Scientific management originated in the early 1900s. It is the first type of management theory used (GCU 2013). With this theory, productivity increases profit for the organization. Participative decision occured in the 1920s when workers were tired with having no voice. They were dissatisfied with their type and level of work which affected productivity. “Management is focused on task accomplishment…” (Huber 214). Four elements are involved in management. These four elements include planning, organizing, coordinating and controlling. Planning includes long and short term objectives. Organizing collects and configures resources. Coordinating directs and controlling monitors and adjusts. 

The routine use of heparin injects in the hospital and other facilities is a scientific management theory that nurses follow automatically because it is ordered by a doctor. Heparin reduces the risk for blood clots by inhibiting factor X. Almost every hospitalized patient receives sub-q heparin on a regular schedule at the hospital. But not every patient needs heparin. Heparin can cause unnecessary pain and bruising in the patient that does not require heparin shots.  Each patient should be assessed prior to giving heparin. 

Using critical thinking, the patient can be assessed according to the situation. Is the patient bed bound? Does the patient ambulate? If the patient is ambulatory and does not pose a risk for blood clots such as previous ischemic stroke or current smoker, then the patient may not need heparin shots. Does the patient use other DVT prevention methods such as sequential compression devices for their legs? If so, the risk is low and the patient should not automatically receive heparin shots. 

Where I work, we have a Unit Councel that chooses volunteer nurses to sit and participate with a board of administrators in order to make collective choices and decisions about current practices. For example, we lacked an adequate break room on Pediatrics and had to share the break room with Post Partum. This showed a loss of productivity by increasing the amount of time to travel to Post Partum for a break lessening the time spent with patients. This also increased stress in the nursing staff because sometimes we were unable to take breaks because of the travel. Volunteer nurses from my unit brought up this important subject during a unit councel meeting which resulted in Pediatrics now having an adequate break room.

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Numerous factors have created significant challenges in the work environments of contemporary nurses. New advances in biomedical science, the growing need for improved disease prevention and management, integration of new clinical care technologies, cultural diversity and shifts in care delivery have all contributed to the rapidly increasing need for well-educated, experienced nurses (Holloway & Galvin, 2016). Collaboration within multidisciplinary teams fosters opportunities to address clinical problems and issues using various perspectives and expertise. Also, nurses can use research to shape health policy in patient care. Incorporating relevant research findings into clinical practice and evaluating effectiveness, helps close the gap between research and practice (Grove, Burns & Gray 2014).

Research uses investigation, exploration, and discovery to understand the philosophy of science. The use of clinically relevant research can develop, refine, and extend nursing knowledge and strengthen their skills by utilizing evidence- base practices to provide patients with the best outcomes, provide safe nursing interventions and use accurate and precise nursing assessment measures (Parahoo, 2014).

Evidence–based practices (EBP) has impacted nursing practice, education, and science. Three primary goals of the Magnet Recognition Program are supported by research, evidence-based practice and quality improvement. Evidence-based practice is guided by research findings, quality improvement, and expert opinion to identify methods of improvement (Parahoo, 2014). EBP uses the best evidence stemming from research and applies it to the clinical decision-making. EBP typically comes from systematic review, meta-analysis, or established evidence-based clinical practices. Other evidence comes from randomized controlled trials, quantitative studies, qualitative studies, and expert opinion and analyses. EBP integrates current trends, identifies assessment, diagnostic strategies and therapeutic interventions that reflect current evidence including data and research literature to the individualization of care with the inclusion of patient preferences (Grove, Burns & Gray, 2014).