OPT: Transformation of nursing process for contemporary practice

doi:10.1016/S0029-6554(98)90022-7

Nursing Outlook

Volume 46, Issue 1, January–February 1998, Pages 29-36

https://doi.org/10.1016/S0029-6554(98)90022-7 Get rights and content

Abstract

Over time, clinical, educational, and social forces have influenced the development of three generations of traditional nursing process. The first generation was concerned with problems and process. Analysis of second-generation models revealed interest in understanding the nature of diagnosis and diagnostic reasoning. We have proposed a third generation model that underscores the importance of critical, metacognitive, and thinking skills that support outcome specification and testing in clinical reasoning. Clinicians, educators, managers, and administrators are invited to consider the OPT model as an alternative to traditional nursing process. The OPT model may be one of many transitional reasoning models^35,36 needed for contemporary nursing practice.

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Citation Excerpt :
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Citation Excerpt :
The OPT model builds on the heritage of the traditional nursing process and at the same time differs from it in several important ways. The OPT model provides a structure for iterative clinical reasoning by focusing on organising patients' needs and nursing care activities around keystone issues and outcome specifications (Kautz et al., 2005; Kuiper et al., 2017; Pesut and Herman, 1999, 1998). The first factor, “Understanding the patient”, consists of items from the noticing phase and the interpreting phase, along with one item from the responding phase, items relating to knowing the patient.
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The purpose of this study was to determine how knowledge sources, ready knowledge, and disposition toward critical thinking and reasoning skills influence the accuracy of student nurses' diagnoses. A randomized controlled trial was conducted to determine the influence of knowledge sources. We used the following questionnaires: (a) knowledge inventory, (b) California Critical Thinking Disposition Inventory, and (c) Health Science Reasoning Test (HSRT). The use of knowledge sources had very little influence on the accuracy of nursing diagnoses. Accuracy was significantly related to the analysis domain of the HSRT. Students were unable to operationalize knowledge sources to derive accurate diagnoses and did not effectively use reasoning skills.
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¹: DANIEL J. PESUT is a professor and Chair of the Department of Environments for Health at Indiana University School of Nursing, Indianapolis.

²: JOANNE HERMAN is an associate professor at the University of South Carolina College of Nursing, Columbia.

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OPT: Transformation of nursing process for contemporary practice

Abstract

J Prof Nurs

J Prof Nurs

Nurs Outlook

Nurs Outlook

Metacognitive skills in diagnostic reasoning

Nurs Diagnosis

Using metacognitive skills: the quality audit