Comprehensive decision-making

  1. Competency

    Modify clinical judgment within an iterative, outcome-based cycle of clinical reasoning and client needs.

    Student Success Criteria

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    As part of the clinical portion of your BSN Capstone course in your senior semester, you have the opportunity to attend a two-day seminar with senior nursing students from other academic institutions. The theme of this seminar is the application of clinical judgment to determine the best evidence-based solutions for nursing practice.


    For a clinical judgment roundtable with faculty and students that is sponsored by your academic institution, you must prepare one scenario based handout to promote robust discussion regarding the application of clinical judgment as an outcomes-based dynamic cycle of clinical reasoning and client needs. The handout must contain these components:

    • Describe a clinical situation where you applied an outcome-based cycle of clinical reasoning to select what you considered the “best” client intervention based on information available.
    • Include relevant external and internal cues and hypotheses
    • Discuss the outcomes based, iterative cycle of clinical reasoning you applied after the initial intervention to select the next “best” interventions appropriate for the particular situation based on client needs.
    • Rationales and evidence based findings were included to support choices for the next “best” interventions


    Answer preview

Under the goal-setting phase, which falls fifth, the critical decision made was to improve the infant’s wellbeing within 7 days and constantly monitor the progress in monthly checkups upon discharge. The best intervention to achieve the goal was lactation education. This was necessary, considering that during interactions with the mother, the infant’s mother did not receive any training about it during the prenatal stage. In a summarized study by U.S. Preventive Services Task Force (USPSTF), the Center for Disease Control and Prevention (CDC) (n.d.) revealed breastfeeding education as an effective intervention that motivates mothers to initiate the practice. Based on the outcomes, this intervention was more effective once implemented during the pre and postnatal stages by influencing exclusive breastfeeding and feeding duration.

Further, in the action-taking phase, the lactation training entailed teaching the infant how to latch the breast, how the mother should motivate the child to breastfeed, and foods to take to increase breast milk production. During the evaluation phase, this created a chance to assess the effectiveness of the lactation education intervention implemented.

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Comprehensive decision-making