NFDN 2008

Unit 1: Roles and Responsibilities of the

Graduate Practical Nurse

Topic 1.2
Leadership in Nursing: Problem Solving and
Decision-making
Problem Solving

and

Decision-making

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Learning Objectives

Explore problem solving and decision-making.

Explore critical thinking in relation to nursing problem

solving and decision making

Application through individual or group exercise

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Problem Solving and
Decision-making

Problem Solving
By reducing the difference between current and desired
conditions

Decision-making
Choosing a preferred a course of action from a set of
alternatives.

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 How is Problem Solving different form
Decision Making?
Problem Solving
• Define the problem
• Gather data
• Analyze the data
• Develop solutions, decision
making
• Select solutions, decision
making
• Implement the solutions
• Evaluate the result
Decision Making
• Define the problem
• Identify goals
• Decide how you will meet each
goal
• Think about level of importance of
each goal
• Think of alternative solutions or
options
• Decide on your optimal choice
that meets each goal
Critical Thinking
“the intellectually disciplined
process of actively and skillfully
conceptualizing, applying, analyzing,
synthesizing, and/or evaluating
information gathered from, or
generated by, observation, experience, reflection,
reasoning, or communication to belief and action”
(Glaser, 1941)

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Critical Thinking in Practice
• involves recognizing problems and
finding ways to solve them by
gathering pertinent information,
appraising evidence, and evaluating
arguments.
• Careful analysis and judgement to
come to a conclusion.
• Examination and testing of beliefs,
assumptions and relationships in
light of evidence to reach valid
conclusions.

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Not using Critical Thinking can negatively
impact patient care

• Purposeful thinking Verify beliefs, actions and

• Solid reasoning conclusions

• Relevance Continuous cycling of

• Look at both strengths relevant clinical information
and limitations
• Weigh evidence Simply accumulating
knowledge is not enough!
• Discriminate among
possible choices Health care workers often
fail to question the validity
of recommended practices
Methods of Problem Solving and
Decision Making
Intellectual Processes

• Scientific method
• Nursing process
• Problem-solving process
• Decision-making process
Intellectual Processes

• Ethical decision making

• Creative decision making
• Shared decision making
• Critical thinking
Creative Decision-Making

• Lateral or Appreciative inquiry

divergent thinking • Define the
problem
• Discover
• New and
imaginative ideas • Dream
• Design
• Deliver
Intuitive Decision-Making
• Subconscious integration of all the experiences,
conditioning, and knowledge of a lifetime

• Without conscious thought

• Role of intuition in nursing

Factors That Affect the Quality of Decisions

• Individual decision biases

• Group decision biases

• Fallacies

• Personal attributes
Applying the Problem Solving Process
• Define the problem
• Gather data
• Analyze the data
• Develop solutions
• Select solutions (purposeful inaction)
• Implement solutions
• Evaluate the results
Rational Decision Making Model
• Be aware of assumptions.

• Set goals first; then state and weight criteria

according to importance.

• Next, generate alternatives, and rate each alternative.

• Lastly, evaluate each alternative to see which is best.

Bounded Rationality Model
• Satisficing decision
• Optimizing decision
• Fishbone diagram
• Ms (methods, machines, manpower, materials)
• Ps (place, procedure, people, policies)
• Ss (surroundings, suppliers, systems, skills)
 Clinical Judgement Model
Phases
• Noticing
• Interpreting
• Responding
• Reflecting
• Clinical reasoning
• Clinical journaling

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Group Decision Making

• Criteria
• The decision must be of high quality.
• All who are responsible for the implementation
must accept the decision.
• Advantages
• Challenges
• Strategies
Leadership and Team Development
• Shared decision-making
• Team development
• Coordination, cooperation and communication
• Team Competencies
• Group performance dynamics
Team Decision Support Tools
• Electronic meetings
• Brainstorming
• Six thinking hats
• Nominal group technique
• SWOT (strengths, weaknesses, opportunities,
and threats) analysis
6 Thinking Hats Decision Making Tool
Uses different Colors for different Roles
Black Hat - Negative, Critical
Blue Hat – Rational, Decisive
Green Hat – Creative, Innovative
Red Hat – Intuitive, Emotional
Yellow Hat – Positive, Optimistic
White Hat – Objective, Factual
Each role has a different
color and uses a different
style of thinking.
As participants of the
group switch from one hat
to another, they are able
to examine and reconsider
their own style of thinking
and how it affects their
own decision-making and
problem solving.
Yoder-Wise (2015). P 120
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Questions
????

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