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Acute Care Nursing 1 NRSG258 Australian Catholic University Dealing Clinical Patients

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James Moore
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Acute Care Nursing 1 (NRSG258) Australian Catholic University Clinical Reasoning Sample For Dealing With Clinical Patients

CHAPTER 1CLINICAL REASONING: WHAT IT ISAND WHY IT MATTERSTRACY LEVETT-JONES

LEARNING OUTCOMES Completion of the activities in this chapter will enable you to:explain what it means to ‘think like a nurse’defi ne and explain the process of clinical reasoningjustify why nursing students need to learn about clinical reasoning discuss how clinical reasoning errors can adversely affect patient outcomesexplain the relationship between clinical reasoning and critical thinkingexplain how stigmatising, stereotyping, preconceptions and assumptions can negatively impact clinical reasoningexplore and discuss different types of clinical reasoning errors. CHAPTER 1CLINICAL REASONING: WHAT IT ISAND WHY IT MATTERSTRACY LEVETT-JONES.

WHAT DOES IT MEAN TO ‘THINK LIKE A NURSE’?

WHY IS CLINICAL REASONING IMPORTANT?

CLINICAL REASONING?Clinical reasoning is a systematic and cyclical process that guides clinical decision making, particularly in unpredictable, emergent and non-routine situations, and leads to accurate and informed clinical judgments. Clinical reasoning is defined as ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process’ (Levett-Jones et al., 2010, p. 516). The clinical reasoning cycle (Figure 1.1) is informed by a body of research undertaken by Hoffman (2007) and Levett-Jones et al. (2010).  diagram showing the clinical reasoning cycle and describing the nursing actions that occur during each stage is provided in Figure 1.2. The cycle begins at 1200 hours and moves in a clockwise direction through eight stages: look, collect, process, diagnose, plan, act, evaluate and reflect. Although each stage is presented as a separate and distinct element in this diagram, in reality clinical reasoning is a dynamic process and nurses often combine one or more stages or move back and forth between them before reaching a diagnosis, taking action and evaluating outcomes. Table 1.1 provides an example of a nurse’s clinical reasoning while caring for a man following surgery for an abdominal aortic aneurysm. Stages of the clinical reasoning cycle1. Consider the patient situationDuring the first stage of the clinical reasoning cycle, the nurse begins to gain an initial impression of the patient and identifies salient features of the situation. This first impression, which Tanner (2006) refers to as ‘noticing’, is critical but can be negatively influenced by the nurse’s preconceptions, assumptions and biases.

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Acute Care Nursing 1 NRSG258 Australian Catholic University Dealing Clinical Patients

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