Question

what are the steps of clinical reasoning? relate the steps to the nursing process

View Video first then list and describe the steps to “The Clinical Reasoning Cycle”, and relate the steps to the nursing process.

Answer 1

Clinical reasoning is defined as the “the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process”.

Stages of the Clinical Reasoning Cycle

	Steps	Description
1	Consider the patient situation	Describe or list facts, context, objects or people.
2	Collect cues/ information	Review current information (e.g. handover reports, patient history, patient charts, results of investigations and nursing/medical assessments previously undertaken) Assimilate new information (e.g: by undertaking patient assessment) Recall subject knowledge relevant to the situation (e.g. physiology, pathophysiology, pharmacology, epidemiology, therapeutics, culture, context of care, ethics, law etc)
3	Process information	Interpret: analyse data to come to an understanding of signs or symptoms. Compare normal versus abnormal. Discriminate: distinguish relevant from irrelevant information; recognise inconsistencies, narrow down the information to what is most important and recognise gaps in cues collected. Relate: discover new relationships or patterns; cluster cues together to identify relationships between them. Infer: form opinions that follow logically by interpreting subjective and objective cues; consider alternatives and consequences. Match current situation to past situations or current patient to past patients (usually an expert thought process) Predict an outcome (usually an expert thought process)
4	Identify problem / issue	Synthesise facts and inferences to make a definitive diagnosis of the patient‟s problem.
5	Establish goals	Describe what you want to happen, a desired outcome, a time frame.
6	Take action	Select a course of action between different alternatives available
7	Evaluate	Evaluate the effectiveness of outcomes and actions by asking questions like : “has the situation improved now?”
8	Reflect on process and new learning	Contemplate what you have learnt from this process and how you could have done differently.