NRSG265: Principles of Nursing Medical - Essay Writing - Medical Science Assignment Help

Assignment Task:

Task:

The aims of these resources are to: 

• Define the process of clinical reasoning 

• Explain and justify why nursing students need to learn clinical reasoning 

• Describe and exemplify the process of clinical reasoning 

WHAT IS CLINICAL REASONING? 

In the literature the terms clinical reasoning, clinical judgment, problem solving, decision making and critical thinking are often used interchangeably. In this learning package we use the term clinical reasoning to describe 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 (Hoffman, 2007; Kraischsk & Anthony, 2001; Laurie et al., 2001). The clinical reasoning process is dependent upon a critical thinking „disposition? (Scheffer & Rubenfeld, 2000) and is influenced by a person?s attitude, philosophical perspective and preconceptions (McCarthy, 2003). Clinical reasoning is not a linear process but can be conceptualised as a series or spiral of linked and ongoing clinical encounters. 

WHY IS CLINICAL REASONING IMPORTANT? 

Nurses with effective clinical reasoning skills have a positive impact on patient outcomes. Conversely, those with poor clinical reasoning skills often fail to detect impending patient deterioration resulting in a “failure-to-rescue” (Aiken, Clarke, Cheung, Sloane, & Silber, 2003). This is significant when viewed against the background of increasing numbers of adverse patient outcomes and escalating healthcare complaints (NSW Health, 2006). According to the NSW Health Incident Management in the NSW Public Health System 2007 (2008) the top three reasons for adverse patient outcomes are: failure to properly diagnose, failure to institute appropriate treatment, and inappropriate management of complications. Each of these is related to poor clinical reasoning skills. The Quality in Australian Healthcare Study (Wilson et al, 1995) found that “cognitive failure” was a factor in 57% of adverse clinical events and this involved a number of features including failure to synthesise and act on clinical information. Education must begin at the undergraduate level to promote recognition and management of the deteriorating patient, the use of escalation systems and effective communication (Bright, Walker, and Bion, 2004).

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