Module 4-Decision support for care delivery

In the article, “Judgment under uncertainty: Heuristics and Biases”, Tversky and Kahneman state that “people rely on a limited number of heuristic principles which reduce the complex tasted of accusing probabilities and predicting values to simpler judgmental operations”. I had assumed that this was not the case with me, which I would be able to use probabilities to come to a more accurate conclusion. But upon doing the examples provided in the article I came to the same conclusion, as did the greater public. I was disappointed but it made me think. I learned that instead of putting a “respiratory patient” into the usual criteria of respiratory patients I should see this patient as an individual and look for symptoms outside of the normal assessment. Employing this would lead to better assessment. Employing this would lead to better assessment skills. Also when I look at sample sizes I will ignore the smaller sample size and rely on my statistical training to help determine if an intervention is truly making a difference.

The article “Clinical Decision Support Systems in Nursing” by J.Anderson and P.Wilson brought to light the issue of CDSS (clinical decision support systems) and CPG (clinical practice guidelines) and using both to further the evidence based clinical decision-making. I have used CPG in my own work and most colleagues rely on this system when they are unsure of a correct method for a procedure. Adding CDSS’s would enhance the decision-making and practical aspects of patient care.

An overall change has occurred with my feelings towards CDSS’s. At first I wondered what the point was of another decision-making tool. The evidence was overwhelmingly in favor of the CDSS’s and adding it to the CPG processes this showed the greatest improvement of patient outcomes.