A model of the multidimensional nature of experienced dietitian clinical decision‐making in the acute care setting

2020 ◽  
Vol 33 (5) ◽  
pp. 614-623 ◽  
Author(s):  
R. Vo ◽  
M. Smith ◽  
N. Patton
Keyword(s):  
Decision Making ◽  
Acute Care ◽  
Care Setting ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Acute Care Setting

scholarly journals A Qualitative Study of Clinical Decision Making in Recommending Discharge Placement From the Acute Care Setting

2003 ◽  
Vol 83 (3) ◽  
pp. 224-236 ◽  
Author(s):  
Diane U Jette ◽  
Lisa Grover ◽  
Carol P Keck
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Acute Care ◽  
Care Setting ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Occupational Therapists ◽  
Clinical Decision ◽  
Acute Care Setting ◽  
Rehabilitation Professionals

Abstract Background and Purpose. One of the roles of rehabilitation professionals in the acute care setting is making recommendations for patients' discharge placement. The purpose of this investigation was to explore the decision-making process of physical therapists and occupational therapists when recommending discharge destination for patients following acute care hospitalization. Subjects. Participants were 7 physical therapists and 2 occupational therapists in an acute care rotation at a large academic medical center. Methods. A grounded-theory strategy was used. Three interviews were conducted and guided by questions about participants' approaches to discharge decision making. Information from the interview transcripts was used to define constructs. A model was generated to explain the relationships among the constructs. Results. Decision making regarding discharge recommendations was guided by 4 constructs: patients' functioning and disability, patients' wants and needs, patients' ability to participate in care, and patients' life context. Information was filtered through therapists' experiences and modified by the health care team's opinions and by health care regulations. Discussion and Conclusion. The decision making of the rehabilitation professionals studied in recommending discharge placements for their patients reflects consideration of patients as individuals and the environments in which they live. Information about patients is filtered through the experience of therapists and influenced by health care regulations and opinions of other health care professionals, the patients, and their associates. The findings might be used in teaching clinical decision making to clinicians and students as they learn to make discharge recommendations.

scholarly journals Acute care nurses' perceptions of barriers to using research information in clinical decision-making

2002 ◽  
Vol 39 (1) ◽  
pp. 46-60 ◽  
Author(s):  
Dorothy McCaughan ◽  
Carl Thompson ◽  
Nicky Cullum ◽  
Trevor A. Sheldon ◽  
David R. Thompson
Keyword(s):  
Decision Making ◽  
Acute Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Research Information ◽  
Acute Care Nurses ◽  
Nurses Perceptions

scholarly journals The effect of the quality of vital sign recording on clinical decision making in a regional acute care trauma ward

2017 ◽  
Vol 20 (5) ◽  
pp. 283-287 ◽  
Author(s):  
Claire M. Keene ◽  
Victor Y. Kong ◽  
Damian L. Clarke ◽  
Petra Brysiewicz
Keyword(s):  
Decision Making ◽  
Acute Care ◽  
Vital Sign ◽  
Clinical Decision Making ◽  
Clinical Decision

Clinical impact of a sub-epidermal moisture scanner: what is the real-world use?

2021 ◽  
Vol 30 (3) ◽  
pp. 198-208
Author(s):  
Louisa Musa ◽  
Nicky Ore ◽  
Gillian Raine ◽  
Glenn Smith
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Real World ◽  
Early Identification ◽  
Care Setting ◽  
Clinical Decision Making ◽  
Community Care ◽  
Clinical Decision ◽  
Increased Risk ◽  
Palliative Care Setting

Objective: The presence of sub-epidermal moisture (SEM) over a bony prominence is indicative of incipient pressure ulcer (pressure injury/decubitus/bedsore) (PU). Early identification of patients at increased risk of PU can prompt interventions that reduce the incidence and severity of hospital (or community)-acquired PUs (HAPUs). This study evaluated the clinical utility of a SEM Scanner device in HAPU management. Method: The study used a pragmatic ‘real-world’ approach. HAPU data before and during SEM Scanner use were obtained through routine audit. Patients had regular visual and daily SEM Scanner skin assessments over the sacrum and heels. Nursing care otherwise followed standard of care according to the established protocols of individual participating sites. HAPU incidence rates were determined and feedback gathered from health professionals on how the device influenced HAPU-related clinical decision-making. Results: There were 15 participating sites: 13 acute care, one palliative care and one community care setting. The sample size was 1478 patients. All sites reported a substantial reduction in mean HAPU incidence: 87.2% in acute care settings; 46.7% in the palliative care setting and 26.7% in the community care setting. A 100% incidence reduction was reported in 10 (66.7%) sites. In the palliative care setting, SEM Scanner results changed HAPU-related clinical decision-making for 40% of patients scanned. The community care site demonstrated a 82% change in clinical decision-making. Conclusion: In this study, SEM analysis fitted seamlessly into routine skin assessment and enabled early identification of increased risk of tissue damage, with clinically important reductions in the incidence of HAPU across all participating sites.

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