Problem Solving and Decision Making PDF
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Uploaded by IlluminatingBaltimore
Ramathibodi School of Nursing
2025
Jantra Keawpugdee
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This document discusses problem-solving and decision-making in nursing, covering the meaning, importance, roles of nurses and steps in the problem-solving process. It provides examples from different types of problems encountered in nursing practice. The document is presented as a lecture or educational material related to nursing.
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Problem solving and Decision making Dr. Jantra Keawpugdee, RN, DR.P.H. (Nursing) Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University 1/22/2025 Jantra Keawpugdee 1 Ob...
Problem solving and Decision making Dr. Jantra Keawpugdee, RN, DR.P.H. (Nursing) Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University 1/22/2025 Jantra Keawpugdee 1 Objectives 1. Describe the meaning and the importance of problem solving and decision making 2. Describe the roles of nurse in problem solving and decision making 3. Apple the roles of nurse to solve and mange selected situation in nursing profession problem solving and decision making 1/22/2025 Jantra Keawpugdee 2 Problem solving or decision making - Which is the most important, Why? 1/22/2025 Jantra Keawpugdee 3 Problem solving or decision making Problem solving is an analytical process used to identify the possible solutions to the situation at hand. Decision making is a choice made by using one’s judgement. 1/22/2025 Jantra Keawpugdee 4 1/22/2025 https://www.youtube.com/watch?v=klAE9ML0XLs Jantra Keawpugdee 5 Problem solving or decision making - Which is the most important 1/22/2025 Jantra Keawpugdee 6 7 1/22/2025 https://youtu.be/JAdTjHsOid0?si=0-UTt7xEpXTIS9NE Jantra Keawpugdee Question 1: What is the problem of this situation? 1/22/2025 Jantra Keawpugdee 8 What is the Problem solving Problem solving is a part of decision making and is a systematic process that focus on analyzing a difficult situation. Problem solving always includes a decision-making step. (Bessie L. & Carol J., 2012) Problem solving is defined as thinking directed toward the achievement of a goal by means of a novel and appropriate idea or product. (Diane L., 2010) 1/22/2025 Jantra Keawpugdee 9 Question 2: As a nurse related to your experience, what is your problem? 1/22/2025 Jantra Keawpugdee 10 The most common problems in the nursing profession 1. Not Enough Nurses: This leads to a nursing staff that is overworked as they struggle to keep up with the demands at their workplace. 2. Professional Relationships: Nurses often get the brunt when inter- professional relationships are not going well. This conflict extends to the relationships between nurses and patients, or even coworkers. 3. Patient Satisfaction: No one wants to be admitted to a hospital or clinic only to be waiting even longer just to see a nurse. By the time we reach the patient, they are grumpy and disappointed in the service they are receiving. (Nurse Together Editorial Team, 2014) 1/22/2025 Jantra Keawpugdee 11 The most common problems in the nursing profession 4. Job Safety: Nurses are surrounded by people who are sick with any manner of disease or illness, so the chance of contracting a contagious illness is quite a bit higher for nurses than it is for the general public. 5. Technology: It is quite a challenge to integrate it into our daily work, leadership especially since it changes so rapidly. 10 Trends Predicted to Impact the Workplace in 2017 - Greenhouse Grower (Nurse Together Editorial Team, 2014) 1/22/2025 Jantra Keawpugdee 12 Map and Analyze Process Identify potential root causes Input Process Output Donabedian’s Model 1/22/2025 Jantra Keawpugdee 13 Types of problem The types of problem, it was divided into three types, first, a simple problem is a single cause and clear solution. Second, the complex problem has multiple causes, is difficult to understand, and complex solution. The last, complex problem seems to be so complex it’s difficult to envision a 5Es Instructional Model (with a Blended Twist!) | Blend Education (teachable.com) solution. 14 1/22/2025 Jantra Keawpugdee Question 3: Referring to the clip video, what type of problem and why do you think about that? 15 1/22/2025 Jantra Keawpugdee 3 Problem Types 1. Simple problems are ones that have a single cause, are well-defined, and have a clear and unambiguous solution. Figure 1 A simple problem map: https://www.marcuscoetzee.com/identifying- simple-complex-and-wicked-problems/ 16 (Peter, 2021) 1/22/2025 Jantra Keawpugdee Example An adult patient has a high fever, and you suspect they may have an infection. Therefore, the cause of this problem of this infection. 17 1/22/2025 Jantra Keawpugdee 2. Complex problems tend to have multiple causes, are difficult to understand and their solutions can have multiple solutions. Figure 2 A complex problem map: https://www.marcuscoetzee.com/identifying- simple-complex-and-wicked-problems/ (Peter, 2021) 1/22/2025 Jantra Keawpugdee 18 Example An adult patient with multiple chronic conditions, such as diabetes, heart disease, and kidney disease, is admitted to the hospital due to complications related to all these conditions. The patient is also dealing with mental health issues, such as depression, and has a language barrier as they are not fluent in the primary language spoken in the hospital. 19 1/22/2025 Jantra Keawpugdee 3. Wicked problems are problems that seem to be so complex it is difficult to envision a solution. Climate change is an example of a wicked problem. Figure 3 A complex problem map: https://www.marcuscoetzee.com/identifying- simple-complex-and-wicked-problems/ (Peter, 2021) 1/22/2025 Jantra Keawpugdee 20 Example Reducing the risk of falls in elderly patients is a common nursing challenge, as it involves multiple factors and no one-size-fits-all solution. Falls can result from a combination of factors such as medication side effects, physical limitations, and environmental hazards. 1/22/2025 Jantra Keawpugdee 21 Step in the problem-solving process 1. Define the problem: As the step that has a clear understanding of the problem for which you’re going to find a solution. Question 4: What is the problem in this situation in this clip video? (Frank, 2010) 1/22/2025 Jantra Keawpugdee 22 Step in the problem-solving process 2. Gathering information: Starts by gathering as much input and information as possible from a variety of sources. Question 5: What is the obstacle in this situation? (Frank, 2010) 23 1/22/2025 Jantra Keawpugdee Step in the problem-solving process 3. Determine the desired outcome: Come up with multiple viable solutions to a problem. Question 6: What do you think about the solving of this problem? (Frank, 2010) 1/22/2025 Jantra Keawpugdee 24 Step in the problem-solving process 4. Develop solutions: Comparing the benefits of the solution, and expanding the ability to look at problems as always having a potential for multiple solutions is a key conceptual element in dealing with problems. We can begin with questions like, the solution is easily achievable, and what the possible outcome of this solution. 5. Consider consequences: This step should be done carefully for each alternative solution and careful analysis of the available options is essential. (Frank, 2010) 1/22/2025 Jantra Keawpugdee 25 Step in the problem-solving process 6. Make decisions: Various techniques or tools are useful for driving decision- making to one selected choice. 7. Implement and evaluate solutions: This is the action and feedback stage. Checks on effectiveness need to be made and then feedback into the problem- solving process. The evaluation involves doing a check and asking whether anything was missed. This self-correcting measure will help ensure that the best decision has been made. (Frank, 2010) 1/22/2025 Jantra Keawpugdee 26 1/22/2025 Jantra Keawpugdee https://youtu.be/JAdTjHsOid0?si=0-UTt7xEpXTIS9NE 27 Conclusion Implement and Define the evaluate solutions problem Make decisions Gathering information Determine the Consider desired outcome consequences Develop solutions 28 1/22/2025 Jantra Keawpugdee Applying the problem-solving in nursing process These steps include: Assessment. Use critical thinking skills to brainstorm and gather information. Diagnosis. Identify the problem and any triggers or obstacles. Planning. Collaborate to formulate the desired outcome based on proven methods and resources. Implementation. Carry out the actions identified to resolve the problem. Evaluation. Reflect on the results and determine if the issue was resolved. (American Nurses Association, 2023) 29 1/22/2025 Jantra Keawpugdee The challenges of problem-solving 1. Lack of motivation: Feeling unmotivated can make it challenging to start or complete a task, which can be caused by stress, boredom, or fatigue. Creative thinking by thinking outside the box may be able to find more efficient ways to solve the problem. 2. Lack of knowledge: People can struggle to identify and solve problems because they don’t have the necessary information, experience, or skills. Fortunately, skills can be improved through practice and education. (Aastha, 2023) 1/22/2025 Jantra Keawpugdee 30 The challenges of problem-solving 3. Lack of resources: This can take many forms, from insufficient information or tools to solve a problem to being uncomfortable asking for help. When faced with a lack of resources, it’s essential to identify what you need and find ways to obtain it. 4. Emotional barriers: Feelings of anxiety, stress, and frustration, which can prevent you from taking action on available solutions. To overcome emotional barriers, it’s essential to focus on your goals and address the underlying causes of the problem. (Aastha, 2023) 1/22/2025 Jantra Keawpugdee 31 The challenges of problem-solving 5. Cultural and societal barriers: These barriers can take many forms, such as prejudice, and cognitive biases, and may be related to how a society values, and different knowledge. Social barriers can also play a role in problem-solving from interacting with others with different solutions. 6. Fear of failure: Fear can prevent us from taking risks and trying new things. Several ways to reduce fear include practice and positive self-talk. Whether seeking advice from colleagues or getting support from others can help you develop new strategies for overcoming obstacles. (Aastha, 2023) 1/22/2025 Jantra Keawpugdee 32 The relationship between problem-solving and decision-making To solve the problem, we have to have the decision-making to choose the best solution. Decision-making focuses on identifying the real cause of the problem. The decision maker might later choose to address the real cause of the problem or might decide to do nothing at all about the problem due to limitations. (Marquis & Huston, 2015) 1/22/2025 Jantra Keawpugdee 33 1/22/2025 https://youtu.be/_cf7dwG_u74?si=RmPfGhW9e6SxeXwn Jantra Keawpugdee 34 Question 7: In the clip, what do you think about the decision making of the pig? If you were the pig, what would you do? why? 35 1/22/2025 Jantra Keawpugdee Mind Mapping 1/22/2025 Jantra Keawpugdee 36 http://4.bp.blogspot.com/-bT_pykZzxrE/TZVnD2PBryI/AAAAAAAAAgE/-7x6yYsWkZs/s320/tenancy-ag Fish bone diagram 1/22/2025 Jantra Keawpugdee 37 http://www.macrobusiness.com.au/wp-content/uploads/2011/12/cartoon-round-table-discussion-300x243.jpg Brainstorming 1/22/2025 Jantra Keawpugdee 38 What is the Decision making 1/22/2025 Jantra Keawpugdee 39 https://www.youtube.com/watch?v=XT0Awg-Fpxw 1/22/2025 Jantra Keawpugdee 40 What is the Decision making Decision making is making choices that will provide maximum benefit. (Diane L., 2010) Decision making is a complex, cognitive process often defined as choosing a particular course of action. Decision making is always more than one possible course of action and the decision marker must choose between the alternatives. (Bessie L. & Carol J., 2012) 1/22/2025 Jantra Keawpugdee 41 What is the Decision making Decision-making is a complex process. It involves gathering and making sense of a great deal of information. (Caroline, 2015) Strategic decision-making is the process of developing and putting into action choices that will influence the long-term welfare of the organization. (Lampel, 2018) Decision-making is the process of making choices by identifying a decision, gathering information, and assessing alternative resolutions. (Yahaya, 2023) 1/22/2025 Jantra Keawpugdee 42 Concepts of decision-making 1) Minimally impacts current operations 2) Helps achieve important priorities 3) Is consistent with values 4) Is acceptable to those involved in the decision 5) Can be implemented with the constraints (time, resources, and other priorities) 6) Considers pros, cons, and risks Hierarchy of Decision Making | Hardcore Closer - Sales Training For The Modern Marketplace 1/22/2025 Jantra Keawpugdee (Finkelman, 2006) 43 Decision-making process Step 1: Identify the decision You realize that you need to make a decision. Try to clearly define the nature of the decision you must make. This first step is very important. Step 2: Gather relevant information Before making a decision, gather necessary information from both internal and external sources, including self-assessment and online sources, to ensure a well-informed decision-making process. (Yahaya, 2023) 1/22/2025 Jantra Keawpugdee 44 Decision-making process Step 3: Identify the alternatives Using collected information, identify multiple possible paths of action, and use imagination and additional information to construct new alternatives. List all desirable alternatives in this step. Step 4: Weigh the evidence Imagine the outcome of each alternative, evaluating if the identified need is met or resolved. As you go through this internal process, favor options with higher potential for reaching your goal. Place the alternatives in a priority order based on your value system. 1/22/2025 Jantra Keawpugdee (Yahaya, 2023) 45 Decision-making process Step 5: Choose among alternatives After evaluating all evidence, choose the best alternative or a combination of alternatives. Your choice in Step 5 may be similar to the one at the top of your list in Step 4. Step 6: Take action You’re now ready to take some positive action by beginning to implement the alternative you chose in Step 5. 1/22/2025 Jantra Keawpugdee (Yahaya, 2023) 46 Decision-making process Step 7: Review your decision & its consequences In the final step, evaluate the decision's effectiveness in addressing the identified need. If it doesn't, repeat certain steps to make a new decision, such as gathering more detailed information or exploring alternative options. Review your decision Five influences that will wreck your decision-making (dialoguereview.com) & its consequencesand (Yahaya, 2023) 1/22/2025 Jantra Keawpugdee 47 Exercise 1 Comparing the Decision-Making process with the Nursing Process Decision-Making Process Nursing Process Step 1: Identify the decision Step 2: Gather relevant information Step 3: Identify the alternatives Step 4: Weigh the evidence Step 5: Choose among alternatives Step 6: Take action Step 7: Review your decision & its consequences 1/22/2025 Jantra Keawpugdee 48 Exercise 1 Comparing the Decision-Making process with the Nursing Process Decision-Making Process Nursing Process Step 1: Identify the decision Assess and diagnosis Step 2: Gather relevant information Step 3: Identify the alternatives Plan Step 4: Weigh the evidence Step 5: Choose among alternatives Implementation Step 6: Take action Step 7: Review your decision & its consequences Evaluation 1/22/2025 Jantra Keawpugdee 49 Level of decision-making Individual decision-making is the process of relying on one person's knowledge, intuition, and judgment to make a choice or judgment. Group decision-making is the process of involving multiple people with different perspectives, skills, and experiences in making a collective choice or judgment. (Hartzell, 2017) 1/22/2025 Jantra Keawpugdee 50 There are three traditional levels of decision-making 1. The institutional (top) level for strategic planning. This is concerned with the general organizational objectives and the broad problems of the positioning (or repositioning) of the organization within its environment. 2. The managerial (middle) level for gathering, coordinating, and allocating of resources for the organization. This has to do with planning budgets, formulating personnel practices, and deciding on routine capital projects. (Hartzell, 2017) 1/22/2025 Jantra Keawpugdee 51 There are three traditional levels of decision-making 3. The technical (low) level involves the acquisition and utilization of technical knowledge for operational controls such as production scheduling, inventory control, and measurement of worker efficiency. (Hartzell, 2017) 1/22/2025 Jantra Keawpugdee 52 The challenges of decision-making 53 1/22/2025 Jantra Keawpugdee 1. Information complexity: When making decisions, we need to process a large number of different pieces of information. Sometimes this information may be vague, or ambiguous, or there may be a contradiction between the information. This makes it difficult for us to understand and process this information. 1/22/2025 Jantra (Ay,Keawpugdee Polat, & Kashimi, 2020; Chan et al., 2018; Colaizzi, 1978) 54 2. Uncertainty: Even when we have complete information, we may not be able to determine the outcome of the decision because the future is uncertain, and we cannot predict all possible outcomes. 3. Time pressure: In many cases, we need to make decisions quickly, which can lead to insufficient time to fully consider all the options and possible outcomes. 1/22/2025 Jantra Keawpugdee 55 (Ay, Polat, & Kashimi, 2020; Chan et al., 2018; Colaizzi, 1978) 4. Lack of expertise and skills: In some cases, we may not have enough expertise or skills to understand or deal with the problems we face. This can make it difficult for us to make the best decisions. 5. Emotional impact: Our emotional state may influence our decision-making process. For example, when we feel anxious or depressed, we may make overly pessimistic or conservative decisions. 1/22/2025 Jantra Keawpugdee 56 The decision in the nursing organization 1/22/2025 Jantra Keawpugdee 57 Poor communication of information Within the care team, the timely and accurate transmission of information is very important to ensure that all members have a comprehensive understanding of the patient's condition and make the right care decisions. Barriers to information exchange can lead to misunderstandings, delayed treatment, or unnecessary complications. (Solman, 2017) 1/22/2025 Jantra Keawpugdee 58 Uneven distribution of resources In some healthcare facilities, due to resource constraints, certain care services may not be equitably distributed to all patients. This may result in some patients not receiving necessary nursing services or increase the pressure and dissatisfaction rate of nursing work. (Solman, 2017) 1/22/2025 Jantra Keawpugdee 59 Inadequate training and education of caregivers The level of expertise and knowledge of caregivers is critical to the provision of quality health care. Lack of necessary training and education can result in caregivers being unable to effectively respond to complex patient situations or lacking the necessary skills to provide advanced care services. (Solman, 2017) 1/22/2025 Jantra Keawpugdee 60 Example The recommendation of Global predictions of essential skills for occupations required by 2020 encompasses complex problem- solving, critical thinking, creativity, people management, coordinating with others, emotional intelligence, judgment, and decision-making, service orientation, negotiation, and cognitive flexibility. These are the capabilities required now of nursing leaders and organizations. It will be the changing context that will need to be navigated with a further focus on interprofessional planning and delivery of care to achieve the desired patient care outcomes. (Solman, 2017) 1/22/2025 Jantra Keawpugdee 61 Leadership and management implications 62 1/22/2025 Jantra Keawpugdee The essential leadership skills for problem-solving and decision-making 1/22/2025 Jantra Keawpugdee 63 The essential leadership skills for problem- solving and decision-making ✓Critical thinking ✓Creativity ✓Conflict management ✓Communication (Diane L. Huber, 2010) 1/22/2025 Jantra Keawpugdee 64 Critical thinking Critical thinking is a systematic, purposeful, and information-based skill that enhances problem-solving effectiveness. It involves considering alternative viewpoints and is essential for nurses to be open-minded, analyze complex information, and overcome obstacles for effective decision-making. (Diane L. Huber, 2010) 1/22/2025 Jantra Keawpugdee 65 Creativity Creativity and problem-solving are interconnected, with creative problem- solving focusing on novel ideas or products to achieve goals. Leaders and managers must act with creativity to achieve desirable outcomes, as traditional problem-solving emphasizes rational thought. (Diane L. Huber, 2010) 1/22/2025 Jantra Keawpugdee 66 Conflict management Decision-making often involves multidisciplinary actions, involving conflicts between staff members and patients and families. Leaders may employ negotiation or conflict management to address tasks and relationships. (Diane L. Huber, 2010) 1/22/2025 Jantra Keawpugdee 67 Communication In some problems, the leader does not actually solve the problem but, rather persuades others to solve the problem. Thus, communication skill is very important for the leader. (Diane L. Huber, 2010) 1/22/2025 Jantra Keawpugdee 68 Exercise Situation: In the treatment unit, there are many complaints from the patients and relatives about the information before doing procedures. If you were the head nurse of the treatment unit, what would you do to solve this problem? Please follow the problem- solving and decision-making processes and select one of the decision tools to solve the problem. 1/22/2025 Jantra Keawpugdee 69 Decision making tool 1. Brainstorming 2. Cause and effect diagram 3. Affinity diagram 4. Tree diagram) 5. Matrix data analytic 6. Delphi technique 7. SWOT Analysis 1/22/2025 Jantra Keawpugdee 70 1. Brainstorming http://4.bp.blogspot.com/-bT_pykZzxrE/TZVnD2PBryI/AAAAAAAAAgE/-7x6yYsWkZs/s320/tenancy-agreement.jpg 1. Define problem 2. Generating ideas 3. Developing the solution 1/22/2025 Jantra Keawpugdee 71 1. Brainstorming 1/22/2025 Jantra Keawpugdee 72 2. cause and effect diagram http://4.bp.blogspot.com/-bT_pykZzxrE/TZVnD2PBryI/AAAAAAAAAgE/-7x6yYsWkZs/s320/tenancy-agreement.jpg Problem result cause 1/22/2025 Jantra Keawpugdee 73 3. Affinity diagram 1/22/2025 Jantra Keawpugdee 74 4. Tree diagram 1/22/2025 Jantra Keawpugdee 75 5. Matrix data analytic 1/22/2025 Jantra Keawpugdee 76 6. Delphi technique 1/22/2025 Jantra Keawpugdee 77 7. SWOT Analysis Internal factors Strengths(S) are things that the organization does particularly well, or in a way that distinguishes it from others. Weaknesses(W) are inherent features of the organization and focus on people, resources, systems, and procedures in the organization. Think about what could improve, and the sorts of practices that should be avoided. 78 1/22/2025 Jantra Keawpugdee 7. SWOT Analysis External factors Opportunities (O) are openings or chances for something positive or situations that could be favorable for the goals and objectives of the organization. Threats (T) include anything that can negatively affect or be an obstacle of the organization. 79 1/22/2025 Jantra Keawpugdee 7. SWOT Analysis Figure 6 The table of the SWOT Analysis https://www.penfill.co/strategy/competitive-positioning/ 1/22/2025 Jantra Keawpugdee 80 Do you have any questions http://www.hes.edu.au/assets/Resources/Images/General-Images/iStock000006428830XSmall-discussion.jpg 81 next.gif 1/22/2025 Jantra Keawpugdee References ▪ Aastha, B. (2023). 6 Common Problem Solving Barriers and How Can Managers Beat them? Risely. Retrieved 19 Octorber, from https://www.risely.me/problem-solving-barriers-and-ways-to-overcome- them/#What_are_The__Barriers_to_Problem_Solving? ▪ American nurse association. (2023). Problem Solving in Nursing: Strategies for Your Staff. Retrieved 19 October, from https://www.nursingworld.org/resources/individual/nurse-managers/problem-solving-in-nursing/ ▪ Ay, F., Polat, Ş., & Kashimi, T. (2020). Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses. 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King (Eds.), Existential-Phenomenological Alternatives for Psychology (pp. 6). Oxford University Press. ▪ Diane, H. (2010). Leadership and Nursing Care Management (4th Edition ed.). Saunders. 1/22/2025 Jantra Keawpugdee 82 References ▪ Eriksen, S., Huynh, C., & Keller, L. (2013). Decision Trees. In Saul I. Gass & M. C. Fu (Eds.), Encyclopedia of Operations Research and Management Science (3th ed., pp. 390-394). Springer New York, NY. https://doi.org/10.1007/978-1-4419-1153-7 ▪ Frank, B. (2010). Critical Thinking and Decision-Making Skills. In L. H. Diane (Ed.), Leadership and Nursing Care Management (4th ed., pp. pp. 93-117). SAUNDERS ELSEVIER. ▪ Hoffman, K., Donoghue, J., & Duffield, C. (2004). Decision-making in clinical nursing: investigating contributing factors. J Adv Nurs, 45(1), 53-62. https://doi.org/10.1046/j.1365-2648.2003.02860.x Lampel, J. (2018). Strategic Decision-Making. In M. Augier & D. J. Teece (Eds.), The Palgrave Encyclopedia of Strategic Management (pp. pp. 1600-1603). Palgrave Macmillan UK. https://doi.org/10.1057/978-1-137-00772- 8_595 Lee, J., Cho, H., & Shin, S. (2021). Nursing strategies for the post‐COVID‐19 era. International Nursing Review, 68. https://doi.org/10.1111/inr.12653 Nurse Together Editorial Team. (2014). 8 Common Problems in the Nursing Profession. Retrieved 19 October, from https://www.nursetogether.com/9-common-problems-nursing-profession/ Odoch, B. E. (2023). Types and techniques of decision making. Makerere University. Retrieved 19 Octorber from https://www.researchgate.net/publication/371179720_Types_and_techniques_of_decision_making 1/22/2025 Jantra Keawpugdee 83 [email protected] [email protected] 1/22/2025 Jantra Keawpugdee 84