Root cause thinking: a nurse-client partnership utilizing clinical reasoning and judgment to improve client outcomes

NANDA International 2012 Conference Abstract
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Session 1.2
Clinical Judgement Track
Oral Poster

Elizabeth J. Ackley
Gail Ladwig
Michelle  Aerbosold
Dana Tschannen
Marie Giordano

A process entitled Root Cause Thinking (RCT) is now being taught in several US nursing programs.  This is an integration of four major processes:  Root Cause Analysis, Patient Storytelling, Nursing Process, and Motivational Interviewing.  Root cause analysis has traditionally been used in health care to determine the cause of harmful sentinel events (Mengis & Nicoline, 2010; Percarpio, Watts & Weeks, 2008).   RCT is an adaptation of root cause analysis and utilizes “clinical reasoning and judgment” in applying the process to a client’s health situation, to determine the underlying causes of health problems and prevent further problems from developing. Several nursing articles have addressed this process at a beginning stage  (Harris, 2010; Holloway, 2010).,   Nurses  work with the client, family  and other disciplines as needed  to Improve client outcomes by modifying or resolving the underlying causes and thus improving the client’s health. RCT is timely because with health care reform there is reimbursement for nursing care in physicians’ offices for surveillance and teaching of clients.  In addition it has become imperative that clients not be readmitted to  the hospital soon after discharge because of the loss of reimbursement for care.  Use of RCT could help reduce readmission rates. This is a concept presentation, not a research study.

Results / Findings
Concept Presentation

Discussion / Conclusion
Definition of Root Cause Thinking A process of actively synthesizing gathered information collected through observation, experience, reflection, reasoning, and communication  to determine the underlying  causes of the client’s current health status, in both illness and well states.

Concept Presentation.

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