Critically analyse and evaluate clinical reasoning and decision making to inform evidence-based practice.
Reflection and deconstruction of the clinical reasoning and care prioritisation undertaken via an individual case study. 2000 words
Assessment Content
Essay
Learning outcomes (to be demonstrated by the essay)
*Illustrate a systematic understanding of nursing knowledge and skills required to effectively assess and prioritise individual care needs;
*Critically analyse and evaluate clinical reasoning and decision making to inform evidence-based practice.
You are required to write a 2000 word essay that provides reflection and deconstruction of the clinical reasoning and care prioritisation process undertaken via an individual case study.
Your reflection and deconstruction of the clinical reasoning and care prioritization process will be based on the case study provided below.
Jack is an 18 years old male, who is attending university to study a Bsc programme in forensic Psychology. He has been admitted from his University residence following an acute asthma attack.
He has had a Past Medical History of Asthma since he aged 6 years, has Eczema, and has a reported allergy to Penicillin and Pollen. He has been treated with a dose of Nebulised Salbutamol 5mg and Ipratropium 0.5mg, as well as IV Hydrocortisone 100mg in the Emergency Department 2 hours ago. His Oxygen saturation improved from 92-96% in the emergency department and oxygen has been discontinued. Blood has been taken for FBC, U&Es, CRP, and Cultures. Peripheral sampling for blood gases showed a high normal value for pCO2 and a low normal value for pO2. He has received a Chest X-ray and is awaiting Medical review.
Initial assessment interview on admission to the Medical Assessment unit
• Jack is struggling to give a full history due to shortness of breath, however, the information gleaned so far is as follows
• One week ago, Jack developed symptoms of a cold virus.
• He has been experiencing increasingly tight chest, night cough and difficulty breathing over the last few days.
• He has taken his ‘reliever inhaler’ 4-6 times in 24 hours, as well as doubling the dose of his ‘preventer’ inhaler. He has not renewed his ‘rescue medications’ since moving away to university as he has not yet registered with a local GP.
• Jack is emotionally distressed and frightened
• Has IV access, with Normal Saline in situ at an infusion rate of 50mL an hour.
• EWS has increased to 5 from 3 during the transfer from the Imaging department, with a fall in Oxygen saturation to 93% on-air and an increased respiratory rate of 25bpm. He is now pyrexial at 37.80C.
Priorities identified based on the initial information and assessment above
• Anxious and frightened
• Is increasingly short of breath
• Feels feverish and unwell
Guidance
In deconstructing and reflecting on the decision-making process that may have led to the priorities identified, you may argue that other issues should have been prioritised.
These observations can form part of your arguments and the development of the critical evaluation of assessment processes.
You can question, concerning theory and evidence, why the particular priorities identified could or should be different, and how and why such priorities might have been decided on.
This means you will need to draw some inferences and surmise about the case study provided in thinking about the assessment process. In a sense you are starting from the final stage of assessment, that is, the identified priorities, and working backwards to deconstruct the potential process that led to the decisions made.
Illustrative examples (anonymous) can be used from your own practice experience as a student nurse. The work should adhere to usual legal, ethical and professional principles and no person or organisation should be identified.
The reflection/essay has to be written in 7 levels of English.
The style of prepared reflection/work has to be done in Havard style.
