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Instructions of NURS 223 7-2 Flip 4
Flip #4 Evaluating Outcomes and Your Thinking
- Due Oct 6, 2023 by 11:59pm
- Points 10
- Submitting an external tool
- Attempts 1
- Allowed Attempts 5
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 fifth step of the CCJF, Evaluating Outcomes and Your Thinking to the following case study:
Evaluating Outcomes and Your Thinking: (NP/Evaluating (NCSBN/Evaluating Outcomes)
This week’s Evaluating Outcomes and Your Thinking Flip Assignment will complete your time caring for Mindy Johnson. Recall that during the last several weeks, you identified a problem, gathered information, determined what actions to take, and took action. Now it’s time for you to evaluate your actions/interventions by collecting and making meaning of new information. This allows you to determine if your actions/interventions caused Mindy Johnson’s conditions to improve, worsen or stay the same. You also need to evaluate your thinking process that determined your actions/interventions. Your thinking process flows from Caputi’s Clinical Judgment Competencies embedded within the 5 Clinical Judgment Steps.
You completed your action(s)/intervention(s) (identified in your Take Action Flip) on Mindy Johnson and collect the following information.
- BP 142/80 mm Hg, heart rate 88, respirations 16, temperature 100.5 degrees F, pulse oximetry is 96% on room air
- Regular sinus rhythm with S1 and S2 heart sounds
- Watching TV and talking with partner
- Room temperature is warm
- Alert and Oriented X 3
- Rates pain as mild to moderate
- Dressing is intact with small amount of shadowing
- Bowel sounds are hypoactive in all quadrants
- Lung sounds are clear bilaterally
- Upper and lower extremities have +1 edema
- Coccyx area is slightly red
- Hemoglobin: 11.5%
- Hematocrit: 36%
- Platelets: 400,000/mm3
- WBC’s 15,000 mm3
- Glucose 110mg/dL
- Sodium 143 mEq/L
- Potassium: 4.2 mEq/L
- Creatinine: 1 mg/dL
- BUN: 17 mg/dl
Instructions
- Read the case study above and closely review this week’s Flip Rubric, as it has changed from the previous Flip Rubrics.
- Do not recite the case study narrative within your Flip recording.
- State the priority patient problem you previously chose in the Taking Action Flip and why you chose it as the priority problem.
- State the action(s)/intervention(s) you previously chose in the Taking Action Flip and why you chose it/them.
- Briefly reflect on how the fifth step of the CCJF, Evaluating Outcomes and Your Thinking, affects your ability to provide safe care to your patients and impacts their outcomes.
- Briefly talk through your thinking process for the 2 Clinical Competencies within the 5th step of Evaluating Outcomes and Your Thinking by using the Cognitive Guidance Tools provided to you in Chapter 7 (Caputi, 2022).
- Questions to ask yourself for the 2 Clinical Competencies of Step 5/Evaluating Outcomes and Your Thinking:
- Evaluating Data: Consider the following:
- What changes did you expect to see in your patient after your interventions/actions?
- What information do you needed to collect to determine if your patient’s problem improved, worsened, or stayed the same as a result of your interventions/actions?
- Would other interventions have been more effective?
- Evaluating and correcting thinking: Identify and rate yourself on a scale of 0 to 5, two clinical judgment competencies you effectively used and two clinical competencies you need to improve upon.
- Provide an explanation as why you believe you did the 2 competencies well.
- Provide an explanation of what you will do to improve the 2 competencies you were challenged by.
- Evaluating Data: Consider the following:
Grading
Remember, you are a clinical judgment novice, and our goal is to provide you with lots of low-stakes opportunities 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.
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Step-By-Step Guide of NURS 223 7-2 Flip 4
Introduction To NURS 223 7-2 Flip 4
This Owlisdom assignment of NURS 223 7-2 Flip 4 focuses on the fifth step of the Clinical Competency Judgment Framework (CCJF): “Evaluating Outcomes and Your Thinking.” You will use this steps to assess the effectiveness of the interventions implemented for a patient, Mindy Johnson, and reflect on your clinical decision-making process. This step is essential for transitioning from a novice to an advanced beginner nursing student, as it enhances your ability to provide safe and effective patient care by evaluating and refining your clinical judgments.
Introduction
We will discuss the introduction in this NURS 223 7-2 Flip 4 section.
- Describe that the focus is on applying Step 5 of the CCJF to evaluate the effectiveness of interventions and reflect on clinical decision-making.
Example
“Hello, everyone. Today, we’re focusing on the fifth step of the Clinical Competency Judgment Framework—Evaluating Outcomes and Your Thinking—using the ongoing care of Mindy Johnson as our context.”
Context Setup
- Include relevant medical history, medications, lab results, and current condition.
Example
“Over the past few weeks, we’ve followed Mindy’s post-operative recovery. We’ve identified problems, taken actions, and now we need to evaluate the effectiveness of these interventions and reflect on our decision-making process.”
Review Of Actions Taken
This NURS 223 7-2 Flip 4 section will discuss the Review Of Actions Taken.
- Clearly mention the priority problem and the interventions chosen to address it.
Example
“In our last session, we prioritized managing Mindy’s pain and risk of infection post-cholecystectomy. We implemented a Morphine PCA and monitored her vitals and wound site closely, aiming to enhance her recovery and comfort.”
Current Patient Status
This NURS 223 7-2 Flip 4 section will discuss the Current Patient Status.
- Include vital signs, physical observations, and any relevant lab results.
Example
“Currently, Mindy’s vitals are stable with a slight fever, her pain is mild to moderate, and her lung sounds are clear. However, there’s still mild edema and slight redness at the coccyx area. These observations are critical as we evaluate our interventions.”
Evaluating Data
This NURS 223 7-2 Flip 4 section will discuss the Evaluating Data.
- Describe the changes you anticipated seeing after the interventions.
- Determine the information needed to assess whether the patient’s problem has improved, worsened, or stayed the same.
- Reflect on whether different actions could have been more effective.
Example
“Let’s dive into evaluating the data:
I expected the PCA to control her pain effectively, which it has to a certain extent.
To assess improvements or declines, we monitored her pain levels, wound condition, and overall mobility.
Reflecting on other possible interventions, considering her slight fever and oedema, could we have optimised her fluid management or adjusted her analgesic schedule sooner?”
Evaluating And Correcting Thinking
This NURS 223 7-2 Flip 4 section will discuss Evaluating And Correcting Thinking.
- Identify and rate your performance on two clinical judgment competencies you executed well and two that need improvement.
- Explain what steps you will take to improve the competencies you found challenging.
Example
“Regarding my clinical judgment:
I rate myself highly on monitoring and responding to acute changes—these competencies were crucial in managing Mindy’s pain and preventing complications.
Areas for improvement include my anticipation of potential complications like infection, given the redness observed. In the future, I will incorporate more proactive measures into my care plans.”
Reflecting on Step 5 Impact
- Explain how evaluating outcomes and your thinking affects patient care and outcomes.
Example
“Reflecting on this step, evaluating outcomes and our thought processes is vital. It not only helps in confirming the effectiveness of our actions but also in refining our clinical judgment, ensuring safer patient care.”
Closing Reflection
We will discuss the Closing Reflection in this section of NURS 223 7-2 Flip 4.
- Emphasise the significance of each competency in enhancing clinical judgment and patient care.
Example
“Conclusively, this evaluation helps us understand what worked and what didn’t, guiding future care decisions. I will focus on enhancing my preventive strategies and continue to adapt my interventions based on ongoing assessments and patient feedback.”
CLOSING
By following these guidelines of NURS 223 7-2 Flip 4, you will effectively apply the fifth step of the Clinical Competency Judgment Framework (CCJF) to evaluate the outcomes of your interventions and reflect on your clinical thinking process. This structured approach ensures comprehensive assessment and continuous improvement in patient care, which is essential for developing advanced clinical judgment skills. Practising these NURS 223 7-2 Flip 4 competencies will enhance your ability to provide safe, effective, and empathetic patient care. In the next module of NURS 223, we will explore the 9-1 final flip.
