Clinical Judgment is a Dynamic Process
Competency
Modify clinical judgment within an iterative, outcome-based cycle of clinical reasoning and client needs.
As part of the clinical portion of your course in your senior semester, you have the opportunity to attend a two-day seminar with senior nursing students from other academic institutions. The theme of this seminar is the application of clinical judgment to determine the best evidence-based solutions for nursing practice.
Instructions:
For a clinical judgment roundtable with faculty and students that is sponsored by your academic institution, you must prepare one scenario based handout to promote robust discussion regarding the application of clinical judgment as an outcomes-based dynamic cycle of clinical reasoning and client needs. The handout must contain these components:
Describe a clinical situation where you applied an outcome-based cycle of clinical reasoning to select what you considered the “best” client intervention based on information available.
Include relevant external and internal cues and hypotheses
Discuss the outcomes based, iterative cycle of clinical reasoning you applied after the initial intervention to select the next “best” interventions appropriate for the particular situation based on client needs.
Rationales and evidence based findings were included to support choices for the next “best” interventions
In Summary
The handout must contained a detailed description of a clinical situation where the student applied an outcome-based cycle of clinical reasoning to select the “best” client intervention based on information available.
The cycle of clinical reasoning was explained using a complete list of external and internal cues and hypotheses.
Described a detailed, appropriate outcomes-based, iterative cycle of clinical reasoning to select the next “best” interventions appropriate for the particular situation. Provide rationales or evidence-based findings for your choices related to “best” interventions.
The choices were supported by robust rationales and at least one summary of appropriate evidence-based findings.
Do not use 1st person in scholarly writing. Use 3rd person only. APA format. Formal style reflected throughout the document, including no spelling, grammar, or APA format errors present. Adequate references with adequate in text citation. Please do this assignment using only research published within the past 5 years. Plagiarism free
Expert Solution Preview
Introduction:
The importance of clinical judgment in nursing practice cannot be overemphasized. It involves the ability to make effective decisions based on available information and observations, with the primary goal of achieving optimal client outcomes. In this assignment, students are required to prepare a scenario-based handout that showcases their knowledge of outcome-based clinical reasoning. The handout should highlight the use of external and internal cues, hypotheses, and evidence-based findings to make an iterative cycle of clinical reasoning that leads to the selection of the “best” intervention.
Answer to Content:
The scenario presented involved a patient with a history of chronic obstructive pulmonary disease (COPD) who presented to the hospital with severe respiratory distress. Initial assessment revealed that the patient had significant hypoxia with a saturation level of 80%, and an underlying pulmonary infection was suspected. An outcome-based cycle of clinical reasoning was initiated, considering the client’s needs and available information.
External cues such as abnormal vital signs, patient’s lack of response to conventional oxygen therapy, and internal cues, including reduced air entry and raucous breathing, were noted. Hypotheses based on these cues suggested a likelihood of a worsening pulmonary disease progression, sepsis, and respiratory failure.
The initial intervention included supplemental oxygen at high flow rates, nebulization, and intravenous antibiotics. Continuous monitoring of the patient’s vital signs, oxygen saturation, and response to treatment was carried out, and the outcomes noted. The next intervention was selected based on the client’s response to the initial intervention, which resulted in the reintroduction of inhaled corticosteroids and bronchodilators and close monitoring of the client’s fluid status.
Rationales and evidence-based findings were employed to support the choice of subsequent interventions. For instance, the use of corticosteroids and bronchodilators was supported by evidence from several studies demonstrating improved lung function, reduction in inflammatory markers, and a decrease in the rate of hospital readmission among COPD patients.
In conclusion, the scenario presented the important role of clinical reasoning in nursing practice based on available information and client needs. It demonstrated the use of iterative, outcome-based cycles of clinical reasoning and evidence-based findings to select the “best” intervention for optimal patient outcomes.
