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Application of the Evidence Based Decision Making Model Scholarly Paper
Background
To make clinical judgments, the nurse must grasp the situation at hand using a comprehensive,
accurate, systematic approach. Nurses consider information from a variety of sources.
Examples of sources are shift report, assessments, lab and diagnostic test information, and
information from other team members. Tanner (2006) calls this noticing. This process
generates information that the nurse uses to interpret meaning and identify priority patient
issues.
Once the priority patient issues are identified, nurses need to select the most appropriate
interventions or responses from different alternatives. This action is called clinical decisionmaking. When choosing from alternatives, nurses should consider
• What are the possible alternatives I can choose from to give my patient safe and appropriate
care?
• How do the alternatives weigh against the best available evidence?
• What contextual factors do I need to consider?
The focus of N3TT3 requires students to apply a deeper understanding of situations with a
focus on humanistic, person-centered responses. It is the consideration of the context of the
situation that helps nurses ensure their care is person-centred. One method of approaching
person-centred clinical decision-making is through the use of the Evidence-based Decisionmaking (EBDM) model, which was introduced in the first EIDM module and can be found on the
EIDM website, or in your textbook (Cullum, Ciliska, Haynes, & Marks, 2009). Within this model,
before making a clinical decision, health care providers consider the context of the situation
within five areas:
• Valid, relevant research evidence
• The clinical state, setting and circumstances
• Patient preferences and actions
• Health care resources
• Clinical judgment and expertise as a nurse
In this assignment, students will expand upon their learning related to critiquing individual
studies/reviews, and consider the larger context. The focus is on retrieving and appraising the
best available evidence to answer a research question and considering the contextual factors
prior to making a clinical decision by applying the Evidence Informed Decision Making Model
(Cullum, Ciliska, Haynes, & Marks, 2009).
So my opening paragraph and topic of choice will go something like this……I was working on a busy pediatric unit and had been assigned a 2 month old with a suspected diagnosis of menengitis. The Doctors decided to do a lumbar punture to test the spinal fluid for any sign of infection. I asked the Doctor how much topical anasthesia or pain medication he wanted ready for the infant. The Doctor replied that we would use glucose for pain relief and just squirt it in the baby’s mouth during the procedure. I was stunned by this reaction, I had never heard of anything like that for pain which led me to the following question…..Is oral glucose as effective or more effective than topical anasthetic and commonly used pain relievers such as opioids and/or acetaminophen for treating neonatal pain?
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