The ‘five rights’ of clinical reasoning : An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients

Journal article


Levett-Jones, Tracey, Hoffman, Kerry, Dempsey, Jennifer, Jeong, Sarah Yeun-Sim, Noble, Danielle, Norton, Carol Anne, Roche, Janiece and Hickey, Noelene. (2010). The ‘five rights’ of clinical reasoning : An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today. 08, pp. 515-520. https://doi.org/10.1016/j.nedt.2009.10.020
AuthorsLevett-Jones, Tracey, Hoffman, Kerry, Dempsey, Jennifer, Jeong, Sarah Yeun-Sim, Noble, Danielle, Norton, Carol Anne, Roche, Janiece and Hickey, Noelene
Abstract

Acute care settings are characterised by patients with complex health problems who are more likely to be or become seriously ill during their hospital stay. Although warning signs often precede serious adverse events there is consistent evidence that ‘at risk’ patients are not always identified or managed appropriately. ‘Failure to rescue’, with rescue being the ability to recognise deteriorating patients and to intervene appropriately, is related to poor clinical reasoning skills. These factors provided the impetus for the development of an educational model that has the potential to enhance nursing students’ clinical reasoning skills and consequently their ability to manage ‘at risk’ patients. Clinical reasoning is the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process. Effective clinical reasoning depends upon the nurse’s ability to collect the right cues and to take the right action for the right patient at the right time and for the right reason. This paper provides an overview of a clinical reasoning model and the literature underpinning the ‘five rights’ of clinical reasoning.

Keywordsclinical reasoning; nursing student; novice nurse; failure to rescue; at risk patients
Year2010
JournalNurse Education Today
Journal citation08, pp. 515-520
PublisherElsevier Ltd
ISSN0260-6917
Digital Object Identifier (DOI)https://doi.org/10.1016/j.nedt.2009.10.020
PubMed ID19948370
Scopus EID2-s2.0-77954535953
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online30 Nov 2009
Publication process dates
Accepted30 Oct 2009
Deposited27 Mar 2025
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