Midterm Review Notes for RNSG 1125 - Professional Nursing Concepts I

Clinical Judgement

1. Definition

   • An interpretation or conclusion regarding a patient’s needs, concerns, or health problems that guides action.
   • Involves deciding on action or modifying standard approaches based on patient responses (Tanner).

2. Attributes

   • Appropriate Response: Requires a holistic understanding of the patient.
     • Holistic Perspective: Influenced by various factors related to the patient and caregiving situation.
     • Situation Perception: Understanding elements in the environment over time and space.
   • Process Orientation: Guided by the nursing process.
   • Reasoning and Interpretation: Ability to analyze data and decide on proper actions.

3. Antecedents

   • Sound judgement and analytical reasoning skills.
   • Awareness of patient and self, creativity, inquisitiveness, and a strong knowledge base.
   • Persistence in clinical practice.

Nursing Process and Clinical Judgement

• The nursing process aids clinical judgement through the ADPIE framework:
  1. Assessment: Collect objective and subjective data.
  2. Diagnosis: Identify actual or potential health issues.
  3. Planning: Establish measurable goals and priorities.
  4. Implementation: Execute interventions.
  5. Evaluation: Assess outcomes and adjust care accordingly.
• Supports systematic problem-solving in patient care over time.

Tanner’s Clinical Judgement Model

1. Noticing: Awareness of the clinical situation influenced by context and experience.
   • Example: Clinical assessments, lab results, and family involvement.
2. Interpreting: Assigning meaning to gathered data through reasoning patterns.
3. Responding: Making decisions based on interpretation, leading to action.
4. Reflecting: Assessing the outcomes post-action (reflection-in-action and reflection-on-action).

Evidence Based Practice (EBP)

1. Definition

   • Integrates current best evidence with clinical expertise and patient preferences for optimal healthcare delivery.

2. Attributes

   • Replicability, Reliability, Validity, and Individualized Care: Ensure the evidence is consistent and applicable to individual scenarios.

3. Antecedents

   • Competence in problem identification and understanding the importance of research.
   • Recognition of patient preferences through PICOT framework:
     • P: Patient, population, or problem
     • I: Intervention of interest
     • C: Comparison
     • O: Outcome
     • T: Timeframe

4. Florence Nightingale’s Contributions

   • Advocated for patient needs and nursing standards.
   • Recognized the distinction between nursing and medicine, promoting health.

Professionalism in Nursing

1. Definition

   • Integration of skills and knowledge with respect and dignity for all patients while maintaining accountability.

2. Antecedents & Attributes

   • Self-awareness, personal and ethical values, effective communication, and lifelong learning.

3. Professional Identity

   • Develops through actions, ethical considerations, and transformation in skills and role within healthcare.

Safety in Nursing

1. Definition

   • Protection from harm and injury through effective systems and performance.

2. Types of Safety Errors

   • Diagnostic, Treatment, Preventive, and Communication Errors: Errors that can compromise patient care.

3. National Patient Safety Goals

   • Ensure effective patient identification, communication, medication safety, and prevention of errors in surgery.

Patient-Centered Care

1. Definition

   • Recognizes patients as partners in care, respecting their preferences, values, and needs.

2. Attributes

   • Non-judgmental, empathetic, culturally competent, and patient empowerment

3. 6 Cs of Nursing

   • Compassion, Competence, Confidence, Conscience, Commitment, and Comportment.

Conclusion

• Understanding these foundational topics prepares you for effective nursing practice, focusing on patient-centered care and safety while fostering clinical judgement through evidence-based practice.