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Instructions of NURS 223 2-2 Flip 1
Purpose
We will take some time upon the completion of each step of the CCJF to reflect and practice the information you’ve gained. Self-reflection and deliberate practice are two ways to develop your clinical judgment skills to transition from a novice to advanced beginner nursing student. Stopping to reflect and practice new skills you’ve learned before moving on to the next step of the framework supports information retention and provides cognitive scaffolding for subsequent steps in the framework.
Task
Use the Flip interactive video program embedded below to apply your learning of the first step of the CCJF, Getting the Information to the following case study:
Getting the Information: (NP/Assessing) (NCSBN/Recognizing Cues)
You receive a report from a Post-Anesthesia Care Unit (PACU) nurse about Mindy Johnson, a 60-year-old woman who is being transferred to you on a busy medical/surgical unit. Ms. Johnson had an open cholecystectomy surgery without complications and has been stable in the PACU. She received fentanyl (Sublimaze) 50 mcg IV 30 minutes ago. The PACU nurse states the patient has been complaining about her level of pain and states the patient is being “overly sensitive and unrealistic about where her level of pain should be after surgery.”
Ms. Johnson’s medical/surgical history includes:
- diabetes mellitus type 2
- diabetic neuropathy with chronic pain
- hypertension
- hysterectomy
Ms. Johnson’s home medications are as follows:
- metformin (Glucophage) 500 mg po BID
- glipizide (Glucotrol) 5 mg po daily
- hydrochlorothiazide 25 mg po daily
- amitriptyline (Elavil) 50 mg po daily at HS
Ms. Johnson’s lab results are as follows:
- Hemoglobin: 12%
- Hematocrit: 37%
- Glucose: 120 mg/dl
You settle Ms. Johnson in her room and complete an initial head-to-toe assessment and identify the following findings:
- BP 162/88 mm Hg, heart rate 110, respirations 20, pulse oximetry is 98% on room air
- Alert and Oriented
- Grimacing, moaning, and guards her incision
- States she is in severe pain
- Dressing is intact
- Lung sounds are clear and diminished in the bases
Instructions
- Read the case study above.
- Do not recite the case study narrative within your Flip recording.
- Identify the patients’ priority problem/issue.
- Briefly reflect on how the first step of the CCJF, Gathering Information affects your ability to provide safe care to your patients and impacts their outcomes.
- Briefly talk through your thinking process for the 5 Clinical Competencies within the 1st step of Gathering Information by using the Cognitive Guidance Tools provided to you in Chapter 3 (Caputi, 2022) HERE.Links to an external site.
- Questions you can ask yourself for the 5 Clinical Competencies of Step 1/Gathering Information:
- Ask yourself what information is important and what information is missing? (determining important information)
- Ask yourself what might you be seeing, hearing, feeling, and smelling if you were in the patient room? (scanning the environment)
- What is your knowledge level regarding the problem you identified, how does the past patient’s medical history impact the problem, and what are the objective and subjective signs and symptoms associated with the problem? (identifying signs and symptoms)
- Ask yourself if you assessed the patient in a head-to-toe fashion, did you assess everything you needed to assess, did you miss anything? (assessing systematically and comprehensively)
- Ask yourself if the information you’ve collected is accurate and was your equipment reliable? (ensuring accurate information)
Grading
Remember, you are a clinical judgment novice and my goal is to provide you with a low-stakes opportunity to further understand and practice your newly learned Clinical Competencies. Each Flip should be approximately five minutes and address the criteria identified within the directions and rubric. The Flip video platform will automatically place a link back to the Canvas assignment in this section.
Step-By-Step Guide on NURS 223 2-2 Flip 1
Introduction To NURS 223 2-2 FLIP 1
This Owlisdom assignment of NURS 223 2-2 Flip 1 focuses on the first step of the Clinical Competency Judgment Framework (CCJF), which is “Getting the Information.” You will apply this framework to a case study involving a post-surgical patient, Mindy Johnson. NURS 223 2-2 Flip 1 aims to practice gathering and interpreting initial information effectively to develop clinical judgment skills. This process involves identifying the patient’s priority problem, reflecting on the importance of gathering information and discussing the five clinical competencies associated with this step.
Introduction
- Describe that the focus is on applying the first step of the CCJF to a specific case study to develop clinical judgment skills.
Example
“Hello everyone, today we’re diving into the first step of the Clinical Competency Judgment Framework (CCJF), which focuses on ‘Getting the Information.’ We’ll apply this to our case study involving Mindy Johnson.”
Case Overview
We will discuss the case overview in this section of NURS 223 2-2 Flip 1.
- Summarize the case study.
- Include relevant medical history, medications, lab results, and current condition.
Example
“Let’s focus on Mindy, a 60-year-old post-surgical patient with a history of diabetes and chronic pain. She’s showing signs of severe pain despite recent pain medication. Our goal today is to utilize the CCJF to gather and interpret initial information effectively.”
Identify the patients’ priority problem/issue.
Identifying Priority Issues
We will discuss identifying priority issues in this section of NURS 223 2-2 Flip 1.
- Based on the information provided, determine the patient’s priority problem.
Example
“The priority issue here appears to be Mindy’s severe pain post-surgery. Given her history of chronic pain and current pain expressions, it’s crucial to reassess her pain management strategy. We also note her elevated blood pressure and heart rate, which may be related to her pain levels.”
Briefly reflect on how the first step of the CCJF, Gathering Information, affects your ability to provide safe care to your patients and impacts their outcomes.
Reflecting On The Importance Of Gathering Information
We will discuss the case overview in this section of NURS 223 2-2 Flip 1.
- Discuss the significance of gathering accurate and comprehensive information.
Example
“Gathering accurate information is pivotal. It ensures that we don’t just treat symptoms superficially but understand underlying causes and conditions. This careful collection of data directly impacts our ability to provide safe, personalized care and significantly influences patient outcomes.”
Briefly talk through your thinking process for the 5 Clinical Competencies within the 1st step of Gathering Information by using the Cognitive Guidance Tools provided to you in Chapter 3 (Caputi, 2022)
Discussing The 5 Clinical Competencies
This section of NURS 223 2-2 Flip 1 will discuss the 5 Clinical Competencies.
- What information is crucial, and what might be missing?
- Consider what you would see, hear, feel, and smell in the patient’s room.
- Relate the patient’s medical history to her current signs and symptoms.
- Ensure you have covered all necessary aspects in a head-to-toe assessment.
- Ensure that the information collected is precise and the equipment used is reliable.
Example
“Firstly, determining important information is critical. We need to discern what is relevant in Mindy’s current state, which in this case includes her vitals and pain level. Next, scanning the environment helps us gather contextual clues—her physical reactions and the setup in her room provide insights beyond verbal communication.”
“Understanding the medical background and identifying symptoms tells us how her past conditions might influence her current state. For instance, her diabetic neuropathy might be exacerbating her pain perception.”
“Systematically assessing Mindy from head to toe ensures no crucial detail is missed, like checking her surgical site and ensuring no complications are arising post-operation.”
“Lastly, verifying the accuracy of the information gathered, including the reliability of the medical equipment used to monitor her vitals, ensures that our clinical decisions are based on solid data.”
Application Of Competencies
This section of NURS 223 2-2 Flip 1 will discuss the Application Of Competencies.
- Show how you would use these skills in the patient’s scenario.
Example
“In Mindy’s scenario, I reassessed her pain using a systematic approach, ensuring to consider her expressions and non-verbal cues seriously rather than dismissing them as being ‘overly sensitive.’ This helped in planning to adjust her pain management regimen appropriately.”
Closing Reflection
In this section of NURS 223 2-2 Flip 1, we will discuss the Closing Reflection.
- Emphasize the significance of each competency in enhancing clinical judgment and patient care.
Example
“Reflecting on this process highlights the significance of each competency in enhancing our clinical judgment. Every step from accurate information gathering to critical assessment shapes our decisions, ensuring we provide care that is both effective and empathetic.”
CLOSING
By following these guidelines of NURS 223 2-2 Flip 1, you will effectively apply the first step of the Clinical Competency Judgment Framework (CCJF) to a real-world case study. This structured approach ensures comprehensive information gathering and critical evaluation, which are essential for developing advanced clinical judgment skills. Practicing these competencies will enhance your ability to provide safe, effective, and empathetic patient care. In the next module of NURS 223, we will explore the 4-1 TICKET TO CLASS.
