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NRSG 138 ASSESSMENT TASK 3

NRSG 138 ASSESSMENT TASK 3: Written Meta-Reflection (Understanding of the Roper Logan and Tierney Model of Care and the Clinical Reasoning Cycle)
Section – 1
I believe that the Roper Logan (RL) and Tierney Model of Care (TMC) and the Clinical Reasoning Cycle (CRC) play an important role in undertaking various healthcare interventions. I effectively utilized this model of patient care to develop therapeutic and professional relationship with the assessed patient. Indeed, I attained the opportunity of evaluating the vital signs of a patient in the clinical setting. I utilized therapeutic communication during the process of vitals recording for concomitantly assessing patient’s psychiatric state, level of consciousness and expressivity. The therapeutic alliance also helped me to understand patient’s mobilization pattern and level of independence in undertaking the activities of daily living (ADL) and personal care. The RL and TMC advocate the impact of various developmental stages on the physical, psychological and sociocultural demands of the individuals. This eventually determines patient’s ADL and interpersonal relationship pattern. I tried to assess the intelligence level, values, motivation, temperament and emotional state of the patient while sharing the vital signs under the amicable environment (Wilson, Woodlands, ; Barrett, 2013, pp. 56-57). I attempted to effectively maintain a safe environment for the patient through effective therapeutic communication. This resulted in the configuration of a respectful collaboration for effectively increasing patient’s trust, shared accountability, and compliance to the recommended treatment approaches (Keller, Eggenberger, Belkowitz, Sarsekeyeva, & Zito, 2013). I improved my clinical reasoning skills while effectively recording the clinical history through systematic questioning and thoughtful acquisition of the desired data. Eventually, the clinical reasoning cycle helped me in preparing a rational healthcare management plan through shared decision-making (Linn, Khaw, Kildea, & Tonkin, 2012).
Section – 2
I believe that the thorough assessment of the factors and attributes that impact the patient’s ADL is necessarily required during the clinical assessment. The root cause analysis of patient’s ADL rationally assists in configuring mitigative measures to improve the wellness outcomes. I understand that the nurse professional must undertake proactive measures to effectively reduce the environmental risk factors for the treated patient. The effective maintenance of patient’s surroundings is highly required for reducing the risk of trauma. I also understand the value of an effective communication process during the clinical assessment. I believe that the effective utilization of Levett-Jones’s Clinical Reasoning Cycle is needed for the successful incorporation of RL and TMC in the nursing care practice. I think that the nursing professionals require developing reflective approaches while undertaking the process of clinical reasoning. The articulation of expert reasoning in the process of clinical evaluation is highly essential for effectively improving the therapeutic outcomes (Delany & Golding, 2014). The acquisition of cues, processing of significant patient information, the establishment of goals and self-reflection on the outcomes are substantially required through effective clinical reasoning by the nursing professionals. The utilization of clinical reasoning cycle and RLT nursing model by the nurse professional assists in evaluating those disease manifestations that directly impact the sexuality, working pattern, movement, body temperature, cleansing attributes, bowel pattern, drinking habits, and breathing pattern of the chronically ill patients. This substantiates the need for developing clinical reasoning skills to facilitate the effective utilization of Roper Logan and Tierney (RLT) Model of Care in the clinical practice (Lee, Lee, Bae, & Seo, 2016).
Section – 3
The clinical reasoning cycle assists in acquiring new information through the systematic assessment of the treated patient. For example, I encountered a patient scenario where the review of current information and clinical history assisted undertaking the process of clinical correlation. The assessment of patient’s increased blood pressure and evaluation of his history of beta-blocker utilization provided a significant clue related to ongoing hypertension (PMH, 2018). Similarly, I understand that patient’s elevated blood pressure might indicate his/her increased level of stress or anxiety (Pan, et al., 2015). Indeed, I recently evaluated a patient affected with the right knee pain. The clinical reasoning cycle effectively assisted in understanding the patient situation, acquisition of cues and process information, and identification of problems. The assessment of patient’s vital signs and general appearance helped in identifying his overall health, wellness, and risk of acquiring critical health issues (Churpek, Adhikari, ; Edelson, 2016). The clinical reasoning assisted in effectively correlating patient’s knee pain, blood pressure, anxiety and other physical changes. The CRC assisted in evaluating the impact of patient’s increased knee pain pattern on his mobility pattern and other activities of daily living and personal care. The RLT approach was eventually utilized to understand and evaluate patient’s personal care limitations under the sustained impact of restricted mobility. These findings reveal the requirement of concomitantly utilizing CRC and RLT strategies for assessing the significant clinical and psychosocial patient outcomes. The assessment of patient’s elimination pattern (through RLT model of care) in many scenarios facilitates the evaluation of drug compliance, disease pattern, age, and injury (through CRC). These facts reveal the pattern of the interrelationship between CRC and RLT model of patient care.
Section – 4
I believe in the requirement of developing a systematic software for improving the process of clinical reasoning in the healthcare facilities. Furthermore, the development of psychological theories and patient-centeredness is highly required for effectively improving the quality and precision of clinical assessment (Eysenbach, McGrath, Liaw, Davies, ; Salminen, 2017). I also believe in the significance of clinical goal establishment for action planning. The nurse professional in a multitude of patient scenarios requires utilizing the RLT model of care with the objective of integrating the findings in the patient’s healthcare goals. For example, in many clinical situations, I effectively included the requirement of administering education and counseling/relaxation sessions after evaluating the disturbed sleep pattern of the treated patients (IQWIG, 2017). This indicates the significance of RLT model of care in configuring healthcare goals and treatment interventions for the target population. Indeed, I acquired the opportunity of recording the vital signs and provisionally diagnosing the conditions like hypertension, tachycardia, bradycardia, obesity, smoking addiction, substance abuse, dysphagia, depression, anxiety, shortness of breath, immobilization, dysuria, and chronic pain. These diagnoses were indeed retrieved through the systematic utilization of clinical reasoning cycle. The CRC-based outcomes evidently assisted to gather important cues regarding patient’s activities of daily living, personal care, and quality of life. Eventually, the RLT model of care provided deeper insight into the patient’s mobility and ADL constraints. Both of these assessments significantly assisted in determining the overall state of health and wellness of the treated patient. Accordingly, the treatment/healthcare interventions were improvised with the objective of improving the patient care outcomes and reducing the rate of admission in the healthcare settings. These facts advocate the need for utilizing RLT and CRC approaches in the context of generating the impeccable clinical outcomes.
References
BIBLIOGRAPHY Churpek, M. M., Adhikari, R., & Edelson, D. P. (2016). The value of vital sign trends for detecting clinical deterioration on the wards. Resuscitation, 1-5. doi:10.1016/j.resuscitation.2016.02.005
Delany, C., & Golding, C. (2014). Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC Medical Education. doi:10.1186/1472-6920-14-20
Eysenbach, G., McGrath, C., Liaw, S. Y., Davies, D., & Salminen, H. (2017). A Clinical Reasoning Tool for Virtual Patients: Design-Based Research Study. JMIR Medical Education, 3(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691243/
IQWIG. (2017, 03 09). Insomnia: Problems sleeping – information for teenagers. Retrieved from Informed Health Online Internet: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072503/
Keller, K. B., Eggenberger, T. L., Belkowitz, J., Sarsekeyeva, M., & Zito, A. R. (2013). Implementing successful interprofessional communication opportunities in health care education: a qualitative analysis. IJME, 253-259. doi:10.5116/ijme.5290.bca6
Lee, J., Lee, Y. J., Bae, J., & Seo, M. (2016). Registered nurses’ clinical reasoning skills and reasoning process: A think-aloud study. Nurse Education Today, 75-80. doi:10.1016/j.nedt.2016.08.017
Linn, A., Khaw, C., Kildea, H., ; Tonkin, A. (2012). Clinical reasoning – A guide to improving teaching and practice. TIGP, 18-20. Retrieved from https://www.racgp.org.au/afp/201201/45593
Pan, Y., Cai, W., Cheng, Q., Dong, W., Ting, A., ; yan, J. (2015). Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies. Neuropsychiatr Dis Treat, 1121-1130. doi:10.2147/NDT.S77710
PMH. (2018). Hypertension (High Blood Pressure). Retrieved from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024199/
Wilson, B., Woodlands, A., ; Barrett, D. (2013). Care Planning: A guide for nurses. New York: Routledge. Retrieved from https://books.google.co.in/books?id=7Y99AwAAQBAJ;pg=PA56;dq=Roper+Logan+care+model;hl=en;sa=X;ved=0ahUKEwjU-Ov9tpHbAhUFrI8KHcpyAZEQ6AEIRzAG#v=onepage;q=Roper%20Logan%20care%20model;f=false