Clinical Reasoning and the Deteriorating Patient

 

Length: 2000 words, APA style must be used

Introduction and Conclusion MUST be included

Task

 

This assessment will require the student to apply the clinical reasoning cycle to a complex scenario and discuss the nursing role.

Using the Case Study provided, you will apply the Clinical Reasoning Cycle to the Case Scenario.

Your critical analysis should address the following:

1. Analyse the case study and develop a discussion of the application of each element of the Clinical Reasoning Cycle as outlined by Levett-Jones, T. (Ed.). (2017). Clinical Reasoning: Learning to think like a nurse (2nd ed.). Frenchs Forest, NSW: Pearson Australia.
2. Use the clinical data provided to identify moments of deterioration and four (4) evidence-based nursing interventions that are appropriate at the moments of deterioration. Include your reasoning, justification and rationale utilising ‘the slippery slope’.
3. Use the ISBAR communication tool provided to develop a handover script to the Medical Officer you are calling (No more than 250 words).

While sub-headings can be used to structure this assessment, tables and dot points are not permitted.

Your responses must be supported by peer-reviewed evidence, commensurate with the level of evidence-based practice expected of a beginning practitioner.

You must support your discussion with 16 or more recent references (less than 7 years old) and credible sources.   Credible sources include the following:

• peer reviewed journal articles (these are the highest quality sources)
• contemporary text books
• best practice guidelines
• government documents
• health facility clinical guidelines, pathways and policies/procedures
• websites containing content aimed at health professionals (usually ending in .org, edu or .gov)

 

Presentation

Leave 2 cm margins and double line space your work, so that there is ample space for markers to comment. In addition,

Introduction and Conclusion MUST be included

 

• Font must be 12pt, unless otherwise indicated.
• All pages must be numbered.
• Student name and number must be included in the header or footer of every page of every assignment.
• A title page must accompany your written assessment task and include the subject name and code, title of the assessment task, due date, submission date, lecturer’s name, student name and student number.

 

Requirements

 

Referencing

 

Correct and consistent referencing is an important component of producing professional and credible academic work. Marks will be awarded for high quality referencing.

 

Please refer to the following text for information on how to reference your paper:

 

American Psychological Association (APA). (2010). Publication Manual of the American Psychological Association (6th ed.). Washington DC: APA.

 

 

Rationale

Subject learning outcomes

This assessment task will assess the following learning outcome/s:

• be able to collect, interpret and document subjective and objective data in the seriously ill or deteriorating person (aligns with Nursing and Midwifery Board of Australia National Competency Standards for the Registered Nurse: 1.1, 1.2, 2.5, 4.1, 5.1, 5.2, 5.3, 7.4, 8.1, 8.2).
• be able to demonstrate a broad knowledge which links the underlying pathophysiology of serious cardiac, respiratory and neurological presentations to their clinical manifestations (NMBA 2.6, 3.1, 3.4, 4.1, 7.4).
• be able to apply theoretical knowledge, critical thinking and the use of best evidence to contribute to the planning and implementation of appropriate nursing interventions for the person experiencing a serious or life-threatening illness (NMBA 1.2, 2.5, 2.6, 3.1, 3.2, 3.3, 3.4, 4.1, 6.1, 6.2, 6.4, 7.1, 7.2, 7.4, 7.7, 7.8, 8.1, 8.2, 10.3).
• be able to apply theoretical knowledge to safely perform selected procedural skills including venepuncture, intravenous cannulation, administration of blood products and management of central venous access devices, required for the care of patients experiencing serious or life-threatening illness (NMBA 1.2, 2.5, 7.1, 7.2, 7.4).
• be able to analyse the legal and ethical considerations associated with the management of the deteriorating patient (NMBA 1.1, 2.1, 2.2, 2.3, 2.4, 2.5, 7.4, 7.5, 7.6, 9.3, 9.5).
• be able to communicate effectively with individuals, groups and members of the interdisciplinary team in the acute care environment (NMBA 1.2, 2.3, 2.4, 2.5, 5.1, 5.2, 5.3, 6.1, 6.2, 6.3, 7.4, 7.5, 7.6, 7.7, 9.1, 9.2, 9.3, 9.4, 10.2, 10.4)

 

MARKING CRITERIA

 

1. Applies the Clinical Reasoning Cycle to the Case Study	25.5-30 All of the relevant information from the case study has been accurately applied to each element of the Clinical Reasoning Cycle.	22.5-25   Most of the relevant information from the case study has been accurately applied to each element of the Clinical Reasoning Cycle.	Weighting 30		0-14.5 One or more elements of the clinical reasoning cycle and/or critical information from the case study has been omitted and/or The discussion contains several inaccuracies.	/30
2. Identifies moments of clinical deterioration to plan and justify nursing actions.	25.5-30   Identifies 4 nursing interventions that are safe, evidence-based and appropriate for the relevant moments of deterioration.     Each intervention is supported by a comprehensive and accurate rationale that establishes strong links to the clinical data and Slippery Slope.	22.5-25   Identifies 4 nursing interventions that are safe, evidence-based and appropriate for the relevant moments of deterioration.   Each intervention is supported by a detailed and accurate rationale that clearly explains how it is linked to the clinical data and the Slippery Slope.	Weighting 30		0-14.5 Identifies less than 4 nursing interventions, and/or the interventions identified are unsafe.   Rationales are absent, inadequate or do not consider clinical data and the Slippery Slope.	/30
3. Application of the ISBAR framework to develop handover script.	17 – 20 Comprehensively and concisely communicates all relevant patient information to the interdisciplinary team member using the ISBAR format. Application of ISBAR framework that shows the student has examined and addressed the major issues involved.	15 – 16.5  Comprehensively communicates all relevant patient information to the interdisciplinary team member using the ISBAR format. Application of ISBAR framework that shows the student has explained and addressed the major issues involved.	Weighting 20	10 – 12.5	0 – 9.5  Communicates minimal or irrelevant patient information to the interdisciplinary team member. Handover script does not use ISBAR framework. Handover script evidences an insufficient understanding of the patient’s healthcare needs.	/20
4. Communicates effectively using academic writing and professional language.	8.5-10   Formal academic language and correct professional terminology has been used to create a cohesive, concise and analytical piece of work. The assessment is logically and systematically structured with consistent adherence to grammatical conventions. All presentation guidelines have been applied.	7.5-8   Formal academic language and correct professional terminology has been used to create a cohesive and coherent piece of work. The assessment is logically structured and mostly adheres to grammatical conventions. All presentation guidelines have been applied.	Weighting 10	5-6	0-4.5   Formal and informal language has been used to create a partially structured piece of work that includes multiple grammatical errors impacting on the clarity of the discussion.  Presentation guidelines have not been adhered to.	/10
5. Applies evidence/information from credible sources and with academic integrity	8.5-10 The assessment is supported by an extensive range of current (less than 7 years), peer-reviewed, scholarly sources of health information and research (16 or more appropriate sources), which has been evaluated and synthesised to support all assertions.   APA referencing conventions for both in-text citations and the reference list have been accurately and consistently applied.	7.5-8   The assessment is supported by a wide range of current (less than 7 years), peer-reviewed, scholarly sources of health information and research (14 or more appropriate sources), which have been integrated to support most assertions made.   APA referencing conventions for both in-text citations and the reference list have been almost always accurately and consistently applied.	Weighting 10