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Clinical Reasoning Cycle: Understanding the Critical thinking Process

01 Apr 2021 4199 16 minutes
Clinical Reasoning Cycle Explained

In the year gone by, the world has come to pay attention to the role of healthcare workers. They were called on to help society in the gravest of the situation and were trusted to make decisions during such times. This is how critical the roles of these professionals are. But how do they make such important decisions on a daily basis? How do they judge situations? What guides them?

Along with the theoretical and practical knowledge of medical sciences, medical professionals need to be trained for such decision-making skills too. And concepts like the clinical reasoning cycle guide them through this. It is one of the few popular concepts that are used by medical professionals, especially nurses, to navigate through their everyday work environment, which requires them to constantly take decisions under critical conditions on an urgent basis. So, it is necessary for every medical professional to be familiarized with this very important model. Let us start by understanding the basic clinical reasoning process definition and origin.

What Is the Clinical Reasoning Cycle?

The first questions that might arise in your mind must be who created the clinical reasoning cycle and why? It is a concept that was designed by Tracy-Levett Jones, a professor of nursing at Newcastle, who aimed at providing a systematic decision-making model to healthcare professionals, especially physicians and nurses. The model facilitates them to think logically in a systematic way to arrive at a practical decision. It walks them through several necessary phases and considerations regarding the patient so they can make a comprehensive patient management plan that will be best suited.

Most feel that the work of nurses is limited to the application of their medical knowledge, but they have to make clear and accurate judgments, taking into consideration the personal judgments, attitudes, and perspectives of their patients. Having to consider so many medical and psychological aspects can get very complex for them if they do not have an organized path to follow. In the clinical reasoning cycle, nurses step in to make sure that a decision is made without missing any of the aspects or dimensions. Let us understand how exactly the model does this.

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What Are the 8 Steps of the Clinical Reasoning Cycle?

The clinical reasoning Tracy-Levitt Jones cycle has 8 phases in the process. Nurses are required to go through each step of the cycle when making a decision. Although these are steps and must be followed in order, in practice, often nurses move back and forth between the phases as necessary until they arrive at a proper decision. Here are the 8 phases:

Step 1: Consider the Patient Situation

This quite naturally has to be the first thing to do. This phase starts as soon as you are introduced to a new patient. You have to collect all relevant data related to the patient here. You need to gather all details regarding the medical condition of the patient and other necessary information like their age, the ward they are admitted to, the timing of their admission, etc. This data should be recorded in an organized way to produce information in the later stages.

For example, a 48-year-old woman was admitted for a stroke.

Step 2: Collect Cues And Information

Now the nurses are required to build on the preliminary data that they acquired in the previous step and inquire even more deeply into the situation. It essentially means digging into past medical conditions and the severity of the current situation. This will typically involve the medical history of the patients, their complaint history, vital signs, any results of medical investigation, current medical plan, etc. These are cues that the patients will provide the professionals with. They are required to apply their medical knowledge in several areas like pharmacology, physiology, pathology, culture, etc., to generate meaningful information from these pieces of data.

Step 3: Processing the Information

The clinical reasoning cycle is all about analytical thinking, and this step demands the nurses to analyze the information. After you have gathered all kinds of information, you are now at a stage where you can draw out the relevant information for further analysis. This is a very critical stage where a professional is required to apply their knowledge and analyze the entire health condition of the patient. This analysis is crucial as it is aimed at finding the answers to the problems the patient is facing.

Step 4: Identify Problems

Now that you have done an elaborate study of the patient issues, will be able to identify the reason causing it. This is why focusing on the information processing stage is important, as only after detailed analysis, you can reach the root of the problem. Once you have found out the cause, you need to clearly state it, as this piece of information will kick-start the diagnosis procedure in the coming steps.

Step 5: Establish the Goals

In the clinical reasoning cycle, this is where the diagnosis process of the ailment starts. After having a good understanding of the patient's health condition, one can proceed with their treatment plan. The nursing assignment helps experts emphasize that the treatment plan should not be open-ended and should be time-oriented, except in some cases. The nurse should be clear about what steps to take next and should make a detailed plan of the same. The plan should reflect the time frame within which they expect the outcomes of the treatment.

Step 6: Take Actions

At this stage, you convert the words and documents into action. The actual treatment of the patient begins here, and it will involve all the health care professionals. Therefore, it is necessary that each and every member involved must be made clear about the treatment plan.

Step 7: Evaluate the Outcome

An effective plan never ends at the implementation phase. Rather, it takes into consideration the responses after the implementation of the plan. In the case of the clinical reasoning cycle, the evaluation phase gives you feedback about how well you have done in the previous phases. Here, the response to the treatment is observed, and all necessary changes and adjustments are made. The nurse is required to monitor and record all the progress in the treatment to determine its effectiveness.

Step 8: Reflection

The last step is to reflect on the entire case and draw lessons for the future. What went right? What went wrong? How could it have been improved? What new findings were made? This will help you in approaching a similar case in the future more efficiently.

These are the 8 stages that will guide to systematically approach any patient's treatment- be it a moderate issue or a gravely severe one. Most of the time, nursing students seek case study help services, as they do not know how to approach cases even if they are on paper. You can employ this cycle in such case studies.

Now that you have understood the cynical reasoning framework, you need to understand the five rights model that will help in implementing the cynical reasoning process easily.

What Are the Five Rights of Clinical Reasoning?

When applying the clinical reasoning cycle in the real world, the nurses need to take each of the above considerations. The Five Rights is a way to understand the essence of the cycle and is a simpler way to guide the nurses through it in a clinical setting. If you are considering taking assignment help because you can't understand the clinical reasoning process, then consider these rights:

1. Right Cues

The right cues' essentially emphasize gathering the most relevant information regarding the patient's health condition. As all of the treatment will be dependent on this information, missing out on getting a piece of information can put the health of the patient at risk.

2. Right Patient

The right patient focuses on understanding the patient. As it is known that not all patients are at the same level of risk, the nurse must be able to analyze the risk a certain patient faces depending on their age, medical history, and other health-related factors.

3. Right Time

Right time refers to the timeliness of recognizing a change in the health of the patient. This is highlighted in the evaluation phase of the clinical reasoning cycle. Not monitoring the treatment patterns of the patient well and failing to act on a critical change at the right time in their health condition can lead to grave consequences most of the time. So this right emphasizes taking action at the right time.

4. Right Action

Along with action at the right time, it is also important to take the right actions. Again the monitoring of changes in the health of patients is deemed important through this right. Failure in medical judgments can be the difference between life and death. Therefore, the right action refers to taking the correct course of action to a change.

5. Right Reason

The "˜right reason' focuses on logical and critical thinking before any action is taken. This means that the nurses should think practically and should be clear about the rationale behind every action they take.

These rights cover the essence of the entire clinical reasoning process and cover every aspect related to dealing with a patient medically. Let's move on to understand why this cycle is given importance in the medical field.

Why Is the Clinical Reasoning Cycle Important?

Although the process has been explained above, you can still be wondering what the importance of the clinical reasoning cycle is and why it is relevant. As mentioned before, the cycle facilitates nurses to think logically and make better judgments. It does so by taking them through the 8 phases of the cycle, compelling them to think analytically and critically while looking at a situation. When approaching a patient case, it might be possible that the nurses might miss out on certain aspects and dimensions and take only the current situation into consideration. And taking everything into consideration is very important to reach a good judgment.

The clinical reasoning process, however, provides a path for nurses that covers all of the aspects. It takes care of everything right from recording the preliminary data of the patient to monitoring the response to the treatment. It helps one to systematically analyze the health condition of the patient, develop a good treatment plan for the same, and then finally, evaluate the treatment and draw lessons from it for the future. It is a framework with which nurses can perform their medical duties efficiently without confusion.

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