Concept, Importance and Step of Decision Making
Decision-making is the act of making a choice among available alternatives. There are innumerable decisions that are taken by human beings in day-to-day life. In business undertakings, decisions are taken at every step. It is also regarded as one of the important function of management
Summary
Decision-making is the act of making a choice among available alternatives. There are innumerable decisions that are taken by human beings in day-to-day life. In business undertakings, decisions are taken at every step. It is also regarded as one of the important function of management
Things to Remember
- Decision making is a key part of a manager's activities.
- Decision making s related to planning, organizing, directing and controlling functions of a manager.
- Decision making is important to achieve the organizational goals/objectives within given time and budget.
- Decision-making is a pervasive function of managers aimed at achieving organizational goals.
MCQs
No MCQs found.
Subjective Questions
Q1:
What are the categories of protein energy malnutrition ?
Type: Long Difficulty: Easy
Show/Hide Answer
Answer: <ol>
<li><em>Kwashiorkor </em></li>
</ol>
<p>Deficiency of protein compare to energy in nutrition causes kwashiorkor. It is usually seen in the 1-4 year age group when the need for protein is high.</p>
<p>The major features includes:</p>
<ul>
<li>Growth failure</li>
<li>Lethargy</li>
<li>Apathy</li>
<li>Irritability</li>
<li>Edema</li>
<li>Loss of appetite</li>
<li>Loss of muscle tone</li>
<li>Enlarged liver</li>
<li>Dermatitis</li>
<li>Pigmentation of skin</li>
<li>Sparse and easily pluckable hair</li>
<li>Brownish colored hair</li>
<li>Anemia and vitamin deficiencies</li>
<li>No interest in toys</li>
<li>Difficult to feed child orally</li>
<li>The child often suffers from recurrent episodes of diarrhea, respiratory and skin infection</li>
</ul>
<ol>
<li><em>Marasmus </em></li>
</ol>
<p>Deficiency of energy as compared to protein in nutrition causes marasmus. It usually occurs during infancy characterized by gross wasting of muscles and subcutaneous tissue resulting in emaciation and marked stunting. It accounts on the large burden on global health. The world health organization(WHO) estimates his death attributable to marasmus approach 50% of the more those ten million deaths of children under the age of five with PEM.</p>
<p>The major signs and symptoms includes:</p>
<ul>
<li>The body weight is <60% of expected weight for the age and height is also affected to some extent.</li>
<li>Wrinkled skin due o muscle wasting and loss of subcutaneous fat.</li>
<li>Abdominal distention with history of diarrhea</li>
<li>Marked weight loss and subnormal height.</li>
<li>Hungry, voracious appetite.</li>
<li>Anemia</li>
<li>A loose fold of skin is prominent over the gluten and him inner side of thighs.</li>
<li>Skin appears dry, scaly, inelastic, and prone to be infected</li>
<li>The bony points appear unduly prominent due to emaciation.</li>
<li>Baby appears alerted.</li>
</ul>
<ol>
<li><em>Marasmic kwashiorkor</em></li>
</ol>
<p>Deficiency of both protein and energy in nutrition shows the signs and symptoms of both(marasmic kwashiorkor)</p>
<li><em>Kwashiorkor </em></li>
</ol>
<p>Deficiency of protein compare to energy in nutrition causes kwashiorkor. It is usually seen in the 1-4 year age group when the need for protein is high.</p>
<p>The major features includes:</p>
<ul>
<li>Growth failure</li>
<li>Lethargy</li>
<li>Apathy</li>
<li>Irritability</li>
<li>Edema</li>
<li>Loss of appetite</li>
<li>Loss of muscle tone</li>
<li>Enlarged liver</li>
<li>Dermatitis</li>
<li>Pigmentation of skin</li>
<li>Sparse and easily pluckable hair</li>
<li>Brownish colored hair</li>
<li>Anemia and vitamin deficiencies</li>
<li>No interest in toys</li>
<li>Difficult to feed child orally</li>
<li>The child often suffers from recurrent episodes of diarrhea, respiratory and skin infection</li>
</ul>
<ol>
<li><em>Marasmus </em></li>
</ol>
<p>Deficiency of energy as compared to protein in nutrition causes marasmus. It usually occurs during infancy characterized by gross wasting of muscles and subcutaneous tissue resulting in emaciation and marked stunting. It accounts on the large burden on global health. The world health organization(WHO) estimates his death attributable to marasmus approach 50% of the more those ten million deaths of children under the age of five with PEM.</p>
<p>The major signs and symptoms includes:</p>
<ul>
<li>The body weight is <60% of expected weight for the age and height is also affected to some extent.</li>
<li>Wrinkled skin due o muscle wasting and loss of subcutaneous fat.</li>
<li>Abdominal distention with history of diarrhea</li>
<li>Marked weight loss and subnormal height.</li>
<li>Hungry, voracious appetite.</li>
<li>Anemia</li>
<li>A loose fold of skin is prominent over the gluten and him inner side of thighs.</li>
<li>Skin appears dry, scaly, inelastic, and prone to be infected</li>
<li>The bony points appear unduly prominent due to emaciation.</li>
<li>Baby appears alerted.</li>
</ul>
<ol>
<li><em>Marasmic kwashiorkor</em></li>
</ol>
<p>Deficiency of both protein and energy in nutrition shows the signs and symptoms of both(marasmic kwashiorkor)</p>
Q2:
Explain the treatment and management of malnutrition ?
Type: Long Difficulty: Easy
Show/Hide Answer
Answer: <p>PROTEIN ENERGY MALNUTRITION</p>
<p><u>Mild PEM</u>:</p>
<ol>
<li>Nutrition education including a demonstration on preparing food eg litto.</li>
<li>Increase the calories and protein in the diet by taking small meals often throughout the day. Eat r drink a nutrition supplement if you have trouble eating the right food.</li>
<li>Supervised feeding</li>
<li>Food supplement</li>
</ol>
<p><u>Moderate PEM:</u></p>
<p>Treatment is as same as mils PEM plus treatment of infection and deficiency status. But if the child is having the moderate PEM with the infectious condition and feeding problem need hospitalization and further management with antibiotic therapy and dietary therapy.</p>
<p><u>Severe PEM:</u></p>
<p><strong>Hospitalization of child</strong>: Criteria for hospital admission includes weight loss less than 60% of expected weight for age or, 70% of weight for height with edema, severe dehydration, diarrhea, hypothermia, shock, systematic or localize infection, jaundice, bleeding, persistent loss of appetite and baby less than 1 year of age.</p>
<p><strong>Ten essential steps of management of severe malnutrition with phase:</strong> Initial stabilization phase (1<sup>st</sup> week) and rehabilitation phase (2-6 weeks)</p>
<p>Steps of management:</p>
<ol>
<li>Hypoglycemia: Treatment and prevention of hypoglycemia should be one simultaneously. If the child conscious and dextrotix <3mmol, administer 50 ml bolus, of 10% dextrose orally or by NG tube, start feeding every 30 minutes for 2 hours throughout the day and night, but if he child is unconscious, give IV 10 % glucose(5ml/kg)followed by 50 ml of 20% glucose anf feeding as above and monitor blood glucose level.</li>
<li>Hypothermia : monitor baby’s axillary temperature, if it is <35 degrees or rectal temperature <35.5 degree centigrade; feed the child immediately, keep the baby warm (using blanket, hot water bags, heater with precautions), ask the mother to sleep with child, again monitor temperature 2 hourly it rises to 36.5 degrees c, ensure the child is covered all the time and monitor and correct hypoglycemia.</li>
<li>Dehydration: it is assume that all children with severe malnutrition is having watery diarrhea may have some dehydration sp treat accordingly. Give special Rehydration solution for malnutrition (rosomal 5ml/kg every 30 minutes for 2 hours orally/ NG then 5-10 ml/kg/hr for next 4-10 hours, of the child is conscious and can drink. But if the child is in shock treat dehydration by slowly infusion of RL or N/2 in 5% dextrose (30ml/kg in 2 hours) followe by N/6 saline in 5% dextrose(100ml/kg) at rate of 10mg/kg in next 10 hours and same solution 5ml/kg for next 12 hours. Continue feeding, if the child is breast feeding, assess hydration level and monitor vital signs as well as stool urine and vomiting.</li>
<li>Electrolytes: correction of potassium and magnesium is essential. So treat accordingly by giving potassium (3-4 mmol/kg/d and magnesium (0.4-0.6 mmol/kg/day but if the child has excess edema. Low sodium-containing food should be preferred.</li>
<li>Infection prevention treatment: assumed that all malnourished children have multiple infections and treat with broad spectrum antibiotics and give immunization(measles) if a child is >6 months.</li>
<li>Correction of micronutrient deficiency: give vitamin A orally on day first, multivitamin, folic acid 1mg/kg (5mg on day 1<sup>st</sup>), zinc 2mg/kg/day, copper 0.3mg/kg/day and iron 3mg/kg/day after weight gain.</li>
<li>Caution feeding:</li>
</ol>
<ul>
<li>Small frequent or low osmolality and low lactose orally, NG feed but no parental.</li>
<li>100 kcal, 1-1.5 gm protein, 130 ml/kg/day fluid but if severe edema then give 100ml/kg/day.</li>
<li>Encourage continue breastfeeding</li>
<li>Monitor and note; amount left over, vomiting, stool pass, daily body weight.</li>
</ul>
<ol start="2">
<li>Catch-up growth: initiated with a vigorous approach of feeding to achieve rapid weight gain >10gm/kg/day. That I achieved through recommended milk based f-100 contains 100 kcal and 2.9gm protein/100ml. Similarly, modified porridge or family foods can also be given. When he appetite return, child is ready for rehabilitation. So, change the starter to catch up formula.</li>
</ol>
<ul>
<li>Replace f-75 with the same amount of f-100 for 48 hours then, increase each successive feed with 10 ml until more feed is finished or when intake is reached about 30ml/kg/feed</li>
<li>Monitor child for a sign of heart failure, puls respiration and if a problem detected, modify feeding.</li>
<li>Monitor progress assessing the rate of weight gain.</li>
</ul>
<ol>
<li>Provide sensory stimulation and emotional support: Stimulate and support child by providing tender loving care, cheerful stimulating environment , play therapy, age appropriate physical activities and maternal involvement in feeding, comforting and caring</li>
<li>Prepare for follow up visit: A child who has 90% weight for height can be considered as recovered. So, teach parents on good feeding practices, sensory stimulation, and play therapy. Likewise advise parents to ensure booster immunization is given including vitamin A, bring child for regular health checkup for growth monitoring.</li>
</ol>
<p><u>Mild PEM</u>:</p>
<ol>
<li>Nutrition education including a demonstration on preparing food eg litto.</li>
<li>Increase the calories and protein in the diet by taking small meals often throughout the day. Eat r drink a nutrition supplement if you have trouble eating the right food.</li>
<li>Supervised feeding</li>
<li>Food supplement</li>
</ol>
<p><u>Moderate PEM:</u></p>
<p>Treatment is as same as mils PEM plus treatment of infection and deficiency status. But if the child is having the moderate PEM with the infectious condition and feeding problem need hospitalization and further management with antibiotic therapy and dietary therapy.</p>
<p><u>Severe PEM:</u></p>
<p><strong>Hospitalization of child</strong>: Criteria for hospital admission includes weight loss less than 60% of expected weight for age or, 70% of weight for height with edema, severe dehydration, diarrhea, hypothermia, shock, systematic or localize infection, jaundice, bleeding, persistent loss of appetite and baby less than 1 year of age.</p>
<p><strong>Ten essential steps of management of severe malnutrition with phase:</strong> Initial stabilization phase (1<sup>st</sup> week) and rehabilitation phase (2-6 weeks)</p>
<p>Steps of management:</p>
<ol>
<li>Hypoglycemia: Treatment and prevention of hypoglycemia should be one simultaneously. If the child conscious and dextrotix <3mmol, administer 50 ml bolus, of 10% dextrose orally or by NG tube, start feeding every 30 minutes for 2 hours throughout the day and night, but if he child is unconscious, give IV 10 % glucose(5ml/kg)followed by 50 ml of 20% glucose anf feeding as above and monitor blood glucose level.</li>
<li>Hypothermia : monitor baby’s axillary temperature, if it is <35 degrees or rectal temperature <35.5 degree centigrade; feed the child immediately, keep the baby warm (using blanket, hot water bags, heater with precautions), ask the mother to sleep with child, again monitor temperature 2 hourly it rises to 36.5 degrees c, ensure the child is covered all the time and monitor and correct hypoglycemia.</li>
<li>Dehydration: it is assume that all children with severe malnutrition is having watery diarrhea may have some dehydration sp treat accordingly. Give special Rehydration solution for malnutrition (rosomal 5ml/kg every 30 minutes for 2 hours orally/ NG then 5-10 ml/kg/hr for next 4-10 hours, of the child is conscious and can drink. But if the child is in shock treat dehydration by slowly infusion of RL or N/2 in 5% dextrose (30ml/kg in 2 hours) followe by N/6 saline in 5% dextrose(100ml/kg) at rate of 10mg/kg in next 10 hours and same solution 5ml/kg for next 12 hours. Continue feeding, if the child is breast feeding, assess hydration level and monitor vital signs as well as stool urine and vomiting.</li>
<li>Electrolytes: correction of potassium and magnesium is essential. So treat accordingly by giving potassium (3-4 mmol/kg/d and magnesium (0.4-0.6 mmol/kg/day but if the child has excess edema. Low sodium-containing food should be preferred.</li>
<li>Infection prevention treatment: assumed that all malnourished children have multiple infections and treat with broad spectrum antibiotics and give immunization(measles) if a child is >6 months.</li>
<li>Correction of micronutrient deficiency: give vitamin A orally on day first, multivitamin, folic acid 1mg/kg (5mg on day 1<sup>st</sup>), zinc 2mg/kg/day, copper 0.3mg/kg/day and iron 3mg/kg/day after weight gain.</li>
<li>Caution feeding:</li>
</ol>
<ul>
<li>Small frequent or low osmolality and low lactose orally, NG feed but no parental.</li>
<li>100 kcal, 1-1.5 gm protein, 130 ml/kg/day fluid but if severe edema then give 100ml/kg/day.</li>
<li>Encourage continue breastfeeding</li>
<li>Monitor and note; amount left over, vomiting, stool pass, daily body weight.</li>
</ul>
<ol start="2">
<li>Catch-up growth: initiated with a vigorous approach of feeding to achieve rapid weight gain >10gm/kg/day. That I achieved through recommended milk based f-100 contains 100 kcal and 2.9gm protein/100ml. Similarly, modified porridge or family foods can also be given. When he appetite return, child is ready for rehabilitation. So, change the starter to catch up formula.</li>
</ol>
<ul>
<li>Replace f-75 with the same amount of f-100 for 48 hours then, increase each successive feed with 10 ml until more feed is finished or when intake is reached about 30ml/kg/feed</li>
<li>Monitor child for a sign of heart failure, puls respiration and if a problem detected, modify feeding.</li>
<li>Monitor progress assessing the rate of weight gain.</li>
</ul>
<ol>
<li>Provide sensory stimulation and emotional support: Stimulate and support child by providing tender loving care, cheerful stimulating environment , play therapy, age appropriate physical activities and maternal involvement in feeding, comforting and caring</li>
<li>Prepare for follow up visit: A child who has 90% weight for height can be considered as recovered. So, teach parents on good feeding practices, sensory stimulation, and play therapy. Likewise advise parents to ensure booster immunization is given including vitamin A, bring child for regular health checkup for growth monitoring.</li>
</ol>
Q3:
How can we diagnose malnutrition ?
Type: Short Difficulty: Easy
Show/Hide Answer
Answer: <ol>
<li>History: history includes dietary history, child heal history and family history etc</li>
<li>Physical examination presentation: Overall appearance, skin, muscles, and an amount of boy fat they have, eating habits etc.</li>
<li>Assessment of nutritional status:</li>
</ol>
<ul>
<li>Growth chart</li>
<li>Weight and height measurement</li>
<li>Measurement of upper mid-air circumference</li>
</ul>
<ol>
<li>Lab tests may include lipid profile, complete blood count, albumin, total protein, iron tests, vitamin and minerals</li>
<li>X-rays, CT scans, MRI to evaluate the health of internal organs and the normal growth and development of muscles and bones.</li>
</ol>
<li>History: history includes dietary history, child heal history and family history etc</li>
<li>Physical examination presentation: Overall appearance, skin, muscles, and an amount of boy fat they have, eating habits etc.</li>
<li>Assessment of nutritional status:</li>
</ol>
<ul>
<li>Growth chart</li>
<li>Weight and height measurement</li>
<li>Measurement of upper mid-air circumference</li>
</ul>
<ol>
<li>Lab tests may include lipid profile, complete blood count, albumin, total protein, iron tests, vitamin and minerals</li>
<li>X-rays, CT scans, MRI to evaluate the health of internal organs and the normal growth and development of muscles and bones.</li>
</ol>
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Concept, Importance and Step of Decision Making
Concept of Decision-Making
Decision-making is the act of making a choice among available alternatives. There are innumerable decisions that are taken by human beings in day-to-day life. In business undertakings, decisions are taken at every step. It is also regarded as one of the important function of management. Managerial functions like planning, organizing, staffing, directing, coordinating and controlling are carried through decisions. Decision making is possible when there are two or more alternatives to solve a single problem or difficulty. If there is only one alternative then there is no question of decision making. It is believed that the management without a decision is a man without a backbone. Therefore, decision making is a problem-solving approach by choosing a specific course of action among various alternatives.
"Decision-making is the selection, based on some criteria from two or more possible alternatives. “- George R.Terry
"A decision can be defined as a course of action consciously chosen from available alternatives for the purpose of the desired result" -J.L. Massie
In conclusion, we can say that decision making is the process of choosing a specific course of action from various alternatives to solve the organizational problems or difficulties.
Importance of Decision-Making
Decision making is considered as the backbone for the business management because without taking the right decision at right time, nothing can be performed. The further importance of decision making can be discussed under the following points:
- Proper utilization of resources: Organization has various resources like man, money, method, material, machine, market and information. All these resources are properly utilized without any leakage and wastage with the help of right decision at right time. As a result, an organization can operate at a minimum cost.
- Selecting the best alternative: As we know that the problem has multiple solutions. Decision making is important to select the best alternative among various alternatives by analyzing them one by one using various financial, statistical, and accounting tools/ technique.
- Evaluation of the managerial performance: Decision making is not only important to select the best alternative but also essential for evaluating the performance of a manager. The quality/success of manager largely depends upon the number of right decision that he/she can take for the organizational success. Therefore, decision making is important to judge the performance of top level of management.
- Employees motivation: Decision making is important to motivate the employees within an organization. It provides an overall framework of operation and guideline to the operating level of staffs. It also provides different types of facilities and benefit on time. As a result, employees are motivated to their job or work as per the organizational requirement.
- Indispensable element/ component: Decision making is indispensable element/ component for the organizational success because without taking the right decision at right time, nothing can be performed as per the plan.
- Achievement of goal/ objectives : Decision making is important to achieve the organizational goals/objectives within given time and budget. It searches the best alternative, utilize the resources properly and satisfy the employees at the workplace. As a result, organizational goal or objectives can be achieved as per the desired result.
- Pervasive function: Decision-making is a pervasive function of managers aimed at achieving organizational goals. Decisions are to be taken in all managerial functions such as planning, organizing, motivating, directing and controlling and in all functional areas such as production, marketing, finance, personnel and research and development. It indicates that the decision-making is spread over many areas of the organization.
Steps of Decision-Making Process
For the rationality, reliability, and enforceability of decisions, managers should follow a sequential set of steps. It is said that a decision is rational if appropriate means are chosen to reach desired ends. In this regards, various management authorities have recognized and described different steps in the process of decision-making. Ricky W. Griffin has suggested six steps in the process of decision making. Accordingly, the steps are:
- Identification of problem: The initial stage of the decision-making process is to identify the exact problem. The problem may occur due to the gap between thinking and do the process. The reason of problems may be internal or external. Decision makers should identify the correct problems before taking any decision. It is not an easy job or task. Therefore, he/she may use his own knowledge, skills, experience and collect information from internal and external sources. It is believed that identification of the correct problem is almost half part of the decision-making process.
- Analysis of problem: After identification of the correct problem decision maker should analyze the problem systematically and scientifically in terms of cost, time, legality, organizational resources, and short-term as well as the long-term impact of the problem. While analyzing the problem he/she may use various financial, accounting and statistical tools or techniques.
- Developing an alternative course of action: As we know that a problem has multiple solutions. Therefore, the decision maker should develop the various possible alternatives for a better decision. While developing the alternative course of action he/she may use their own knowledge, skills, experiences and technical support from the professional planner and experts as well.
- Evaluating alternative course of action: After developing various possible alternatives, the decision maker should evaluate all alternatives one by one for a better decision. In this step he/she should try to search the answers to the following questions:
- Whether the alternative is feasible in terms of cost, time, legality and other organizational resources or not?
- Whether the alternative is satisfactory to solve the organizational problems or not ?
- Whether the features of alternatives are matched with the objectives of the business or not ?
- Selecting the best alternative: After analyzing the various alternatives, the decision maker has to select the best alternative among the various alternative by considering the short-term as well as long-term impact. For this purpose, he/she may use his/her knowledge, skills and experiences. He/she may also concern with other stakeholders for a better decision.
- Implementation of decision: After selecting the best alternative, the manager or superior should convert decision into action. For this purpose, he/she should communicate with their subordinate and manage the various additional resources for the implementation of the organizational decision.
- Review of decision: The last step of the decision-making process is to get response or feedback from other stakeholders of the organization. If the response is positive then the decision-making process is successfully completed. It the response is negative then he/she must go through the first step to take a new organizational decision.
References:
Pokhrel, Dhurb Raj et.al., Business Studies-XII, Asmita Book Publication, Kathmandu
Poudyal, Santosh Raj et.al., Business Studies-XII, Asmita Book Publication, Kathmandu
Bhandari, Kedar Prasad, Business Studies-XII, Bundipuran Prakashan, Kathmandu
Lesson
Decision Making
Subject
Business Studies
Grade
Grade 12
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