Assigment .Apa seven . All instructions attached.
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DecisionMaking.docx
Outline.docx
DecisionMaking.docx
Decision Making-DAX-DL01 Nora Hernandez-Pupo
Decision Making Process Paper Due
6 pages
Use at least 10 current scholarly references [not older than 5 years] other than your main text. Uses APA 7th edition formatting with DOI
Decision-Making Process Paper
Instructions
In this assignment, you will be writing a 6–8-page paper identifying [ maximum page limit is 8 pages- do not exceed as it will incur a penalty], comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing [The following topics are NOT allowed and will not be approved: shortage and nurse turnover, nurse staffing ratios, unit closures, and restructuring, use of contract employees (i.e., registry and travel nurse)]. The topic MUST BE APPROVED by your nursing instructor before writing the paper. Your topic was approved in week 3- please refer to week 3's approved topic. You are required to use APA 7th edition format, and the page count, appropriate headings, the title page, and the reference page. Reflect on your decision-making practices and the implications this will have regarding differing approaches taken by nursing leaders and staff nurses/clinical practitioners in decision-making regarding issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 2 [3 ideal] different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
5. Use at least 10 current scholarly references [not older than 5 years] other than your main text. Uses APA 7th edition formatting.
Please see sample APA 7 paper- DO NOT use an Abstract.
APA_7_Professional_Paper_Template_June_2020.docx
APA 7 professional-annotated-compressed.pdf
Please submit the Decision Making Process Paper in Word [PDF] Format APA 7 formatted (see instructions in the Assignments Tab of Blackboard along with the grading rubric).
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Outline.docx
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Outline: Alarm Fatigue and Technology Overload
Anisleidy Alvarez
Florida National University
Decision Making
Dr. Nora Hernandez-Pupo
May 20, 2026
Outline: Alarm Fatigue and Technology Overload
I. Introduction
1. Background Information: Alarm fatigue refers to a phenomenon where nurses become accustomed to the high frequency of clinical alarms in an acute care environment, potentially compromising patient care at all levels of practice (Michels et al., 2025).
2. Statement of the Problem: Many of the clinical alarms are not actionable, but nurses must assess each one, resulting in nurse burnout, missed critical events, and suboptimal care (Shaoru et al., 2023; (Hani & Abu (2024).
3. Thesis Statement: To overcome alarm fatigue, bedside nurses, nurse managers, and advanced practice nurses must work together to integrate evidence-based decision-making processes to decrease the burden of alarms and enhance patient outcomes.
II. Literature Review/Background
A. Overview of Existing Research:
1. Alarm fatigue is a known phenomenon that negatively impacts patient safety and nurse health (Michels et al., 2025).
2. Research has confirmed that high alarm volumes lead to sensory overload and desensitization and delay action on actionable alarms (Ron et al., 2025).
3. Educational interventions on alarm management knowledge have demonstrated measurable improvement in nurses' behavioural response to alarms (Nyarko et al., 2023).
B. Key Theories and Models:
1. Shared Decision-Making (SDM) Model: Involvement of nurses, technology teams and leadership in the development of unit and institutional level alarm management policies.
2. Clinical Judgment Model (NCSBN): Offers guidance to bedside nurses on how to identify, interpret, and evaluate the significance of alarms in the context of the unique patient (NCLEX, 2024).
3. Transformational Leadership Model: Supports nurse leaders and advanced practice nurses in the facilitation of alarm management changes at a culture or system level (Ystaas et al., 2023).
III. Main Body/Discussion
A. Topic 1: Analysis and Context
1. Alarm fatigue is caused by multiple exposure to excessive, mostly non-actionable alarms from multiple monitoring devices (Michels et al., 2025).
Subpoints:
· In intensive care units (ICUs), up to 820 alarms are generated per patient per day (Uçak et al., 2025).
· The stress and burnout experienced by nurses is directly related to alarm fatigue (Hani & Abu, 2024).
B. Second Topic: Comparative Analysis
Various models of decision making are relevant at different levels of nursing practice.
Subpoints:
· Bedside nurses use Clinical Judgment Model to individualize the alarm threshold and decrease non-actional alarms (NCLEX, 2024).
· Nurse managers use SDM to develop alarm reduction plans for their units in collaboration with the frontline staff.
· Advanced practice nurses and CNOs use Transformational Leadership to champion institutional policy changes, technology purchases, and interprofessional alarm stewardship initiatives (Ystaas et al., 2023).
C. Third Topic: Application and Implications
Each of the models for decision making is feasible in all clinical settings to address the issue of alarm fatigue.
Subpoints:
· Benefits: Decreased nurse burnout, quicker response to critical alarms, enhanced patient safety outcomes (Nyarko et al., 2023).
· Limitations: Demand for resources, staff resistance to change in protocol, and technology infrastructure limitations.
· Recommendations: tiered alarm systems, mandatory alarm management education and interprofessional task forces.
· Funding: HRSA Patient Safety Improvement grants and Sigma Theta Tau International nursing research funding.
IV. Conclusion
Point A
1. Summary of Key Points – Alarm fatigue is a multi-level nursing problem that requires coordinated evidence-based decision-making processes of bedside nurses, nurse managers, and advanced practice nurses.
2. Implications and Next Steps: The models of shared decision making, clinical judgment, and transformational leadership provide evidence informed next steps to reduce the burden of alarms, improve patient safety outcomes and inform institutional quality improvement efforts.
References
Hani, S. B., & Abu, A. (2024). Relationship Between Alarm Fatigue and Stress Among Acute Care Nurses: A Cross-Sectional Study. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241292584
Michels, E. A. M., Gilbert, S., Koval, I., & Wekenborg, M. K. (2025). Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03369-2
NCLEX. (2024). Clinical Judgment Measurement Model. NCLEX. https://www.nclex.com/clinical-judgment-measurement-model.page
Nyarko, B. A., Nie, H., Yin, Z., Chai, X., & Yue, L. (2022). The effect of educational interventions in managing nurses’ alarm fatigue: An integrative review. Journal of Clinical Nursing, 32(13-14). https://doi.org/10.1111/jocn.16479
Ron, R., Barnett, I., Berger, R., & Sberro-Cohen, S. (2025). Alarm fatigue mitigation through nurse empowerment: a pre-post intervention study in two intensive care units. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03613-9
Shaoru, C., Zhi, H., Wu, S., Ruxin, J., Huiyi, Z., Zhang, H., & Zhang, H. (2023). Determinants of medical equipment alarm fatigue in practicing nurses: A systematic review. SAGE Open Nursing, 9(9). https://doi.org/10.1177/23779608231207227
Uçak, A., Cebeci, F., & Tat Çatal, A. (2025). Nurses’ Alarm Fatigue Levels in Adult Intensive Care Units and Their Strategies to Reduce Fatigue: A Convergent Parallel Design. Journal of Clinical Nursing, 34(5). https://doi.org/10.1111/jocn.17644
Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: A systematic review. Nursing Reports, 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108
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