Clinical Reasoning and Care Coordination in Advanced Practice Nursing

This book describes an innovative model for helping APRN students develop the clinical reasoning skills required to navigate complex patient care needs and coordination in advanced nursing practice. This model, the Outcome-Present-State-Test (OPT), encompasses a clear, step-by-step process that students can use to learn the skills of differential diagnosis and hone clinical reasoning strategies. This method facilitates understanding of the relationship among patient problems, outcomes, and interventions that focus on promoting patient safety and care coordination. It moves beyond traditional ways of problem solving by focusing on patient scenarios and stories and juxtaposing issues and outcomes that have been derived from an analysis of patient problems, evidence-based interventions, and desired outcomes.

The model offers a blueprint for using standardized health care languages and provides strategies for developing reflective and complex thinking that becomes habitual. It embodies several levels of perspective related to patient-centered care planning, team-centered negotiation, and health care system considerations. Through patient stories and case scenarios, the text highlights care coordination strategies critical in complex patient situations. It provides students with the tools to collect patient information, determine priorities for care, and test interventions to reach health care outcomes by making clinical judgments during the problem-solving process. Concept maps illustrate complex patient care issues and how they relate to each other. For faculty use, the text provides links to relevant APN competencies and provides guidelines for using the OPT when supervising students in field settings.