Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
CHAPTER 2: Clinical Decision-Making
THE PROBLEM-SOLVING METHOD
Clinical decision-making is the systematic process by which skilled providers make judgments
regarding a patient's condition, diagnosis, and treatment. Skilled providers possess the skills
and knowledge to perform procedures correctly. It is not enough to just perform procedures
correctly, however. You must also choose the correct procedure to meet the woman or infant’s
needs. In addition, you must be able to choose the right time to use a particular clinical skill. The
problem-solving method guides you in giving care that is safe and effective, provides an
organized way to approach and manage care, and uses skills and processes that are common
in everyday life.
Why Is It Important to Use the Problem-Solving Method?
Using a methodical approach to solve problems has three advantages:
• It helps you gather information in an organized manner.
• It helps you gather complete information so that a problem can be correctly identified.
• It helps you avoid using interventions that are not needed.
Steps in Resolving a Problem
The key steps in problem-solving are noted in Table 2.
Step 1: History
Table 2. Steps in the Problem-Solving Method
Take a targeted history.
Step 2: Physical examination
Step 3: Identification of
problems/needs
Step 4: Care plan
Step 5: Follow-up
Perform a targeted physical examination.
Identify needs and problems.
Make a plan of care based on identified needs and
problems.
Follow up with the client to evaluate the care that has
been provided.
This step repeats all the steps of the problem-solving
method, starting with step 1.
Step 1: Take a targeted history
In this step providers will ask specific questions (what, how, where, when, who, why) about a
problem to help make a diagnosis or determine the cause of the problem. Ask the client why
she has come. The reason for seeking care is called the “chief complaint.” The provider asks
the client about the problem (signs, symptoms, etc.) or stated need (vaccination, antenatal care
Integrated maternal and newborn care
Basic skills course
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