Clinicalreasoning and judgment involve examination of different thinkingmodes targeted at making the right decision for an individualpatient. Roffey (2012) noted that an advanced practice nurse`sability to provide high-quality care by making the right thingdepends on proper reasoning and judgment, which may be limited due tolack of experience. As an advanced practice nurse, expert performancedepends on the evaluation of practice and continual learning.
First, as anadvanced practice nurse, I plan to pay attention to the individualpatient`s condition, his or her response to health care intervention,and events or adverse reactions that may harm the patient. Thejudgment of the individual patient`s condition defines his or heroutcomes and subsequent interventions. Here, I plan to attainaccurate and relevant interpretations of the patient`s informationand data regarding his or her condition. This is difficultconsidering each piece of information can vary in its meaning andinterpretation, and may be influenced by past experiences. Roffey(2012) noted that patients tend to be vulnerable to their nurses`actions and experiences, which are linked to them accessing qualitycare.
Finally, once I have identified the problem, having used a processthat utilizes critical thinking, I would then search for and evaluateresearch evidence and potential discrepancies. According to Roffey(2012), the process of applying evidence in nursing practice is partof "a problem-solving method that incorporates all the bestavailable evidence, nurses` expertise, and individual patient`svalues and preferences." Having formulated the plan, it willalso be important to pay attention to barriers that may arise in thisevidence-based practice. These barriers include difficulty inunderstanding patient data, failure to place patient data intoclinical context, and lack of necessary skills in nursing practice.
Roffey, S. (2012). Positive relationships: Evidence based practiceacross the world. Dordrecht: Springer.