Fundamentals of Nursing and Midwifery 2e

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C H A P T E R

LEARNING OUTCOMES After completing this chapter, the learner should be able to accomplish the following: 1. Discuss the context of clinical reasoning in a framework of thoughtful practice 2. Explain the importance of clinical reasoning in the process of care 3. Outline the key components of clinical reasoning 4. Explain how different types of thinking inform clinical reasoning 5. Define the components of critical thinking 6. Identify the links between critical thinking and reflection 7. Explain how clinical judgement and decision making relate to clinical reasoning 8. Appraise the relationships associated with nursing action and the person-centred process of care. Thoughtful practice: Clinical reasoning, clinical judgement, actions and the process of care

cue acquisition decision making failure to rescue intuitive thinking KEY TERMS

action adverse events

clinical reasoning creative thinking critical thinking cues

moral agency motivation pattern recognition prejudice

problem solving process of care

clinical experience clinical judgement

T HIS CHAPTER INTRODUCES the next components of thoughtful practice—clinical reasoning, the actions of clinicians, and the processes of person-centred care (see Figure U3-1 at the start of Chapter 13). It includes a dis- cussion of clinical reasoning, which is an essential component of thoughtful practice. It explains the types of thinking skills that enable the nurse or midwife to assess a person’s situation

and condition, analyse the data collected, prioritise the person’s needs, decide on the appropriate course of action, and evaluate the outcomes of the care delivered. This chapter should be read in conjunction with Chapter 13 so that the rela- tionships between the components of thoughtful practice are understood. Many of the concepts in this area overlap and cannot properly be considered as separate entities because the

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