Simulation Scenario: Clinical Decision Making in Nursing Practice

Running head: SIMULATION SCENARIO
Simulation scenario
Name of the student:
Name of the University:
Author’s note

1SIMULATION SCENARIO
Introduction:
Decision making in nursing practice is a complex phenomenon that determines the use of
subjective and objective data of patient to identify relevant health problems and use critical
thinking to develop the best plan of care. There are several clinical judgment or decision making
models that help nurses during clinical decision making process. The main purpose of this paper
is to use a clinical decision making model to clinical scenario of Mr. Patience, a 19 year old male
involved in motor vehicle crash (MVC). The paper will analyse how use of different decision
making models helped to interpret patient’s situation and plan appropriate intervention for
patient. It also discusses the responsibility of multi-professional health care team in providing
care to patient.
Primary assessment:
The clinical scenario is about Mr. Patience, who sustained MVC after losing control of
his car and being hit by a tree. He has arrived with a cervical collar and long backboard. His
current symptoms include dizziness, shortness of breath and increased lower back pain. To
systematically identify primary issues for Mr. Patience and critically think aboyt best nursing
response, the ADPIE (assessment, diagnosis, planning, implementation and evaluation) nursing
process model has been used. The main rationale behind the use of ADPIE model is that it
provides a useful framework for critical thinking and problem solving while engaging in care of
a patient.
The first step involved gathering data of patient. The ABCDEFGHI assessment of Mr.
Patience gave the following outcome:
A: No airway obstruction found

2SIMULATION SCENARIO
B: HR 128, RR 26. Heart rate is found to be high and breathing rate is also slightly above the
normal limit. Shortness of breath is an issue for patient
C: BP is 90/52 indicating that the patient has low blood pressure. HGB value is 80 which
indicates is hyperglycemic
D: The patient is less responsive and immobilized
E: He has a cervical collar and long backboard. A large bore 18-gauge is inserted in his right
forearm. No other cut or bruises found.
F: Review of his vital signs suggest high heart rate, low blood pressure and low body
temperature
G: He has intense back pain indicated by score of 10/10
H: The review of patient history suggests that he has a history of Type 1 Diabetes.
The advantage of assessment is that it gives an overview of abnormalities in the patient
data. This helped to identify potential problem for patient.
Diagnosis: The following can be interpreted based on patient’s data and assessment records:
Interpretation#1: The first priority concern for patient is intense back pain and immobility due to
C-spine fracture.
Rationale: This has been identified as the primary concern because Mr. Patience’s back pain
score is 10/10 and he has come immobilized with a cervical collar and long backboard. This is
indicative of the fact that he has sustained C-spine fracture. This type of fracture results in loss of
all motor and sensory function below the level of injury. Zonfrillo et al. (2014) suggest that