Clinical Pathways are well structured, multidisciplinary plans of care specifically designed to provide support and very effective problem solving solutions for a wide variety of situations involving patient care.
These are well structured problem solving methodologies that are not only intended for "researchers" but are equally intended for clinical practitioners, nursing management, clinical and non-clinical resource and clinical audit personnel. They are capable of providing solutions ranging from infection to the adequate financial management involving the patient's care.
This holistic and structured approach to problem solving was created by nurses which provides effective solutions associated with the daily management and function of daily patient care (treatments, nursing interventions, special problems, patient's financial concerns etc. ....)
They are structured to specifically identify, document and address problems associated with the managed and structured care involving the patient. These are not like typical nursing practice guidelines, protocols and algorithms. They are utilized by the entire multidisciplinary team and have a focus on the overall quality and coordination of care.
Initially you requested if anyone can provide any examples of how nurses can be effective problem solvers. This information should precisely demonstrate the "clinical tools" available in the nurses toolbox (created by nurses) and how these tools are effectively serving to solve problems in the patient care environment.
Hope that helps.
Last edit by Patient_Care_Asst on Sep 22, '07
In the acute care setting, the kind of problem-solving that nurses do tend to be solving immediate problems versus systems problems or long-term problems. Let me explain what I mean and we can see what practicing nurses from different areas think.
Immediate problems that acute care nurses deal with start with basic patient care. You've got a patient who can't get up who needs to have clean linens on their bed. Basic nursing (and nursing assistant) training will teach ways to change the linens on an occupied bed. Still, in practice, each patient is different and you often can't just perform task A without thought. When starting an IV, you've got to ascertain which vein you think you'll be able to work with. If you don't get it, you've got to reassess your options and try again. If your patient doesn't receive their food tray, you need to make sure that they get something.
When you deal with a critical illness or emergent problems, I'd tend to say that problem-solving gives way to the practice of clinical judgement and knowledge in determining that a patient's condition is deteriorating and what intervention is appropriate.
Home health nurses use their problem solving skills if they find themselves having to improvise with supplies on hand, or in dealing with hovering family members during their visit (acute care nurses also have to deal with hovering family members).
Case management nurses might be more involved in problem solving for the long term care of a disease such as helping a diabetic patient manage their diet.
Nurses who go into management, then, would be the ones more likely to deal with systems problem-solving such coming up with efficent staffing mixes and minimizing unit costs.
Last edit by jjjoy on Sep 24, '07