Week 1: Clinical Judgement Flashcards
Clinical Judgement
- interpretation or conclusion about a patient’s needs, concerns, or health problems.
- can be used for decisions to take actions (or not), modify or improvise approaches based on the patient’s response
3 Main scopes of Clinical Judgement
- Standards-based
- Evidence based and clinical judgement
- Interpretivist perspective
Standard-based approach definition
- part of the 3 main scopes of clinical judgment
- clear cut guidance and standardized approach
- best practice = best treatment
Evidence based practice and clinical judgement definition
- part of the 3 main scopes
- combine best scientific evidence with best patient and practitioner experiential evidence
- interested in optimal outcomes
Interpretivist Perspective
- understands nursing care is not linear
- considers multiple variables for clinical reasoning
Critical Thinking
- process of collecting, interpreting, analyzing, drawing conclusions, presenting, and evaluating information
- both factual and belief-based
- clinical reasoning and judgement are key components
Critical thinking is acquired through …
experience, commitment, and active curiosity
Methods for improving critical-thinking skills
- reflective thinking
- discussion with colleagues
- emotional intelligence
- audible verbalization of thoughts
- literature review
- application of knowledge
-concept maps
-simulation
-role play
-written work
Clinical Reasoning
- cognitive processes that nurses use to understand patient data, identify and diagnose problems, make clinical judgement, and achieve positive patient outcomes
- thinking process by which nurses reaches a clinical judgement
Tanner’s Clinical Judgement Model
- Noticing
- Interpreting
- Responding
- Reflecting
(Noticing) Tanner’s Model
- what’s happening
- may include recognizing the absence of expected significant clues
- includes the influences of the nurse’s own beliefs about the patient
Interpreting (Tanner’s Model)
using logical reasoning to gain understanding of patient’s situation, and what the appropriate action is
Responding (Tanner’s model)
analyzing the situation and choosing the best course of action
Reflecting (Tanner’s model)
-considering appropriateness of the assessment obtained
- considers action taken, and positive and negative outcomes
- learning from actions
What does ADPIE stands for
- Assessment: collecting, validating, and communicating patient data
- Diagnosis: analyzing patient data to identify strength and problems
- Planning: specifying patient outcomes
- Implementation: carrying out plan
- Evaluation: measuring extent to which patient achieved outcomes
Nursing process: ADPIE
- foundation of professional nursing practice_
Assessment definition (adpie)
Collecting, validating, and communicating patient data
Diagnosis (adpie)
Analyzing patent data to identify patent strengths and problems
Planning (adpie)
After diagnosis, creating a plan individualizing parent’s needs. Plan outcomes
