Nursing Expected Utility Theory

Expected Utility Theory

Expected utility theory refers to the formulating of a decision over another that may be presented; generally decided upon through the analysing and assessment of associated risks and outcomes of one choice over another (Pettigrew 2015, pp. 798-9; Shaban 2005, p. 4). The theory of expected utility can be used in many different contexts, an example is the comparison of two outcomes by the risks and possible side effects that each may have to determine the best outcome or one that outweighs the presented risks (Fishburn 2013, pp. 1-2; Pettigrew 2015, p. 799). Expected utility theory is commonly expected in nursing behaviour, it mostly applies to patient care and treatment and is used in day-to-day decision-making (McKenna,

4-5). The benefits of this skill greatly impact the patient, as having a nurse to critically analyse possible treatments and care options around a single patient’s situation ensures a patient-centred care approach and effective treatment (Standing 2010, pp. 115-6; Wu 1996, pp. 9-10). While expected utility theory in nursing is useful in some cases there may come times where decisions are made with a bias and therefore renders the theory inappropriate (Wu 1996, pp. 9-10). An example, could be a nurse who had a bad experience with a particular treatment and does not neutrally compare it to other treatments; this incorporation of physiological thinking can influence a pathway decision that may not necessarily be an accurate approach to a patient’s situation (Pettigrew 2015, pp. 806-7; Wu 1996, pp.

105). Effectual clinical judgement enables a nurse to clearly identify changes in patients and assessments through past experiences and knowledge; through analysing and evaluating objective and subjective data allows for a judgment to be made that will help prevent or reverse a deteriorating patient (Alfaro-LeFevre 2016, p. 105). Each nurse has a different level of expertise and knowledge that makes clinical judgement very individual and unique (Cappelletti, Engel & Prentice 2014, p. 4). When making a clinical judgment a nurse must ensure they stay within their scope of practice, maintain professionalism, are aware of their legal obligations and understand their workplace policies (Alfaro-LeFevre 2016, pp. 105-6). Limitations of the theory social judgment are complacently or over-involvement where one’s judgment leads to an intervention that may go against legal duties, a healthcare professionals scope of practice or workplace policy due to ease (Alfaro-LeFevre 2016, p. 106). Most importantly, clinical judgement can cross and blur to making a diagnosis rather than a plan of care, this action is out of the scope of a registered nurse and can put the patient at risk (Gonda & Hales 2014, p. 115). Overall, clinical judgement is a fundamental element of nursing, experienced nurses are able to utilise the theory most extensively while