Clinical Judgment, Prioritization, and Delegation Flashcards
What are the six steps of Clinical judgment/Clinical reasoning?
STEP ONE: Recognize Cues where relevant and important information is identified from different sources.
Step Two: Analyze cues. In a clinical setting, this means organizing and linking the recognized cues to the patient’s clinical presentation.
Step Three: Prioritize hypotheses, where hypotheses are evaluated and ranked according to priority.
Step four: Generate solutions; identify expected outcomes.
Step Five: Take action, where the solutions that address the highest priorities are implemented.
Step six: Evaluate outcomes. Compare observed outcomes against expected outcomes.
What is the difference between subjective and objective data in a clinical setting?
Subjective data is mainly an opinion, or something unproven, such as a patient telling you they aren’t feeling well and telling you their symptoms. Objective data is what we can prove as fact, such as patient signs, looking at vitals, medical history, etc.
As the call light in room 345, bed 2 rings for the seemingly 12th time this shift, the members of your nursing team (RN, LPN, UAP) Look at each other and sigh in frustration. Mrs. Binkley, a 77-year-old retired librarian, is your patient. She not only has a gastrointestinal bleed, but she also suffers from dementia. The team is documenting the events of their shift and would like to finish before the shift ends, but someone needs to answer her call light.
Two part question:
A. By licensure, who is responsible for answering Mrs. Binkley’s call light?
B. Describe the proper chain of delegation for patient care.
A) Everyone that is involved needs to answer the call light as the patient isn’t stable (Gastrointestinal bleed + Dementia).
B) RN can delegate to LPN, LPN to UAP. RN is ultimately the one responsible for whoever they delegate to.
What is the scope of practice of UAP/Unlicensed assistive personnel? What is outside the scope of practice?
The UAP can ONLY work with stable patients.
ADLs, Feeding (If no swallowing issues), Hygiene care, VS for stable patients, and Phlebotomy.
Outside the scope of practice is Meds, teaching, assessment, planning, or evaluating.
What is within the scope of practice for LPNs? What is outside the scope of practice?
All UAP duties, can gather/monitor data (But not interpret), Work with stable patients with predictable outcomes, Routine procedures, BS, Foley, EKG, Suctioning.
LPNs can implement care but not plan it. They can give meds/injections/narcotics if it’s not the first time and Phlebotomy.
Outside of scope of practice: They cannot teach, assessment, plan or evaluate patients.
What are the five rights of delegation?
Right Task
Right circumstances
Right directions/communications
right supervision/evaluations
Right delegating to the right person
What is within the scope of practice for RN?
All the duties of a LPN and an UAP, in addition to assessment, diagnosis, planning, implementation and evaluation.
TRUE OR FALSE: The scope of practice specifies interventions that are appropriate for patients who have specific medical and nursing diagnoses.
FALSE: Scope of practice is used to delineate actions that are legally permitted for a particular profession based on specific educational qualifications. It does not specify particular interventions that are for particular clinical situations.
