Clinical Reasoning Cycle: Steps and Implementation in Real World Scenario

Running head: CLINICAL REASONING CYCLE
Clinical reasoning cycle
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CLINICAL REASONING CYCLE
Table of Contents
Introduction:....................................................................................................................................2
Considering the patient situation:....................................................................................................2
Collection of information:...............................................................................................................3
Processing the information:.............................................................................................................3
Identification of problems:..............................................................................................................4
Establishing goals:...........................................................................................................................4
Take action:.....................................................................................................................................5
Evaluation and reflection:................................................................................................................6
Conclusion:......................................................................................................................................7
References:......................................................................................................................................8

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Introduction:
The professional practice by the nurses is associated with a varied range of different skills
including clinical judgment, clinical decision making, clinical reasoning, problem solving and
critical thinking in order to provide safe and effective care to the patients. Clinical reasoning
cycle established by Tracy Levett Jones as a model framework allowing the nurses to implement
safe and effective practice along with utilizing all the above mentioned skill and at the same time
be able to learn from their practice experience (Dalton, Gee & Levett-Jones, 2015). As
mentioned by Hur and Roh, (2013), the nursing professionals with a positive critical analytical
skills and reflective skills have positive outcomes on the health and wellbeing status of the
patient. Similarly, the nursing professionals that fail to implement adequate critical analytical
skills in the professional practice are associated with diminished health and safety outcomes.
Hence, the importance of the clinical reasoning cycle is extreme to help the nursing professionals
implement practice in a manner that is inclusive of clinical reasoning and decision making skills.
This essay will attempt to explore the steps of clinical reasoning cycle to evaluate and analyze a
real world care scenario taking the assistance of a perioperative case study.
Considering the patient situation:
The selected case scenario represents a perioperative case involving the patient Candace
Evans, a year old patient who had been admitted to the health care facility to undergo elective
lower uterine caesarean section or LUCS who had been diagnosed with spinal anaesthesia. This
is the first step of the cycle which involves exploring the current situation or condition of the
patient and what information is needed to be collected in the very next step ( Hur & Roh,). In this
case scenario, the patient had undergone a LUCS giving birth to a healthy baby boy and was
shifted to the PACU with intraoperative blood-loss being 150ml, which is alarming. However,

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CLINICAL REASONING CYCLE
while in the PACU, the vaginal blood loss of the patient had been extreme with her pad being
soaked with frank blood and also some clots indicating signs of extreme blood loss due to her
placenta previa (Silver, 2015).
Collection of information:
The second step of clinical reasoning cycle is the elaborative assessment of the patient
where the nurse is required to gather all information available about the patient including past
medical history, current issues, treatment plan, observational data, investigative results, handover
reports and previous medical records (Smith, Loftus & Levett-Jones, 2013). In this case the past
medical history of the patient includes gestational diabetes, anxiety and post natal depression,
which can have a significant impact on her health, hence past medical data should be adequately
collected and documented. Followed by that, the nurse should also take a thorough head to toe
assessment and document her vital signs to understand her present condition.
Processing the information:
In order to complete the patient assessment procedure successfully, the very next step of
the clinical reasoning cycle is associated with processing the gathered information and compare
and contrasting the data with best available evidences to interpret, discriminate, relate and match
the available data to predict care outcomes for the patient. In this case, the past medical history
stated that Candace had gestational diabetes, anxiety and post natal depression, which is needed
to be considered with respect to the blood loss and related complications she is facing.
Furthermore, gestational diabetes is also reported to enhance the risk of placenta previa (Kassem
& Alzahrani, 2013). The vital signs of the patient include heart rate of 88, which is lower than
normal along with a low blood pressure at 104/76, indicating signs of bradycardia which can be
caused by extreme blood loss and exhaustion from the surgery. Her body temperature is also