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Practical use of decision-making frameworks in aged care nursing

LoMonaco, M., McDonald, T., 2010

ERA Conference, Newcastle, Australia

ABSTRACT

Background: Nurses who practise within various aged care contexts invariably work without direct contact with nursing peers while at the same time, directing the nursing work undertaken by care staff teams. Decision-making processes used by nurses in such situations are relatively unknown to other than the practitioners themselves, yet the quality and safety of care pivots on the knowledge and ability of these nurses.

Objective: To understand the uptake by registered nurses in aged care of decision-making frameworks and the relevance of these frameworks to aged care nursing practice. This study combines insights gained through a review of the literature and seven years of aged care nursing experience in Australia to establish a basis for a grounded theory study into this area of nursing practice.

Methods and results: Emergent themes: (1) Clinical decision-making defined; (2) Critical reflection in aged care practice; (3) Nurse competence in clinical decision-making; (4) Typical features of clinical decision-making in aged care; (5) Social factors and communication issues in clinical decision-making; (6) Translation of clinical decision-making frameworks to aged care workplaces.

Conclusions: While research around clinical decision-making processes used by aged care nurses is sparse, there is consistent support for the premise that safe and effective decisions require nursing knowledge and skill in certain areas. These include (i) knowledge of nursing and understanding of problems faced by older people in maintaining or regaining health and function; (ii) skills in assessment, diagnosis and intervention geared to older people with a range of health and functional challenges; (iii) development and application of informed interventions; and (iv) ability to apply research to care contexts in ways that safely guide the actions of the care team.

CITATION LoMonaco, M. & McDonald, T. (2010) Practical use of decision-making frameworks in aged care nursing. Emerging Researchers in Ageing (ERA) Conference, Newcastle Australia. 21-22 October

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