Reasoning in a Specialty Area

Bring to mind an important practice-related decision you have made recently. How did you approach this decision? What aspects of your specialty expertise informed your decision-making?

Evaluate your decision now in light of the principles of clinical reasoning presented in the Learning Resources this week. What new insights arise about your decision making as you look at it through this lens? What questions emerge as you reflect how you use reasoning in your practice?

In this Discussion, you and your colleagues examine the application of reasoning strategies in your specialty area of practice, particularly as it is connected to your EBP Project question.

To prepare:

• Consider the definition of clinical      reasoning and how it is distinguished from other terms in the      Simmons article. (see attached file)
• Bring to mind key characteristics of your      specialty area. Is the concept of clinical reasoning relevant and      sufficient to describe the process you utilize as you      make decisions and solve problems in your area of specialization? Why or      why not? If not, what terminology would be more useful for defining or      characterizing this process?
• Review the literature to identify at least two specific examples of reasoning strategies used in your specialty area. These may be part of your literature review related to your EBP Project question(s). (see PIICOT Question below      at the end of the page)
• Reflect on your EBP Project      question(s) (see PIICOT Question below at the end of the page).      Reexamine your project question(s) through this lens of clinical, or      alternately termed, reasoning.

By Day tomorrow 09/04/18 12 by 10 pm, write a minimum of 550 words in APA format with at least 3 references from the list of required resources below. Include the level one headers as numbered below:

Post a cohesive scholarly response that addresses the following:

1) How are reasoning strategies most often applied in your specialty area? Provide at least two specific examples supported by the literature.

2) How can you apply reasoning strategies to the refinement of your EBP Project question(s)? (see PIICOT Question below at the end of the page)

Required Readings

Terry, A. J. (2018). Clinical research for the doctor of nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter      1, “The Importance of Research in the Doctor of Nursing Practice Degree”
       Read pages 12-18 beginning with “The DNP Graduate with an Aggregate Focus”      (see attached File)

       In this section of Chapter 1, the author explains relationship between the      DNP clinician, the research process, and developing an effective      evidence-based practice. The author also discusses facilitating change in      practice based on critically appraised and validated evidence. In      addition, Carper’s four essential patterns of “knowing” in nursing and      Rosswurm and Larrabee’s six-phase model for reviewing research are      highlighted.

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. Journal of Pediatric Nursing, 28, 479-485.

Harkanen, M., Voutilainen, A., Turunen, E., & Verhvilainen-Julkunen, K. (2016). Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses, Nurse Education Today, 41, 36-43. 

Lee, J., Lee, Y., Bae, J., & Seo, M. (2016). Registered nurses clinical skills and reasoning process: A think-aloud study. Nurse Education Today, 46, 75-80.

Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, 66(5), 1151-1158.

PIICOT Statement

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months