Clinical reasoning is embedded in nurses’ thinking for patient care (Levett-Jones 2013). It is a spiral, continuous mental process, underpinned by critical thinking theory and a sound body of nursing knowledge (Levett-Jones 2013). The clinical reasoning cycle includes considering patient’s situation, collecting cues, processing information, identifying problems, establishing goals, taking action, evaluating outcomes and reflecting on the process undertaken (Levett-Jones 2013). Nursing practice for registered nurses is guided both by the National Competency Standard (Nursing and Midwifery Board of Australia 2006) and the Nursing Practice Decision Flowchart (Nursing and Midwifery Board of Australia 2010) to ensure patients’ safety and to optimise care by challenging medical assumptions and facilitating evidence-based practice. The clinical reasoning framework, therefore, allows nurses to prioritise the most time sensitive and specific information, to recognise deteriorating patients and to manage complex clinical situations (Levett-Jones & Bourgeois 2011). This paper will focus on processing information and identifying the two major problems in the case study of Mr. Brown, a 74-year-old man, who was admitted to hospital after a ‘fainting’ episode with chief complaint of dizziness.
Interpret
Mr. Brown presented in the hospital after a syncopal episode observed by his wife with complaint of dizziness and lightheadedness. Syncope, the result of the sudden drop of blood pressure
This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of
It is widely known that early recognition of a deteriorating patient can contribute largely to a successful outcome, through recognising and taking action on the deteriorating health status of the patient (National Consensus Statement, 2010). This report will explore the ways in which deteriorating patients and clinical reasoning are used in the public health care system in New South Wales (NSW).
Standing (2011), defines clinical decision-making as a complex process that involves observation, gathering information, critical thinking, evaluating evidence, applying necessary knowledge, reflection and problem-solving skills. Every day nurses make important clinical decisions and these decisions have important implications for patient outcomes and deserve serious consideration. Therefore, it is important for nurses to have a better insight of the decision-making process, be able to deliver holistic care and meet essential and complex physical and mental health needs of the patient.
In my week five, I learned about person-centered care(PCC) and we watch two powerful videos related to PCC. The activity about Jim to consider the first four elements of the Clinical Reasoning Cycle(CRC). PCC is the key element of professional nursing practice in Code of conduct (NMBA, 2018) and to achieve this, clinical reasoning skill is fundamental and effects the patient outcome greatly (Cooper et al., 2011). When I was watching video about a senior female patient who were treated from nurses like a task to finish, I was so sad and irritated by their nonprofessional attitudes. In contrast, the other video with Rio 2016 Paralympics was one of my favorite video it is strong and inspiring. I could realize the importance
With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations:
This assignment will critically analyse and justify the decisions based around a fictitious patient using a clinical decision making framework highlighting its importance to nursing practice. The chosen model will demonstrate clinical decision making skills in the care planning process. The patient’s condition will be discussed in-depth explaining the pathophysiology, social, cultural and ethical issues where appropriate in the care planning and decision making process. Any vulnerability that the patient may experience will be discussed and dealt with in the care planning and decision making process. The supporting evidence based literature will be analysed and
Nurses often have to make quick decisions, usually without adequate time to consider the entire situation. Have you ever wondered, how a person knew what to do, seemingly without ever thinking about it? Barbara Carper, was able to answer this question in detail with her “Ways of Knowing Concepts”, which she developed particularly for the nursing profession (Zander, 2011). A few of her concepts will be compared to a clinical situation, personal to this author. The above question will be explained in multiple ways so the reader will better understand Carper’s concepts and how they may apply to their own situation. This will be accomplished by: describing the clinical situation, observing applicable concepts and then relating them to the situation, visiting how an understanding of her concepts explains interventions and critical thinking, and how evidence affects critical thinking and knowing.
This essay sets out to discuss the importance of comprehensive and accurate assessment on a registered nurses’ ability to make excellent clinical decisions. It will examine what factors can change a nurses’ capability to be aware of, and act on abnormal assessment findings. As well as assessment being part of the nursing process that is used in every day nursing, it is also a critical part of patient safety (Higgins, 2008). Assessment findings are used to determine what needs to be done for the patient next. Early warning scoring systems currently exist to aid in the early detection of patient deterioration (Goldhill, 2005). The rationale for the use of these systems is that early recognition of deterioration in the vital signs of a
Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Critical thinking has been described as the ability to gather and process data in such a way as to arrive at the best conclusion using the filters of prior knowledge, experience and external resources to overcome personal emotions, biases, and assumptions. (This description was developed during NUR/300 class, University of Phoenix, S. Colorado, March 16, 2006) Note that critical thinking is described as a
Care within the hospital has become very complex and challenging as nurses are being faced with taking critical decisions associated with care of seriously
The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.
Critical thinking refers to the ability to think rationally and clearly. It enables one be able to think well and be able to solve problems in a systematic manner. It also plays a role in evaluating ideas and acts as a tool for self evaluation. In nursing, critical thinking for clinical decision making refers to the process of thinking in a logical and systematic manner. Nursing practitioners who are critical thinkers strive to be clear, accurate, significant, precise and logic when carrying out their daily activities ADDIN EN.CITE Mateo2009451(Mateo & Kirchhoff, 2009)4514516Mateo, M. A.Kirchhoff, K. T.Research for advanced practice nurses: From evidence to practice. 2009New York, NYSpringer( HYPERLINK l "_ENREF_6" o "Mateo, 2009 #451" Mateo & Kirchhoff, 2009). Critical thinking in nursing involves some elements of thought. It involves being able to figure out a problem, issue or views of somebody else. The goal of thinking is to figure out what one hopes to accomplish ADDIN EN.CITE Sheridan19841096(Sheridan, Vredenburgh, & Abelson, 1984)1096109617Sheridan, John E.Vredenburgh, Donald J.Abelson, Michael A.Contextual Model of Leadership Influence in Hospital UnitsThe Academy of Management JournalThe Academy of Management Journal57-782711984Academy of Management00014273http://www.jstor.org/stable/255957( HYPERLINK l "_ENREF_7" o "Sheridan, 1984 #1096" Sheridan, Vredenburgh, & Abelson, 1984). Critical
Clinical reasoning is “the process of applying knowledge and expertise to a clinical situation to develop a solution” (Carr, 2004 cited in Banning, 2008, p.177). Poor clinical reasoning skills can lead to a “failure to recue” (Aitken et al., 2003) the deteriorating patient. Additionally, studies by Hoffman et al. have compared the way in which the expert nurse and the novice nurse accurately collect cues from which they base their decisions. Effective clinical reasoning is therefore linked to “the ability to collect the right cues and take the right action for the right patient at the right time and for the right reason” (Levett-Jones et al., 2010). The ability to apply these “five rights of clinical reasoning” (Levett-Jones et al., 2010) will be discussed in more detail in Nursing Actions and Interventions: A Reflection.
Clinical reasoning can be defined as, ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient’s problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process’ (Levett-Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that ‘cognitive failure’ resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse’s preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care.
Critical thinking and clinical reasoning are similar in the fact that each term represents a set of methods that guide the nurse to reliable evidence-based practice while delivering care. Critical thinking and clinical reasoning are centered on knowledge base that is associated with the discipline of nursing. With each concept, the nurse must have an existing developed knowledge base in which to apply each concept to. Nurses apply critical thinking and clinical reasoning skills when patient care decisions are made. With both critical thinking and clinical reasoning, information about the patient is collected and examined. They work together to produce clinical judgment. They both direct nursing care to meet patients’ needs resulting in higher quality of care and better patient outcomes.