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7/26/2019 clinical decision making lilik (2).pptx
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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-eective & benetmedical 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
ime constraints
!oor communication "ailure to follo# decision-making steps
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Steps in problem-solving
$ystematically collect, organize, and
analyze data related to a specific problem
or need.
%ake a plan of action.
Implement the plan.
&valuate the results.
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Normative model
'. (efine and analyze the problem
). Identify all available alternatives
*. &valuate the pros and cons of eachalternative
+. ank the alternatives
. $elect the alternative that maimizes
satisfaction/. Implement
0. "ollo# up
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1&I"I2A$I
Diagnosis Planning, etc
inducto
deducto
hypoteticoverivicative
PARADIGMA PROSES DIAGNOSIS
MEMPELAJARI PENDERITADATA DASAR
MANIFESTASI MASALAH
KELAINANSTRUKTUR & FUNGSI
SINTESIS DIGNOSIS
PERUBAHANMORFOLOGI, SELULER & KIMIA
PATOANATOMIPATOFISIOLOGI
PATOGENESISETIOLOGI
DATA DASAR
MEMPELAJARI PENYAKIT
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cientic Problem olving A!!roach
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 DIAGNOSIS
PRIORITY SETTING SYNTHESIS
TREATMENT DIAGNOSIS
ALTERNATIVES PLANNING
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Making critical decisionsrequires critical judgmentthe use of knowledge andexperience to diagnosepatients and plan their
treatment.
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Critical Decision Making
The ability to anticipate The ability to prioritize
The ability to problem-sole !elies heaily on knowledge base"n ability to learn from past
mistakes
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3ledsoe et al., Essentials of
Paramedic Care: Division 1I
4 )55/ by !earson
&ducation, Inc. 6pper$addle iver, 78
9ritical thinking is not an
action but a #ay of life.
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Acuity
The seerity or acuteness of yourpatient#s condition
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Protocol
" standard that includes general andspeci$c principles for managingcertain patient conditions
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Standing Orders
Treatments you can perform beforecontacting the medical directionphysician for permission
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Algorithm
%chematic &ow chart that outlinesappropriate care for speci$c signsand symptoms
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Paramedics Criticalhinking Skills !" o# $%
'nowing anatomy( physiology( andpathophysiology
)ocusing on large amounts ofdata *rganizing information
+dentifying and dealing withmedicalambiguity
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Paramedics Criticalhinking Skills !$ o# $%
,ierentiating between releantand irreleant data
"nalyzing and comparing similarsituations
xplaining decisions and
constructing logical arguments
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terimakasih
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