DECISION MAKING - JOURNAL

PRESENTATION

MRS. SNEHA PRAKASH

FINAL YEAR M.SC (N)
NAVODAYA COLLEGE OF NURSING
RAICHUR

Reference : NNT March 2008

Mrs. Prema. P
Principal
Navodaya College of Nursing
 Objectives

To introduce the topic

To define decision making
To list out the levels of decision
To explain briefly the approaches to decision making
To describe the process of decision making
To mention the decision making styles
To describe the decision making situations and
techniques applied in each situations
To list out the two step process in decision making
To describe the criteria for implementation
 Introduction

• Decision making is the cognitive process leading

to the selection of a course of action among
variations
• It is a psychological construct
• It begins when we need to do something
• It is both managerial and organizational process
 Definitions

• Decision making is a position or opinion or

judgement reached after consideration and
choosing between alternative courses of
action using cognitive processes such as
memory, thinking and evaluation.
• The process of selecting from several choices,
products or ideas and taking action.
• Decision making is the process of choosing the
best from the alternative solutions under a
given set of circumstances
 Cont

• The process of mapping likely consequences

of decisions, working out the importance
of individual factors and choosing the best
course of action to take.
• Decision making is a conscious human
process involving both individual and
social phenomenon based upon factual
and value premises which concludes with
a choice of behavioural activity.
 DECISION LEVELS


STRATEGIC
 Highest level
 Concerns general
directions, long term
goals, philosophies and
values



TACTICAL
 Support strategic
decisions
 Medium range, medium
significance, with
moderate consequences



OPERATIONAL
 Everyday decisions, used
to support tactical
decisions
Approaches
Cont
 Process
Identify and define the problem

Identify the decision to be made

Gather relevant information

Identify alternatives

Weigh evidence

Choose among alternatives

Take action

Review decision and consequences

 Decision Making Styles

A1 : solve the problem or C1 : share the problem with

make the decision by using relevant individual, getting
information available at that their ideas without bringing
time them together in group

A2 : obtained the necessary C2 : share the problem

information from with the subordinates as a
subordinates without their group, collectively obtaining
knowledge and then decide their ideas and suggestions
the solution
Decision Making Situation & Techniques
Applied in Each Situation

• In groups
• In one’s personal life
• In health care
• In business and management
• In clinical nursing practice
 Decision making groups
 TECHNIQUES
• Unanimity
 Requires every one to agree on a given
course of action


• Majority
 Requires support from more than 50% of
the members of the group


• Range voting
 Allows a group to select one option from a
set. The option with highest average is chosen.
 Cont
• Consensus
 Requires the majority to approve the given course of
action and the minority to go along with the course of
action.


• Gathering
 Involves all participants acknowledging each other’s
opinion and tends towards a problem solving approach
in which as many opinions as possible can be satisfied


• Sub-committee
 Involves assigning responsibility for evaluation of a
decision to a subset of a larger group
 Cont
• Plurality
 The largest block in a group decides, even if it
falls short of a majority


• Dictatorship
 One individual determines the course of action


• Participatory
 Each actor would have a say in decisions
directly proportionate to the degree that particular
decision affected by him or her
 Decision Making in one’s Personal life
• Listing the advantages and disadvantages of each
option, and then taking a decision.
• Flipping a coin
• Accepting the first option that seems to achieve
the desired result
• Prayer, astrology, tarot cards
• Acquiesce to a person in authority or an expert
Decision making in health care

 In the health care field, the steps of making a

decision is BRAND which includes :


• Benefits of the action

• Risk in the action
• Alternatives to the prospective action
• Nothing
• Decision
Decision Making in Business and
Management
• SWOT analysis
 evaluation by the decision making individual or
organization of Strengths, Weakness, Opportunities and
Threats with respect to desired end state or objective.


• Analytic hierarchy
 procedure for multi level goal hierarchy


• Buyer decision process

 transaction before, during and after a purchase.


• Cost-benefit analysis
 process of weighing the total expected costs vs. the
total expected benefits
 Cont
• Control ethics
 a decision making framework that balances the
tensions of accountability and best 1 outcome


• Decision trees
 - Programme Evaluation and Review Technique (PERT)
 - critical path analysis
 - critical chain analysis


• Force field analysis

 analyzing forces that either drive or hinder movement
toward a goal
 Cont
• Pareto analysis
 selection of a limited number of tasks that produce
significant over all effect


• Robust decision
 making the best possible choice when information is
incomplete, uncertain, evolving and inconsistent


• Satisfying
 the tendency to select the first option that meets a given
need


• Scenario analysis
 process of analyzing possible future events
Decision Making in Clinical Nursing Practice
• Nursing is a self regulated and competency based
profession where in registered nurses are
accountable for their own practice at all times


• Professional nursing practice must be sensitive,

relevant and responsive to the needs of the
individual client


• The quality of practice help the nurse to achieve the

goal and have a direct impact on the ability to
provide competent and professional care
 Principles
• The practice of nurses must meet the legislative
requirements and standards relevant to the profession


• Nurses should see at no time, client safety or well being

be compromised as a result of changes to nursing
practice


• Nurses are responsible for their own level of competence

and require additional experience and education to
attain and maintain competence


• Health care agency should support competent nurses to

provide a quality outcome for the client


• Health care agencies are responsible for ensuring that

resources are available for determining if a new
procedure is reasonable
 Two Step Process in Decision Making in
Nursing Practice
• STEP I
 Is the new procedure reasonable, appropriate and
consistent with the current professional practice of
nursing.


1. the risks or possible complications and benefits to the

client of performing the new procedure and the
consequences of not performing the procedure.
2. The appropriateness of performing the new procedure in
the particular setting for the specific clients or group
of clients
3. The opportunity to acquire the knowledge and skill to
safely perform the procedure, including the
management of potential complications



 Cont

• STEP 2
 If the procedure is determine to be
appropriate, reasonable and consistent
with current professional practice
proceed to implementation.
 Criteria for Implementation

• There must be a written policy identifying the newly

introduced procedure including conditions or
restrictions on implementation.


• There must an educational programme of theory and

clinical practice to allow the nurse to attain
competence in performing the new procedure


• There must be some form of competency assessment

at the completion of educational programme.
 Cont

• Agencies must determine what is reasonable with

respect to maintenance of competence.


• The agency ensures appropriate resources are

available during implementation.


• The agencies ensures that there are mechanisms for

reviewing and recording the achievement and
maintenance of competence.
•
Thank You