Assignment

on
Problem solving approach

Submitted to Submitted by
Madam. D. Sengupta Dipsumana Jana
Professor cum Acting Principal M. Sc Nursing 2nd year
Govt. College of Nursing, Burdwan Govt. College of Nursing, Burdwan
Introduction-
Problem finding and problem shaping. Considered the most complex of all intellectual
functions, problem solving has been defined as higher-order cognitive process that requires
the modulation and control of more routine or fundamental skills. Problem solving occurs
when an organism or an artificial intelligence system needs to move from a given state to a
desired goal state.
Definition-
A problem being defined as the difference existing between a situation or condition
prevailing and the desired situation.
Problem solving is defined as decision making for solving a problem.
Principles of problem solving-
Problem solving like other managerial activities is facilitated by proper organization. In
organizing subordinates, problem-solving efforts, a manager should observe the following
principles:

• To resolve problems affecting organizational efficiency, the manager should separate

large problems from small ones, use policy to solve the smaller problems, and
conserve managerial time for solving major problems.
• The manager should delegate smaller problems to subordinates and teach them to
solve these by applying existing agency rules.
• In resolving operational problems, the manager should consult internal and external
experts, so that solutions will be based on current knowledge.
• Problem solutions are most effective when the manager approaches problems in
relaxed fashion and refuses to solve problems under stress.
• It is impossible to anticipate all eventualities or to expect 100 percent accuracy in
diagnosing and resolving problems. Therefore, it is unwise to agonize over selecting a
solution.
Problem solving process-
The steps of the problem-solving process are the same as the steps of the nursing process and
the decision-making process: assess and analyze, plan, implement and evaluate.
Problem solving consists of the following steps:
1. Identification and specification of the problem.
2. Collection of data in relation to the problem.
3. Analysis of available data and inference.
4. Identifying probable solutions and selection of the best solution.
5. Implementation of solution with feedback.
6. Modification of solution, if necessary, on the basis of feedback data.
Approaches to problem solving-
There are five main approaches to problem solving
1. Routine
2. Scientific
3. Decisional
4. Creative
5. Quantitative
These approaches are strategies for problem solving and any one approach may be suitable
for the given situation.
1. Routine approach: This approach deals with problem solving on traditional methods.
a. What has always been in the past, when such situation occurred? If we do it now
the same way we may succeed. b. There is Standard Operating Procedures (SOP) in
many departments of the hospital. These SOPs tell that what should be in a particular
situation. How is it done? Who does it? When will it be done? Step by step approach
to deal with the problems. c. Another way of problem solving based on the traditional
methods is, to have regards for the superior officer's opinion and orders. Whatever
they direct, instruct or order, presume that they are correct and follow it 100%. Such
methods are of great value in medical care setting, like where the treatment of the
patient is concerned.
2. Scientific approach: The first step in this approach is to identify the problem. Second
step is preliminary observation regarding the proposed scheme. Then we have to
derive solutions to the problems. With the use of current knowledge and with
controlled experiments investigate the proposition. The data so collected are classified
and analyzed. On the basis of analysis, a tentative solution is drawn. The solution so
derived is implemented in that situation.
3. Decisional approach: This is one of the most popular and also common approaches
to deal with the problems. First of all, we have to state as to what is the desired result.
After making definition of the problem, various possible alternatives are sorted out
then each alternative is evaluated from the point of view of its suitability and
relevance. The best alternative is selected and implemented in the given situation. For
any given situation several decisions can be made.
4. Creative approach: First step is to define the problem and decisions makers study
the information, people and facilities involved and concentrate on interactions and
outputs from the inputs. Creativity and innovations of idea is given due consideration.
This method uses the ability to develop new ideas and to implement them. The core
theme is to create and apply new idea. It represents a new way of achieving the
desired result without being prejudice.
5. Quantitative approach: Problem solving is done by construction of mathematical
models. First define the problem and construct a mathematical model and derive a
solution from the model. Evaluate the model as well as the solution drawn from the
model and implement the solution to solve the problem. The computer is of great
help, when the mathematics is complex and the calculations are of large volume.
Identification of the problem of speciality unit-
During our clinical experience at Labour room in Burdwan Medical College & Hospital, we
have found that the used syringes and needles are disposed in one container along with other
materials instead three separate bucket such as ampoules, plastic paper and also the amount
of hypochlorite solution is less and strength is not known. The used syringes and needles are
not properly disposed.
Steps of problem solving-

Step I: Identification and specification of the problem:

Improper disposal of used needles and syringes.
Step II: Collection of data in relation to the problem.
What? Used needles and syringes are not properly disposed Where? In labour room of
Burdwan Medical College & Hospital. From whom data is collected? Nurses (sister in
charge, staff nurses, student nurses), doctor and group D staff. Data is collected regarding
used syringes and needle.
 How extensive is the problem?

• Needle prick injury for care giver and group D.

• Waste management protocol is not maintained.
• Chance of recycling of syringes and needles.
• Needles and syringes carry blood which is a good source of nosocomial infection if
not disinfected properly.
Data collection procedure
Data is collected through observation checklist while the health care professionals are
handling the syringes and needles after use and Interview is taken from nurses and group D
staffs.
A. Interview schedule on disposal of used syringe and needle:
Instruction: The responses of every question will be either 'yes' or 'no'. If all the answers are
'no' then it is said that there is improper disposal of syringe and needle.

Sl. No Statements Yes No

1. Is supply of syringe adequate?

2. After use are you destroy the needle in needle destroyer?

3. Are you cutting the used syringes in syringe cutter?

4. Do you have receptacle with strainer containing 1% hypo chloride

solution to receive syringes and needles separately?
5. Do you know how to prepare the 1% hypo chloride solution?

6. Do you dispose of the broken needles and shredded syringe in to the

receptacles containing 1% hypo chloride solution separately?
7. Do you prepare 1% hypo chloride solution every day?

8. Do the group D staff collect the disinfected needles and syringe by

untouched technique?
9. Do the group D staff finally dispose of the disinfected needles from
the ward in the puncture proof container?
10. Do the group D staff finally dispose of the disinfected syringes in
the blue plastic bags from the ward?
 B. Observation checklist on disposal of used syringe and needle:
The supervisor will silently notice the disposal and mark their behavior either yes or
observation is "no" then it is stated that there is improper disposal of syringe and needle.

Time: 10:00 am
Place: Burdwan Medical College & Hospital
Ward: Labour room
Name of the supervisor:
Name of the supervisee:

Behavior Yes No Remarks

1. Wear protective gloves while handling syringes and

needles.
2. Recap the needle after use.
3. Break the needle and syringe after use.
4. Put the needle in separate 1% solution hypochlorite.
5. Carry the needle and syringe during disposal in a
puncture proof container.

Step III: Analysis and inferences:

• Used needles are destroyed by needle destroyer and syringes are destroyed by syringe
cutter.
• They are not disposed of two separate receptacles containing 1% hypochlorite
solution
• Group D staff is preparing the bleaching solution but they don't know the strength.
• The receptacle contains syringes, needles and ampoules, plastic and paper also.
• There is scarcity of receptacles and gloves.
• Staffs and doctors are not motivated regarding biomedical waste management.
• Training and supervision of group D is not done.
• Puncture proof disposable containers are not available.
Step IV: Identifying probable solutions and selection of the best solution.

• More supply of receptacles and gloves from the hospital store.

• Staff development Programme regarding waste management.
• Training of group D regarding handling of syringes and needles after disinfection and
about the disposal of these items
• Supply of reusable puncture proof container if disposable containers are not available.
• Supply of bowl and strainer so that the needles can be put into the strainer which is
deep in the bowl containing 1% bleaching solution.
 • Supply of big bowl or bucket for receiving syringes for disinfection by 1%
hypochlorite solution.
• Supply of one big bucket for other materials such as plastic, ampoules etc.
• Motivate all health care professionals to dispose syringe and needles at their proper
place.
Step V: Implementation of solution with feedback

• Request the sister in charge to give two separate container one for needle and one for
syringe, one strainer and one hard plastic box for carrying the needles.
• Teaching regarding waste management is given to the Staffs and Group D.
Sister in charge has provided the things needed. She has given strict instructions to the staff
for changing of hypochlorite solution every day and new poster for disposal of waste
materials are hanged on the wall. Arranges meeting and discussion for problem solving with
the staffs. Sister in-charge also provided strainer. The staff nurses and students are motivated
to dispose the syringe and needles properly. Group D are motivated to wear gloves and how
to handle the syringes and needles after use.
Step VI: Modification of solution, if necessary, on the basis of feedback data.
Policy of disposing the used syringes and needles is changed in the ward. According to the
policy doctors are also forced to maintain it.

Conclusion-
Problem solving and decision making are process and interdependent. These are intangible,
its effect can only be felt. These are analytical and critical thinking. As a nurse administrator
we have done the job of problem solving during our clinical experience which was effective
for the ward and also for our learning.
Bibliography:
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ltd; 2015.
2. Vati. J. Principles and practice of nursing management and administration.1st Edition.
New Delhi: Jaypee Brothers medical publishers(p) ltd; 2013.
3. Sudha. R. Nursing Education Principle& Concepts. 1st Edition. New Delhi: Jaypee
Brothers medical publishers(p) ltd; 2013.