References
Clinical decision-making and its place in paramedic practice
Abstract
In the pre-hospital environment, paramedics are required to make clinical decisions, often rapidly to ensure correct treatment and care is provided. Decisions made by paramedics majorly impacts on the life, clinical outcome, safety, health and wellbeing of their patients. With the introduction of the Newly Qualified Paramedic Framework, it potentially has never been more pertinent to examine the decision-making process-an integral part of paramedicine.
The implementation of the NQP framework has prompted an exploration into clinical decision making and its place in an ever-evolving profession. Through examination of theories and frameworks, this article aims to identify the underpinning evidence that enables a paramedic to reach a competent decision and the barriers experienced in the process.
After completing this module the paramedic will be able to:
Paramedics must recognise that decision making is not the same as problem solving; however, one does complement the other. Decision making is defined by Dowie (1993) as the assessment of the alternative, arguing that such decisions are based on assessments of the future, with ethical and legal considerations. Problem solving is a systematic process that focuses on analysing a difficult process after which a decision will be reached (Cork, 2012).
The subject of how paramedics make decisions is arising more frequently in the literature. However, is still largely unexplored when compared with other health professions. Decision making in a clinical context has however been studied by many authors heavily over the last 50 years, all of whom offer different terminology to describe it. What was described as clinical decision making by Field (1987) was described as clinical reasoning by Carnevelli et al (1984) and clinical judgments by Thompson and Dowding (2002).
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