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Author's note: Critical reflection in clinical decision making

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Added on  2021-04-17

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Clinical judgment and decision making is a necessary component on nursing practice and use of tools like the clinical reasoning cycle guides the nurse to systematically process and interpret patient’s information for planning and delivery of care (Kuiper, Pesut & Arms, 2016). Clinical reasoning cycle: Consider the patient situation In the first stage of the clinical reasoning cycle I start to be able to know about the patient situation, patient information, and the chief complaint then start to think about it. are oral temperature 36.8

Author's note: Critical reflection in clinical decision making

   Added on 2021-04-17

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Running head: ADVANCED CLINICAL DECISION MAKINGAdvanced clinical decision makingName of the student:Name of the University:Author’s note
Author's note: Critical reflection in clinical decision making_1
1ADVANCED CLINICAL DECISION MAKING Introduction:Critical reflection has become a necessary element in nursing practice to engage ineffective decision making for the safety of patient. The clinical reasoning skill of nursecontributes to positive outcome in patient (Hunter & Arthur, 2016). This essay looks at theprocess of reflective decision making in nursing practice by analysis of the case scenario of Mr.H.S, a 23 year old admitted to the hospital after a motor vehicle crash (MVC). The interpretationof patient situation, treatment needs and evaluation of outcome is done by the use of clinicalreasoning cycle. Clinical judgment and decision making is a necessary component on nursingpractice and use of tools like the clinical reasoning cycle guides the nurse to systematicallyprocess and interpret patient’s information for planning and delivery of care (Kuiper, Pesut &Arms, 2016). The main aim of this essay is to critically discuss about the methods used toidentify patient issues and engage in reflective decision making for the recovery of patient.Based on the challenges faced in deciding the best care for patient, it also proposesrecommendation for nursing professional development. Clinical reasoning cycle:1.Consider the patient situationIn the first stage of the clinical reasoning cycle I start to be able to know about thepatient situation, patient information, and the chief complaint then start to think about it.We have Mr. H.S. a 23-year old male was referred from al Ruwais hospital after beinginvolved in MVC. Patient arrived to ER hypotensive, normal heart rate, RR andsaturation. He was complaining of pain in the left upper chest, neck, lower back, pelvisand left ankle. Patient come with report of CT trauma which was positive for pubic ramifracture with retroperitoneal pelvic hematoma. XR show left ankle fracture with hairlinefracture of calcaneus. Hypotension improved after IV fluids administration. Patientadmitted in the surgical ward after doing Open Reduction Internal Fixation (ORIF) forleft medial, malleolus.Patient is non-know of allergy. He has wound 40×7.5 cm onlateral aspect of foot with degloving of dorsal skin with macerated edges, all othersystems are normal and The vital signs of Mr. H.S. are oral temperature 36.8 degC, bloodpressure 144/86 mmHg, heart rate is 92, respiratory rate 18 br/min, oxygen saturationlevel is 100%.
Author's note: Critical reflection in clinical decision making_2
2ADVANCED CLINICAL DECISION MAKING 2.Collect cues / information2.1. Review current informationDuring the second stage of the clinical reasoning cycle I will start to gather thepatient information throughout the medical and nursing noted patient's clinicaldocumentation and other available cues. The review of CT trauma of patient showedthat M. H.S had sustained pelvic fracture and ankle fracture post MVC. His vitalparameters are at normal range except blood pressure. Apart from his presentinginformation, his past medical history was also reviewed. This showed that Mr. H.Shad no past medical or surgical history and he does not use any medication at home,his mother known of diabetes mellitus type 2 and hypertension.2.2. Gather new informationThe following stage of the clinical reasoning cycle is to gather new andrelevant information for a particular person at a particular point in time by asking thepatient, his family and other health care providers. At 0920 am the patient ring thebell and when I replay he said "I have severe pain", so we ask him about the severityof pain in scale of 0-10 he said “6/10”, then we give him Perflgan as Dr order. Hence,the new information gathered at this stage was that Mr. H.S was currently strugglingwith pain. After gathering this information, another decision making priority was tocritically reflect on the parameters that will be affected by high pain score in patient.Information related to medication provided to student post admission was alsoreviewed. 2.3.Recall knowledgeBased on current and new information collected about the patient, the aim at this stage wasto recall all knowledge gathered during nursing education program and find those informationsthat can be effectively linked to the patient’s problem. Post admission to the hospital, the patientwas found to be hypertensive although other vital signs were normal. This is obvious becausepatient came with report of CT trauma and hypertension is most commonly seen in patient afterblunt trauma. CT report revealed pubic rami fracture which meant he sustained a type of pelvicring fracture. Analysis of evidence based research on complications found in patient with pelvic
Author's note: Critical reflection in clinical decision making_3

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