wcu responses
NURS682 Discussion Response 1
Maria B
The OPT model emerged in the late 90s. This model consists of thinking and reasoning. It encouraged nurses to problem solve by providing guidelines. “In this model, clinical reasoning is defined as the critical, reflective, concurrent, and creative thinking embedded in nursing practice that results in the juxtaposition of problems and outcomes that are subject to interventions and clinical judgments “(Anef et al, 2016, p. 57). The OPT model helps in providing nurses with guidance and strategies to meet patient needs. “The OPT model supports contemporary definitions of the nursing process, which include assessment, diagnosis, outcome identification, planning, implementation, coordination of care, health teaching and promotion, and evaluation” (Anef et al, 2016, p. 57). I have used the OPT model in my nursing career. An example of this is using NANDA. This is a professional organization used to research, develop, and implement standards of care for patients. Most nurses that I have worked at have used this organization that has been beneficial in the care of patients.
“CCCR requires the concurrent consideration of several levels of perspective: patient-centered, team-centered, and system-centered reasoning” (Anef et al, 2016, p. 101). In the CCCR model there is care management used to reduce costs, improve patient outcomes, and prevent further injury or rehospitalization. I used this model when I worked in a hospice. My role was nurse case manager. The job required me to do home visits, assessments, education, treatments, and figure out what the patient needed. My role required me to communicate with the rest of the team such as the LVNs, CNAs, and the director. When a patient/family wanted to receive hospice services there was a thorough evaluation made to assess what services the patient needed. Doing a thorough evaluation allowed the nurse case manager to determine what medications and treatments were needed. Providing adequate medications, treatment, and care resulted in the patients not being hospitalized but rather being as comfortable as possible. I had a patient with COPD, he was constantly calling the office for shortness of breath. Patient was mostly Spanish speaking, who required extra time when I was educating him on his breathing treatment. I recommended he receive 2 visits a week instead of 1 visit from the LVN to provide education and breathing treatments. This resulted in reduced calls, reduced episodes of shortness of breath, and better quality of life for the patient.
NURS682 Discussion Response 2
Outcome – Present State – Test (OPT) Model
The OPT Model uses cluster and web-like structure to determine what is most important to focus on with a patient with multiple comorbidities (Kuiper et al., 2016). The cluster and web-like structure provide the provider a structure to follow to determine what is most pressing to focus on to ensure the patient gets the care they need. According to Kuiper et al. (2016), the OPT model helps to fill in the gaps in the patient’s story. This model includes judgment, reflection on clinical reasoning, framing the present state and outcome states, and decision-making.
Seo and Rom (2021) found that using the OPT Model in a nursing school program effectively promoted clinical reasoning, problem-solving processes, self-efficacy, and clinical competency. This model reminds me of what nurses do daily when caring for their patients. Once a report is received from the off-going nurse, the nurse taking over the patient’s care should conduct a thorough assessment and determine the most crucial goal for the patient to achieve for the shift. If a patient is septic and on a vasopressor, the goal should be to get off the vasopressor and maintain their own blood pressure. Furthermore, when getting the whole story of the patient, it is essential to know what is causing the patient to become septic. This is when the nurse should question if blood cultures have been drawn and if a urine sample has been sent to identify the culprit. Once all the pieces of the puzzle are put together, a plan could be established to reach positive outcomes in terms of health and wellness.
Care Coordination Clinical Reasoning (CCCR) Model
The CCCR Model is just as it sounds. It is having multiple parts coming together to take care of a patient. When it comes to patient care, there are a lot of moving parts. From the beginning of the patient’s admission, discharge planning is carried out. As Kuiper et al. (2016) write, there is a goal for improved patient experiences of high-quality care, reduced costs, and improved population health. With discharge planning right at admission, this can save the patient time and money. Working in the hospital, this model is evident. So many people and departments in the hospital work together to ensure patients receive the care they need. A phlebotomy is responsible for obtaining labs, a physical and occupational therapist is responsible for patient mobility and getting the patient back to baseline, a respiratory therapist is responsible for ensuring the patient can breathe adequately, and the nurses coordinate the care. The nurses are responsible for a lot of the follow-up that occurs when caring for the patient and ensuring tasks are completed promptly. This coordination keeps the patient’s hospital stay at a minimum.
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