Reaching consensus in healthcare practice across the globe would improve healthcare delivery. With informed decisions, it would become practical and easy to have a doctor in Dubai and another in the US delivering consistent quality care. However, making informed decisions on nursing practice and patient outcomes globally remains a major challenge due to differences in healthcare practices.
The health sector targets the achievement of millennial goals in universal health information transfer, but this remains unachieved due to policy differences
and practical limitations caused by equipment differences. Nevertheless, there is hope in decision-making to optimize health delivery across the globe.
Informed Decision-Making is an Integral Part of Care
It is a process entailing to collect and compare information about problems and situations to make a judgment. Importantly, the decision-making process outcomes are applied to patient care, influencing the patient’s health progress. The American Nursing Association and other stakeholders across the US decided on the scope of the practice decision tree as the best decision-making model. The model guides the decision on whether a nurse can take specific actions depending on their education level. Notably, the model is relevant within the US context and is inapplicable to global decision-making.
The scope of practice decision tree basis on education limits it to the US curriculum. However, the global nursing sector has a diverse curriculum. Different countries have different approaches in their education based on their cultural values and education ideologies. They differed widely on education materials, teaching methods, curricula, evaluation strategies, and career paths.
Therefore, nurses from different educational backgrounds face obstacles in making shared decisions and standardizing healthcare globally. That notwithstanding, nurses can adopt instinct and natural decision-making based on experiences and skills.
Nurses in care contexts, especially critical care nurses, have to grapple with complex information, which complicates the decision-making process. their goal is to minimize errors in decision-making and improve health outcomes.
Medication errors, patient injury, and death are some of the dangers and outcomes of poorly made decisions. Experts can adopt the Naturalistic Decision Making (NDM) approach to optimize the process and receive desirable outcomes in various nursing contexts.
Naturalistic Decision-Making Model
The Naturalistic Decision-Making model has evolved from a traditional analytical model. The analytical model involves determining an ideal option, listing potential options, and rationalizing the best choice. Therefore, the nurse considers and analyzes a series of options.
However, experienced healthcare providers do not use this approach in practice; they adopt the NDM model. NDM involves adopting experiences in the decision-making process, thereby saving time and energy in evaluating a long list of options.
The model is beneficial for nurses and professionals working in a challenging environment. Factors such as high work pressure, limited time, fluctuating environmental factors, and uncontrollable variables have motivated the evolution of the decision-making model. Notably, this signifies the presence of varied approaches in the decision-making process in different healthcare settings, scenarios, and across individuals.
The environmental dynamics and cultural factors shape and reshape the care context. Moreover, healthcare providers from the United States are faced with different cultural and environmental stimuli than those in the Middle East and other areas.
Cultural dynamics play a fundamental role in decision-making and care practice. The West regards decision-making as linear, whereby one begins with problem identification to the solution. People from other cultures perceive decision-making differently. Cultural factors, salient observations, and contextual variables determine the process. Therefore, Western nurses also acknowledge that the process does not need a rigid framework, as observed in NDM adoption.
Nursing education, cultural factors, and institutional policies shape decision-making processes in nursing. The variables differ globally and are likely to create challenges in shared global decision-making efforts among nurses.
Therefore, the sector needs a standardized approach, framework, and model to enhance shared decision-making. The profession can use these differences as a strength in enhancing shared decision-making.
Acknowledging the challenge is the first step towards creating a solution for nurses across different education, cultural, and institutional backgrounds. The process is practiced locally by nurses caring for patients from different educational and cultural backgrounds. However, there are also international discussions on the process and its components.
The process is also known as shared decision-making occurring within a respectful, open, participatory, and collaborative environment. Therefore, global decision-making among nurses must have a value-based and virtue-centered approach as educational, cultural, and institutional differences could cause discrimination.
The nurses have to work through barriers to communication and consensus. Moreover, nurses responding to cross-border patient needs should approach them respectfully like local clients. Time factor, knowledge, and empowerment are integral components of the process.
Nurses might have to integrate NDM in their engagement. Importantly, the parties must consider the process of learning from each other. Besides, they should acknowledge system, educational, and cultural differences as integral variables in their interaction.
In conclusion, establishing a standard global decision-making process is challenging. Notably, nurses find implementing a standard tool at the local level observed in the evolution from a systematic analytical model to NDM.
Educational, institutional, and cultural barriers make it challenging. However, a value-based and virtue-centered approach can enhance collaboration. Communicating respectfully and honestly can enhance shared decision-making among nurses across the globe.
Lastly, time management, knowledge sharing, and empowerment are critical ingredients. Therefore, the process is more dependent on behavior than systematic approaches. Nurses should value each other and create a collaborative atmosphere with patients and healthcare stakeholders. Check out third-party payments, EHR, socio-cultural orientation, and annotated bibliography.
