizing data; making a judgment about the data; and then making a decision based on the knowledge derived from your judgment in order to improve patient outcomes” (p. 51). This literature review will discuss the use of data in nursing; clinical and administrative healthcare decision making.
Using data for both clinical and administrative decision making in health care
The need for knowledgeable quality service in health care is important and can be achieved by using data in decision making as Sherrod and colleagues (2010) note. Nurses are required to be conversant with challenges in nursing management so that they can be acquainted with concerns that require certain data and also be able to make the appropriate decision (p. 52). The Canadian Nurses Association (2002) states that “the use of higher levels of evidence does not eliminate the need for professional clinical judgment nor for the consideration of the client preferences”. Therefore, decision making based on data entail integrating information based on investigation, with professional in clinical practice together with the client’s opinion (p. 1).
According to Canadian Nurses Association (2002), Data can be obtained from published journals, periodic assessments within the medical institution and books. The nurse should strike a balance between beliefs, clinical decisions, the law, and ethics (p. 1). In order to make informed clinical decisions, the nurse must acquire competent administrative proficiency. Data can be collected collectively. This process includes enlightening all the members of staff in every unit to keep note of comments and complaints as well as record important data. Since the nurses are in direct conduct with the patient, they should also develop be skillful in making informed decisions (Sherrod, McKesson & Mumford, 2010, p. 52).
The aim of using data in decision making is to develop a strategy that will assist in giving adequate care while meeting the requirements of the patient to improve their health and make the right for the right procedure in medical care. There are critical areas where nurses must use data to make decisions like in “assigning unit and shift staffing levels based on patient acuity rates, increasing focus on infection control measures based on patient infection figures and a heightened concentration on service delivery based on patient satisfaction survey results” (Sherrod, McKesson & Mumford, 2010, p. 52).
Banning, M (2007) emphasizes that nurses who gain access to data make a knowledgeable clinical decision. Experience leads to competent decision making even in challenging situations (p.3). According to Goodwin (2003), nurses should be included in policy-making processes in health care since they are familiar with healthcare practices and give applicable information (p. 379).
Sherrod, McKesson & Mumford (2010) argue that informed decisions are based on the administrative nurse’s awareness of procedures and accessible information within the division or unit. In cases where data is not availed, arrangements can be made to gain access to the data. The nurse should also have the dexterity in basic statistical. This will enable them to construe the meaning of the data. It is important to look for relevant data that will be meaningful in decision making. It is of equal value for the nurse to compare the division’s standards with those of other units. The comparison may expose areas that require improvement. Accordingly, the division can raise the standards to become the best in clinical care and in administration (p. 53).
The effect of using data in the information along with the Alliance for Nursing Informatics (2009) findings is that informed nursing leads to satisfactory health care. They interact with patients and may help capture the feelings and progress. The information can be used both in the present and in the future to improve health services (p. 4). Information from patients can be useful in making decisions. Procedures for patient care may be evaluated to measure if they are up to standards. For instance, information concerning the conduct of nurses with patients can be used and improvements are made if there is a need (Sherrod, McKesson & Mumford, 2010, p 53).
A nurse must be conversant with statistical vocabulary to make an accurate judgment. Sherrod et al (2010) point out that the nurse should be able to translate the findings, determine whether they are credible and if the data necessitate a certain course of action. While doing the analysis, every division can be analyzed exclusively (p. 53). Nurses are encouraged to attend seminars because they can be beneficial in learning statistics and refresher training. Computer programs are handy in performing analysis and giving results in a short time with accurate results. The understanding of data and results after analysis makes the nurse confident in decision making (Sherrod et al 2010, p 53). National Council for the Professional Development of Nursing and Midwifery (2009) supports decision making based on data. The data will show areas that might have fewer resources in terms of health care hence resources like medicine and also nurses can be allocated to help meet the health needs of patients. The data after evaluation form a basis for imperative policies that transform health care services (p. 2).
A quality improvement model is significant in making decisions. There are three steps involved in making the quality improvement model a success. First, recognize areas that need a change in the division. Upon discovering the areas, collect data to establish the grounds on which the problem is based. Analyze the data and implement the recommendations. Make it a routine to keep an eye on the progress. The second step is involving the other members of staff by communicating. The staff can also contribute ideas that they may be willing to implement to improve the quality of healthcare. The final step is that the nurse must be informed on issues related to data. Whenever there are questions and misunderstandings, the nurse must be able to explain and guide the other members of staff (Sherrod, McKesson & Mumford, 2010, p 53).
The Alliance for Nursing Informatics (2009) affirmed that technology can provide accessible data to nurses and can be useful in determining the right intervention for a patient. The use of electronic records for patients in the health care clinics assists in giving the health record of a patient easily (p. 3). Delaney et al (2000) argue that nurses can be efficient if they gain access to relevant medical records of patients during patient care and after recovery. They can be helpful in giving clinical advice too (p.176). Computerized data has notably reduced errors associated with the recording and delivery of medication. This is due to the availability of data and the fact that the data is available when needed (Menke et al, 2001 p. 4).
According to Menke et al (2001) data that is computerized is useful in both clinical and administrative nursing. In their study, they observed that the nurses used the required time has been assigned for documenting medical processes without spending more time than required. The end result is that it is possible to improve medical care with the information that is accessible. In administration, a remarkable change in the shift was realized as nurses reported as required. In addition, there were reduced differences in the treatment of patients (p. 6).
Menke et al (2001) indicate that there has been an increase in time spent by nurses giving care to patients after the introduction of computerized data in clinical and administrative nursing. This is because nurses spend less time recording and accessing data using the computer. The computer program can be designed in a way recording information is straightforward. Consequently, the patient benefits from the increased attention from the health care givers (p. 4).
The use of computers for data provides a means for the unit to restrict control and get statistics of the number of people who access health records. To restrict access, the persons who are allowed access are given a password. Upon access, one can get access to patient’s data and be able to compile statistics to monitor any occurrences (Menke et al, 2001 p. 4).
Nurse staffing can be challenging without the relevant data to make the decision. Hall (2006) states that nurses can be overwhelmed with a lot of work and can lead to frustrations. When data from a division is brought for analysis, areas that require more staff can be determined and arrangements can be made to meet the staffing need. This will assist in taming the wrong perceptions about nursing if those who are working are taken care of in terms of workload. Therefore, administrative health care, data will help in measuring the labour of the nursing staff in comparison to the number of patients (p 261).
Nurses often find themselves in a dilemma when required to give intensive care and are faced with ethical issues as stated by Erlen & Sereika (1997). If nurses get data on patients, they would be able to give appropriate medical care to patients after deciding on the best way of giving care to patients using the health records. Decisions are delicate for a patient in the intensive care unit and require informed decision making (p. 954).
Conclusion
Rose et al (2007) argue that nurses play a central role in intervening in medical care. They make a decision based on limited data making a risky decision. They can be given access to data to make informed decisions and thereby providing better health care to patients (p. 443). In a study, Ray found out that nurses require data in order to make decisions when ethical issues are involved (p. 479).
Nurses who make a decision based on reliable data make informed decisions and are confident in giving health care. This contributes to the patients’ safety hence health care is given appropriately. Availability of data reduces chances of error in medication and delays in giving medication.
Reference List
Alliance for Nursing Informatics. (2009).Statement to the Robert Wood Johnson Foundation Initiative Future of Nursing: Acute care, focusing on the area of Technology. Web.
Banning, M. (2007). A review on Clinical decision-making: models and current research. Web.
Canadian Nurses Association. (2002). Evidence-based decision making. Web.
Delaney, C., Reed, D. & Clarke, M. (2000). Describing Patient Problems and Nursin Treatment Patterns using Nursing Minimum Data Sets (NMDS and NMMDS) and UHDDS Repositories, 176-179. Web.
Erlen, J. A. & Sreika, M. S. (1997). Critical care nurses, ethical decision- making and Stress. Journal of advanced nursing, 26, 953-961 Web.
Goodwin, L., Van Dyne, M., Lin, S. & Talbert, S. (2003). Data mining issues and Opportunities for building nursing Knowledge.Journal of Biomedical Informatics 36, 379–388. Web.
Hall, L. (2006). Decision making for nurse staffing: Canadian Perspective.Policy Politics Nursing, 7, 4, 261-269. Web.
Menke, J. A., Broner, C. W., Campbell, D. Y., McKissick, M. Y. & Beckett, J. A. E. (2001). Computerized Clinical documentation system in the pediatric intensive care unit. Web.
National Council for the Professional Development of Nursing and Midwifery. (2009). The Irish Nursing Minimum Data Set. Web.
Ray, M. A. (2008). Ethical dilemmas and ethical decision making in nursing Administration experienced by Head Nurses from regional hospitals in southern Thailand, 26, 5. 469-479. Web.
Rose, L., Sioban, N., Johnston., L & Presneil, J. J. (2007). Decision made by critical Care nurses during mechanical ventilation and weaning in an Australian intensive care unit.American Journal of Critical Care 16, 5, 434-443. Web.
Sherrod, F. McKesson, T & Mumford, M. (2010). Are you prepared for data driven Decision making?Nursing Management, 41, 5, 51-54. Web.