DECISION MAKING PROCESS

Decision Making Process

Introduction

In past decision were strictly based on professional paternalism, and do not deal with complex technologies to crate the trade off. Rates of elective surgery and other discretionary interventions are determined in large part by practice style and, sometimes, by geographic variation in resources.. There are various determinants in the decision-making and was created to: a) health decisions that are stimulated by new circumstances, diagnostic or transitional situations of development, b) health decisions that require deliberation or discussion careful because of uncertainty and the sensitivity of the values involved in the benefits and risks, and c) for the decisions that need relatively more efforts during the discussion or deliberation in the implementation phase (Hebert, Hoffman, 2003). There are many models for decision making process

While there is a growing interest on the part of patients in challenging the paternalistic role of physicians as agents and sole decision makers, there are economic forces that have pulled in the opposite direction. Employers, as payers, have promoted the use of managed care, which challenges the autonomy of physicians but sometimes impose its own rules on clinical medicine; and substitutes the managed care company for the physician as the decision maker. This transfer of agency power to third parties - payers, insurance companies, and health. In health care sectors decision are made through consultation of multi disciplinary team so it has enhance the responsibility to give complete information to the patient. Nurses are continuously facing demands to make decisions of care in clinical settings. It becomes necessary for them to make a choice for decision making although it is considered as a complex process. The complexity of this process requires a broad knowledge and access to reliable source and information (Eidelman, Pizov, Sjokist, 2003). The work environment should also be supportive. The decision which nurses make while providing care will affect the effectiveness of clinical practice and it impacts the experiences and life with regards to the health care provided to them in that reference. It is necessary that the nurse should have sufficient knowledge for making decisions without risking the life of the patients. Decision making in nursing has been discussed on the basis of intuitive-humanist model and systematic-positivist models. There are two approaches which are significant in nursing research which include information-processing theory and analytical decision making theory within the systematic-positivist stance (Barry, 2002).

Analytical decision making provides the knowledge that rational decision making precedes action. For analysis systematic step by step procedures are used that are followed until decision is made. The information processing model is a psychological theory which is used in making decisions and providing scientific approaches to decision making. There are 4 stages of decision making for nurses this includes gathering information about the patient, generating hypothesis about the problem, interpreting the hypothesis in the light if tentative hypothesis, choosing the best option for the hypothesis and choosing the best which fits to the evidence (Sackett, Richardson, ...