Chapter 4 Worksheet for: Alfaro-LeFevre, R. (2020) Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach, 7th Ed. (http://www.alfaroteachsmart.com/books.html) 

clinical reasoning, clinical judgment, and decision-making

This chapter at a glance….

Nurses: the glue and conscience of health care
Goals and outcomes of nursing
Goals of Nursing
Outcomes of Nursing
What Are the Implications?
Interprofessional, Patient and Family Centered Care 
21st Century Skills and QSEN Competencies
Principles of Clinical Reasoning
Nursing Accountability―What Do Nurses Do?
	Responsibility versus Accountability
	Thinking Like a Nurse 
Nursing versus Medical Models
Decision-Making and Standards and Protocols
Scope of Practice, Diagnosis, and Decision-making
Novice versus expert thinking
Paying attention to context
Thinking with Health Information Technology (HIT)  
	Guidelines: Using EHR and other HIT 
Is the Care Plan Dead?
Intuition, Logic, Creativity, and Unfolding Reasoning 
Thinking-in-action—Unfolding, Dynamic Reasoning
What About Creativity and Innovation?
Standard Hand-offs: Improving Communication 
Laws, standards, and trends affecting thinking
Patients’ Rights and Privacy Laws
Certification Improves Care and Job Satisfaction 
National Safety Goals and High Reliability Health Care
Empowering Patients: Nurses as Stewards for Safe Passage
The Joint Commission Speak UpTM Initiatives
Time-Outs Promote Group Thinking
Systems-based practice and Social Determinants of Health
Incivility and Violence 
Predictive Care Models: What if?
Predict, Prevent, Manage, Promote (PPMP)
Four Key Strategies
Quick Priority Assessments (QPA)
Disease and Disability Management 
Rapid Response Teams and Code H (Help)
Monitoring for Dangerous Situations
Strategies to Identify, Interrupt, and Correct Errors
Delegating Safely and Effectively

Outcome-focused, evidence-based care 
Clinical, Functional, and Other Outcomes
Dynamic Relationship of Problems and Outcomes
Strategies for Developing Clinical Judgment

Learning outcomes

After completing this chapter, you should be able to:

1.	Describe key elements of interprofessional, patient and family centered practice.
2.	Compare and contrast the terms responsibility and accountability. 
3.	Describe what it is that nurses think about that’s different from other professionals.
4.	Explain the relationships among safety, efficiency, patient and family engagement, and clinical reasoning. 
5.	Apply clinical reasoning principles to develop sound clinical judgment. 
6.	Compare and contrast nursing and medical models. 
7.	Discuss the roles of ethics codes, standards, protocols, and laws in clinical decision-making.
8.	Describe the process of determining your scope of nursing practice. 
9.	Compare and contrast novice and expert thinking. 
10.	Describe the “four steps” and “five rights” of effective delegation.
11.	Explain how health information technology (HIT) and electronic health records (EHR) may promote or inhibit clinical reasoning. 
12.	Describe the role of intuition and logic in unfolding reasoning. 
13.	Explain how to use the predict, prevent, manage, promote (PPMP) approach.
14.	Address how to use critical thinking indicators and the 4-Circle CT model as tools to develop clinical reasoning skills. .

Key concepts
accountability; compassionate care; care coordination; delegation; emotional comfort; physical comfort; empowerment; hand offs; health promotion; human response; medical models; medication and treatment management; mobility; nursing models; patient education; practice scope; social determinants of health; surveillance; failure to rescue; system-based practice; population-based care; predictive care models. See also previous chapters.