Clinical judgement is the process by which healthcare professionals, such as nurses, use their critical thinking and knowledge to make decisions about patient care

QUESTION

Mrs. Anderson, age 85 years. She complained of falling into her chair at home, dribbling when trying to get to the bathroom, being tired, and not being hungry for 1 week. The primary care provider evaluated a urinalysis and complete blood count (CBC) with differential and recommended admission to rule out sepsis and urinary tract infection. Mrs. Anderson also has a fungal infection within her mouth. Mrs. Anderson is a widow of 3 years, was married for 62 years, has three adult children, and lives in her own home with an unmarried son. She has a history of two incidents of CHF 4 years ago, a hysterectomy 22 years ago, an left knee replacement 15 years ago, and situational depression when her husband passed away. VS: BP: 140/88 mmHg, P: 90 beats/minute, RR: 22 breaths/minute, T: 35.7°C. The nurse starts her assessment.

part one : explain clinical judgement model

part two : explain using Transmission Model of Communication

ANSWER

Part One: Clinical Judgement Model

Clinical judgement is the process by which healthcare professionals, such as nurses, use their critical thinking and knowledge to make decisions about patient care. It involves gathering and interpreting relevant data, identifying potential health problems, formulating nursing diagnoses, planning appropriate interventions, implementing those interventions, and evaluating the outcomes of care. A widely used clinical judgement model is the Tanner Model, developed by Patricia Benner and colleagues, which consists of six stages: noticing, interpreting, responding, reflecting, reasoning, and experiential learning.

Noticing: The first stage involves observing and gathering data from the patient, including their verbal and non-verbal cues, physical symptoms, and vital signs. Nurses use their senses to detect any abnormalities or changes in the patient’s condition.

Interpreting: In this stage, the nurse analyzes the collected data to form a preliminary understanding of the patient’s health status. They compare the data with their existing knowledge and past experiences to recognize potential health issues or patterns.

Responding: Based on their interpretation, the nurse determines the appropriate nursing actions or interventions to address the patient’s needs. This stage involves planning and organizing care to promote positive patient outcomes.

Reflecting: After implementing the interventions, the nurse evaluates the patient’s response and reflects on the effectiveness of their actions. They consider whether the expected outcomes were achieved and identify any deviations from the expected course.

Reasoning: During this stage, the nurse engages in critical thinking to make informed decisions about the patient’s care. They consider the best available evidence, research, and clinical guidelines to guide their actions.

Experiential Learning: This final stage involves learning from the experience and incorporating new insights into future clinical practice. It enables the nurse to enhance their clinical judgement skills through ongoing learning and professional development.

Part Two: Transmission Model of Communication

The Transmission Model of Communication is a classic communication theory that describes the process of information exchange between a sender and a receiver. In healthcare settings, effective communication between nurses and patients is crucial for understanding the patient’s needs, providing appropriate care, and ensuring patient safety.

Sender: In this model, the nurse acts as the sender of information. They encode their thoughts and messages into verbal and non-verbal cues, such as spoken words, gestures, facial expressions, and body language.

Message: The message is the information that the nurse wishes to convey to the patient. It may include explanations about the patient’s condition, treatment plans, medications, and self-care instructions.

Channel: The channel is the means through which the message is transmitted from the nurse to the patient. In healthcare settings, the most common channels of communication include face-to-face interactions, written instructions, and electronic communication systems.

Receiver: The patient plays the role of the receiver in the communication process. They receive and decode the nurse’s message, attempting to understand the information being conveyed.

Noise: Noise refers to any barriers or disturbances that may interfere with the accurate transmission and reception of the message. Noise in healthcare communication can include language barriers, environmental distractions, or cognitive impairments that affect the patient’s ability to comprehend the information.

Feedback: Feedback is essential in the transmission model as it allows the nurse to assess whether the message has been received and understood by the patient. It also enables the patient to seek clarification or ask questions about the information they have received.

In the case of Mrs. Anderson, the nurse uses the Transmission Model of Communication to effectively communicate with her during the assessment process. The nurse carefully observes and listens to Mrs. Anderson’s complaints and non-verbal cues, encoding her assessment findings into relevant medical terminology and explanations. The nurse then delivers the message through face-to-face interactions and provides clear instructions for further diagnostics and treatment plans. Throughout the process, the nurse pays attention to any potential noise, such as Mrs. Anderson’s situational depression, which may impact her ability to fully understand the information. Additionally, the nurse seeks feedback from Mrs. Anderson to ensure that she comprehends the assessment findings and the recommended plan of care. Through effective communication using the Transmission Model, the nurse can build a trusting and collaborative relationship with Mrs. Anderson, leading to better patient outcomes and overall satisfaction with the care provided.