Clinical decision making Flashcards

1
Q

Facts

A

can be verified through investigation

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2
Q

Inferences

A

Conclusions drawn from facts; going beyond facts to make a statement about something not currently known

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3
Q

Judgments

A

Evaluation of facts or info that reflect values or other criteria
A type of opinion

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4
Q

Opinions

A

Beliefs formed over time

May include judgements that may fit facts or be in error

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5
Q

Bandwagon reasoning

A

Doing something because everyone else is doing it

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6
Q

Circular reasoning

A

Supporting an opinion by restating it using different words

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7
Q

Cause-and-effect fallacy

A

Linking something that happens to something that occurs before it happens

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8
Q

Either-or fallacy

A

Assuming a detailed question only has a couple of responses

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9
Q

Overgeneralizations

A

Not enough evidence to come to a conclusion

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10
Q

Assessment

A

gathering info to determine what the problem is.

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11
Q

Nursing diagnosis

A

stating the specific problem to solve based on the assessment data obtained

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12
Q

Planning

A

Stating how to know when the problem is resolved

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13
Q

Implementation

A

Giving solutions to resolve the problem

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14
Q

Evaluation

A

Evaluating if the problem has been resolved

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15
Q

Benner’s skill acquisition model

A

Five levels of proficiency that a nurse will progress through as she gains additional clinical experience.
Novice, advanced beginner, competent, proficient, and expert

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16
Q

Benner’s 5 levels of clinical competence: Novice

A

Beginners without nursing experience
Do actions by following rules
Limited ability to act independent of being told what to, when to, and how to do nursing actions

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17
Q

Benner’s 5 levels of clinical competence: Advanced beginner

A

Typically new grads
Have limited nursing experience
Beginning to recognize significant cues from internal cognitive processing

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18
Q

Benner’s 5 levels of clinical competence: Competent

A

After 2-3 years experience
Intentional planning of care
Still not able to see bigger picture from significant cues

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19
Q

Benner’s 5 levels of clinical competence: Proficient

A

Can see the whole picture

Formulates own rules for actions by analyzing significant cues

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20
Q

Benner’s 5 levels of clinical competence: Expert

A

Many years experience
Intuitive practitioner
Highly developed cognitive abilities

21
Q

Lasater’s Clinical Judgement Rubric

A

Developed to measure and evaluate clinical judgment using simulation

22
Q

Features of the Tanner Clinical Judgment Model: Noticing

A

Having sense about what is happening in client situation
May include recognition of or absence of expected sig. cues from client’s responses to illness or medical condition.
Includes influences of the nurse’s own health beliefs about client situations and expectations of the work culture for client care.

23
Q

Features of the Tanner Clinical Judgment Model: Interpreting

A

Using logical reasoning to gain understanding about a situation and determine appropriate actions

24
Q

Features of the Tanner Clinical Judgment Model: Responding

A

Analyzing sit. and choosing best course of action
Intuitive “knowing” from past similar experiences
Using past similar experiences to make sense of a present sit.
Responsive actions by nurse

25
Q

Features of the Tanner Clinical Judgment Model: Reflecting

A

Cognitively reviewing clinical situation
Considering appropriateness of assessment data, actions taken, and +/- outcomes for client
Making mental response adjustments to be done in future similar situations
Learning from actions

26
Q

Lasater’s Clinical Judgement Rubric

A

Based on Tanner’s clinical judgment model.

Developed to measure and evaluate clinical judgment using simulation

27
Q

Lasater’s levels of clinical development: Noticing

A

Focus on significant cues
Recognize differences
Look for cues

28
Q

Lasater’s levels of clinical development: Interpreting

A

Prioritize data

Make sense of data

29
Q

Lasater’s levels of clinical development: Responding

A

Calm and confident
Clear communication
Do planned actions
Skill abilities

30
Q

Lasater’s levels of clinical development: Reflecting

A

Evaluate/analyze self

Desire to be better

31
Q

Intellect

A

Ability to learn, understand knowledge
Capacity for thinking, reasoning intelligently
Salient cues

32
Q

Creativity

A
Outlet for imagination
Finding unique solutions to unique problems when traditional interventions ineffective
Thinking out of the box
Increases number of alternatives
Requires knowledge of the problem
33
Q

Inquiry

A

Search for knowledge, facts.
To gain clarification, find solutions to problems
Differs from query

34
Q

Reasoning

A
Deductive reasoning (top down)
Inductive reasoning (Bottom up)
Clinical reasoning
35
Q

Reflection

A

Action of making sense of occurrences, situations, or decisions by carefully considering totality of experience
Debriefing (reflective thinking)

36
Q

Intuition

A

“Gut reaction”
Use of nursing knowledge, experience, expertise for understanding without conscious use of reasoning.
Process of continual analyzing
Not recommended for new nurses, students

37
Q

Types of decisions made during process of solving problems

A

Value decisions
Time management decisions
Scheduling decisions
Priority decisions

38
Q

Nursing process

A

Used to identify a client’s health status and actual or potential healthcare problems or needs, to establish plans to meet the identified needs, to deliver specific nursing interventions to meet those needs, and to evaluate the success of those interventions

39
Q

What are the five phases of the nursing process?

A
Assessment
Diagnosis
Planning
Implementation
Evaluation
40
Q

Nursing process: Assessment

A

Collect Data
Organize Data
Validate data

41
Q

Nursing process: Diagnosis

A

Analyze data
Identify health problems, risks and strengths
Formulate diagnostic statements

42
Q

Nursing process: Planning

A

Prioritize problems/diagnoses
Formulate goals/desired outcomes
Select nursing interventions
Write nursing interventions

43
Q

Nursing process: Implementation

A
Reassess the pt
Determine the nurse's need for assistance
Implement the nursing interventions
Supervise delegated care
Document nursing activities
44
Q

Nursing process: Evaluation

A

Collect data related to outcomes
Compare data with outcomes
Relate nursing actions to client goals/outcomes
Draw conclusions about problem status
Continue, modify or terminate the pt’s care plan

45
Q

Purpose of assessment

A

To establish a database about the pt’s response to health concerns or illness and the ability to manage healthcare needs

46
Q

Purpose of nursing diagnosis

A

Identify pt strengths and health problems that can be prevented or resolved by collaborative and nursing interventions.
Develop a list of nursing and collaborative problems

47
Q

Purpose of planning

A

Develop an individualized plan of care that specifies pt goals/outcomes
Promote wellness
Prevent illness and disease
Restore health
Facilitate coping and altered functioning

48
Q

Purpose of evaluation

A

Determine whether to continue, modify or terminate the plan of care