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GORDON FRAMEWORK

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NURSING KNOWLEDGE: THEORIES AND CONCEPTS THROUGH THE LENS OF STANDARDIZED NURSING LANGUAGES

Luca Bertocchi, Stella Adereti, Rita Gengo, Suellen Emidio, Ana Choperena, Dorothy Jones

The Marjory Gordon Program for Clinical Reasoning and Knowledge Development

Dorothy Jones

Director of the Marjory Gordon Program

Boston College,Boston (USA)

Suellen Emidio

Stella Adereti

Luca Bertocchi

Rita Gengo

Ana Choperena

Assistant Professor

PhD candidate

Assistant Professor

Assistant Professor

Assistant Professor

University of Navarra - School of Nursing (Spain)

Christine E Lynn College of Nursing, Florida Atlantic University(USA)

University of L'Aquila (Italy)

Nursing Department, University of Tocantins, Palmas (Brazil)

Obabafemi Awolowo University, Ile-Ife (Nigeria)

Index

THE HUMANISTIC DECISION MAKING PROCESS FRAMEWORK

BACKGROUND

WHY A NEW FRAMEWORK?

RELEVANCE TO CLINICAL PRACTICE

PURPOSE

PROCESS DEVELOPMENT

BIBLIOGRAPHY

Background

In nursing, sometimes, the terms 'decision making', 'clinical judgement', 'problem solving' and 'critical thinking have been used interchangeably.

Decision-making is a complex process that includes conclusions about a patient’s status, with a determination of methods to best meet patient need.

It includes the clinical judgment which may express human responses through the formulation of nursing diagnosis, set treatment goals, and select specific interventions.

These types of decision-making processes are focused on the caring for the human health experience of the ‘person’ as a unified entity that interacts with the environment; this is the person-centered approach, typical of the human sciences.

In this holistic and interactive context, standardized nursing languages can provide interoperable nursing classifications that can be used in nursing practice, education, and research to obatain those standars of care.

ADD sources!!!

Why a new Framework?

DECISION-MAKING MODELS

OTHERS

OPT

NP

Lorem ipsum dolor

Lorem ipsum dolor

Lorem ipsum dolor

No time No prediction No decision-making model

No decision-making model Vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et

Critique

Just labels

Pro

Prediction Decision-making model

Interactive

"It is critical that nurses are taught the thinking skills and cognitive reasoning that can help them translate their observations into clinical judgments".

Marjory Gordon

Purpose

The aim of this work is to describe the major concepts of the Humanistic Decision-making Process Framework and their relationships, and explain how this model may guide the process of nurses' decision-making using standardized nursing languages worldwide.

Process development

Process

STEP 3

STEP 2

STEP 1

A team of five nursing researchers and their mentor from ​The Marjory Gordon Program for Clinical Reasoning and Knowledge Development developed the framework.

We identified the concepts of the framework from multiple nursing models (Newman’s theory of Health as Expanding Consciousness, Rogers theory of Unitary Human being; Phillip, 2017, Willis, 2008).

We established the interrelationship between the concepts using a humanistic based care approach and our clinical and teaching experiences.

We refined the model to represent the constant, continuous, and dynamic interaction between the nurse and the person (focusing on clinical reasoning and Standardized Nursing Terminologies), to co-create an evolving care plan through mutual knowing.

The Humanistic Decision-making Process Framework

The Humanistic Decision-making Model (HumDeM)

DATA

PERSON

ENVIRONMENT

OUTCOMES & QUALITY OF CARE

NURSE

STANDARDIZED NURSING TERRMINOLOGIES; MEANING AND CONSCOIUSNESS ARE MISSING

HUMAN EXPERIENCE

MUTUAL KNOWING

"If you cannot name it, we cannot control it, practice it, research it, teach it, finance it, or put into public policy".

Clark and Lang, 1997

Relevance to clinical practice

This non paternalistic approach provides options and freedom of choice where nurses help the client recognize patterns, and increase its awareness through the story regarding why the problems is occuring.

The functional health pattern framework is an holistic approach that identifies eleven patterns and then it allows to synthesize the judgment about that is the nursing diagnosis.

This framework enables the standardization and preserves the individuality of the person. The standardized nursing terminologies allow us to communicate the individuality of the person and how that person manifested the patterns

Nurse leaders and policymakers should take in consideration the use of this culturally sensitive model framework in health care institutions to achieve excellence in patient care, education, and research outcomes. The development of a framework provides a theory-oriented approach to current study, giving clinical nursing practice a well-defined and proven theoretical underpinning. In addition, it may be possible to offer nurses an explanation of the meanings and validity of clinical decision-making based on humanistic principles, and to offer broader guidelines and a general set of ideas for nurses to develop clinical reasoning.

Nurse leaders and policymakers should take in consideration the use of this culturally sensitive model framework in health care institutions to achieve excellence in patient care, education, and research outcomes. The development of a framework provides a nursing theory-oriented approach to current study, giving clinical nursing practice a well-defined and proven theoretical underpinning. In addition, it may be possible to offer nurses an explanation of the meanings and validity of clinical decision-making based on a humanistic model that contains concept to guide decision-making and create opportunity for , and to offer broader guidelines and a general set of ideas for nurses to develop clinical reasoning.

Bibliography

Bibliography

Jones, D., Duffy, M. E., Flanagan, J., & Foster, F. (2012). Psychometric evaluation of the Functional Health Pattern Assessment Screening Tool (FHPAST). International journal of nursing knowledge, 23(3), 140–145. https://doi.org/10.1111/j.2047-3095.2012.01224.x

Karlsen, B, Hillestad, TM, Dysvik, E. Abductive reasoning in nursing: Challenges and possibilities. Nurs Inq. 2021; 28:e12374. Newman MA. Health as Expanding Consciousness. New York: NLN Press; 1986; Phillips JR. New Rogerian Theoretical Thinking About Unitary Science. Nurs Sci Q. 2017 Jul;30(3):223-226. PMID: 28899269. Willis DG, Grace PJ, Roy C. A central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying. ANS Adv Nurs Sci. 2008 Jan-Mar;31(1):E28-40.

Thank youObrigada Dalu Grazie Gracias