Making Clinical Decisions Study Questions and Complete Solutions

What is clinical judgement? "An interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response" (Tanner, 2006, p. 204). Clinical judgment encompasses cognitive, psychomotor, and affective skills. Clinical judgment is specific to the individual. It is rooted in actions based on the ability to analyze empirical information in relation to both the specific situation and the aesthetic and reflective aspects of the nurse and the environment of practice. The most comprehensive conceptual framework for defining clinical judgment in nursing and its philosophical underpinnings are presented in Tanner's Model for Clinical Judgment in Nursing" (Victor-Chmil, 2013, p. 35). What is critical thinking? Critical thinking is what leads to sound clinical judgment and involves the various ways of knowing of the nurse as well as the environment and context within which care is taking place. Clinical judgment considers all types of available information from various sources and integrates them to create the most accurate and inclusive picture of the client situation the nurse makes sound, evidence informed decisions that address the specific needs of the client in a tailored, individualized way. making modifications and adaptations to interventions to best suit the situation at hand requires not only knowledge of the situation itself, but also the specialized knowledge, skills, and abilities that nurses contribute to care. What is Tanner's Model of Clinical Judgement? Tanner says that thinking is a process that needs to be organized to have a positive impact on patients, thinking cannot be random or undirected. The model is used to understand and make decisions about patients' needs. The conclusion informs our action and helps us tailor care to the patients particular situation as opposed to a standardized approach (which isn't wrong in all situations). Clinical judgment requires psychomotor skills, affective skills and critical thought...sometimes happening in situations that are rapidly changing. Noticing, interpreting, responding, and reflecting Explain 'noticing' from Tanner's Model of CJ? What do you notice?....notice an arrow -the obvious notice a male patient, hospital bed, eyes open, appears to be paying attention to the clinician assessing him, skin colour pale pink, no obvious deformity noted, etc. VS not necessary to notice all of the above -talk with him/ notice even more if he correctly answers questions about who he is, where he is, what day it is, you can determine if he is oriented If he slurs his words, has word finding difficulty, cannot speak, mumbles incoherently, does not open his eyes, cannot follow simple instructions, you might determine his LOC is impaired. can notice many things with minimal intervention beyond talking. heart rate, his respiration rate - notice if his chest goes up and down, whether he breathes through his nose or mouth, whether his breathing is noisy or he's coughing etc. add technology, blood pressure is high, his pupils are reactive, he has crackles in his upper lobes bilaterall notice what is normal or abnormal in his lab values. Expectations stem from nurses' knowledge of the particular patient and his or her patterns of responses; their clinical or practical knowledge of similar patients, drawn from experience; and their textbook knowledge. ... caring for a new post operative client may not know much about him beyond what is in his chart, but previous experience and clinical knowledge tells the nurse to expect certain things common with post