NRSG378 - Extended Clinical Reasoning Assignment - Australian Catholic University

Assignment Task

Unit Rationale, Description And Aim

Effective clinical reasoning is a hall mark of Registered Nurse practice in all clinical environments. Registered nurses use methodical and consistent thought processes to; consider the specific aspects of each presenting situation, determine what cues and further information is required, process the information to identify problems, establish goals and determine course of action, evaluate outcomes and reflect on new learning. To achieve effective clinical reasoning communication with patients, family and the members of the nursing and interdisciplinary health team is essential.

This unit will assist students with their ongoing development of theoretical knowledge underpinning provision of nursing care for the person, family and significant others who are experiencing acute deterioration of health. Key principles that underpin best practice will be demonstrated by the use of evidence-based case studies. The nurse’s role in the provision of care for the person experiencing an acute clinical deterioration will be explored across a variety of settings and patient journeys within the context of interdisciplinary care. The content contained within this unit is instrumental in informing nursing students’ future clinical practice across a variety of settings.

The aim of this unit is to support students to extend and consolidate their development of clinical reasoning skills so that they can provide person-centred, evidence-based nursing care of individuals experiencing acute deterioration of health. Most importantly this unit will consolidate students understanding of the fundamental clinical reasoning skills to improve patient outcomes and limit harm and adverse events in their chosen health care settings.

Mode - This unit is offered in a mixed-mode format. This means the content will be delivered both face- to-face and online through on-campus tutorials, online video recordings, guided online activities and resources via weekly modules.

Attendance pattern - Face-to-face on-campus tutorials, online video recordings, guided online activities and resources via weekly modules.

Duration - This unit will be taught over 10 weeks; 5 weeks face-to-face attendance, and 5 weeks guided online activities and resources. You should anticipate undertaking 150 hours of study for this unit, including class attendance, readings and assignment preparation

Topics will include:

Review of underpinning pathophysiology of:

• Respiratory function
• Inflammatory processes
• Cardiovascular function
• Psychosis
• Stress diathesis

Principles of managing a person with acute deterioration:

• Recognition of a person with acute clinical deterioration
  • Assessment and monitoring
    • Early warning scores
  • Diagnostic procedures
  • Risk factors and comorbidities
• Person centered focus
  • Biopsychosocial, spiritual and cultural considerations for the individual
  • Therapeutic communication with person and significant others
  • Professional communication and collaboration in the interdisciplinary team
• Responding to a person with acute deterioration of health
  • Nursing Actions
  • Evaluation
  • Reassessment
• Escalation of care
  • Emergency Codes
  • Health care team
  • Patient and family escalation of concerns
• Setting goals
• Continuity of Care
  • Quality use of medicines
  • Discharge Planning
  • Documentation
  • Legal and ethical Issues

Clinical Reasoning for the patient with acute deterioration:

• Clinical reasoning for people with acute deterioration of respiratory function, their relatives, significant others and carers
  • Asthma
  • Acute Lung Injury/Syndrome
  • Pulmonary Embolism
• Clinical reasoning for people with acute deterioration of cardiovascular function, their relatives, significant others and carers
  • Acute Heart failure
  • Cerebral-Vascular accident
• Clinical reasoning for people with acute deterioration related to Shock, their relatives, significant others and carers
  • Hypovolaemic shock
  • Septic shock
• Clinical reasoning for people with acute alteration of mental health/cognition, their relatives, significant others and
  • Acute psychotic episode
  • Impairment from alcohol/drug
  • Delirium
  • Impact of hospitalisation on psychological state

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