Prepared by nsreen alkhatib MSN

outline Definitions problem solving process

Definitions “ gap between an existing state and desired state” Problem?? “ gap between an existing state and desired state”

Definitions Problem solving process??? systematic process that focuses on Analyzing problem to reach for root cause and selecting appropriate solutions

Decision making and problem solving Decision making is complex, cognitive process often defined as “process of choosing on course of action over another” Problem solving includes Decision making process

Problem solving process

Identify the problem What is the real problem we are facing here?

Identify problem What is the problem? Where is the setting? When it is a problem occurred? Who is affected by problem? What is happening? Why it is happening? What are the causes of problem? What are the consequences of the problem??

Define the context of problem What are the facts that frame this problem ? Define the causes of problem (using fish bone diagram)

fishbone diagram

Analyze the root causes of referral problems by using fishbone diagram by :   Place the problem statement at the right head of the fish. Place the major’s categories of causes in major bons (people, methods, machines and materials). Place the issue that contributes to the main causes in smaller bones.

method people Material age and weight of patient. -patient received certain medication. -medical DX (incontinence surgery..) -poor application of Braden scale . Lack of knowledge about acquired pressure ulcer -call light response . people Turning /repositioning -friction /shearing. Poor application of nurse skin assessment (Braden scale). Acquired pressure ulcer Lift up equipment. Types of bed . heel lift up devices . Oxygen equipment . pillows . Skin protect lotions. Mattress Machine Material

List options what are our most reasonable three or four options?

Analyze options Classify information into categories List information from most important to least important

Decision making tools Decision grid Payoff tables Decision trees Consequences tables Logic model PERT

Alternatives Financial effect important time applicable Decision #1 Health education program for nurses patient and family +++ 12 # develop anew criteria about how to care patient that develop pressure ulcer during hospital izat+ion and to communicate with staff ++ 10 #3 buy support surfaces such as ,special beds and mattress + 5

Decision grid Allow one to visually examine the alternatives and compare each against the same criteria. It is possible to weight some of the criteria more heavily than others if some are more important. To do this, it is usually necessary to assign a number value to each criterion. The result would be a numeric value for each alternative considered.

select solution Important Applicable Time Policy cost

Defend reasons for solution selection

Implement the solution What steps should be taken to implement the best solution to solve problem? What resources you need?

Evaluate the result Who will monitor the implementation process? Who will evaluate the process?

Evaluate the result What indicators whether the intervention is complete? What result will be acceptable to the group?

The End