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Name of the student Name of the Professor Nursing 3 June, 2012 Clinical decision making Introduction: Decision to take blood culture from patient with acute leukaemia In a hypothetical case scenario, a nurse encounters a patient of acute leukaemia with fever.
Fever frequently affects patients with haematological malignancies such as leukaemias, either as a part of the disease process itself or because of the chemotherapeutic drugs used in the treatment. To diagnose the cause, blood culture is mostly required for identification of causative bacteria or fungus. A nurse caring for a patient with acute leukaemia is many a time confronted with the clinical scenarios where he or she is required to make clinical decision to take blood culture from a febrile patient. The nurse may herself make the decision to obtain a blood sample for culture on suspicion of an infection or may act on the orders of a physician. In an autonomous decision, the complexity and the nature of the decision task affect the approach taken towards problem solving (Thompson, Kirkness & Mitchell 2007). The decision taken by the nurse can be analysed for the application of evidence based medicine in routine clinical situations. Analysis and clinical reasoning of the decision Decision analysis allows to share a decision with seniors and colleagues and to evaluate its advantages and disadvantages (Bucknall 2003). Nurse uses the domains of prior knowledge about the patient and his circumstances, ethical knowledge and specific knowledge. This knowledge is accessed and applied by the means of pattern recognition and heuristics (Bohinc & Gradisar 2003). ...
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