Clinical Reasoning in Experienced Nurses

Simmons, Barbara; Lanuza, Dorothy M.; Fonteyn, Marsha; Hicks, Frank D.; Holm, Karyn

doi:10.1177/0193945903253092

Cited by 133 publications

(172 citation statements)

References 52 publications

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“…Thus, CJ included a series of phases of intellectual, psychological and practical behaviors. [10,11] Furthermore, congruent with the current study results, Simmons et al, 2003, explained that CJ in nursing necessitates a perception of the clinical situation, not related patient problems and illness, but about a holistic view of the patient experiences. Additionally, for resources, attitudes, & adaptations, CJ may be a difficult process for nurses.…”

Section: Discussionsupporting

confidence: 85%

“…Additionally, for resources, attitudes, & adaptations, CJ may be a difficult process for nurses. [12] In contrary to the present result, much research has reported that the health care professionals have to comprehend the concept of CJ, essentially in the nursing field. Nurses should have unambiguous recognition of CJ components and phases, which afterward continuously and automatically represents clear interpretation.…”

Section: Discussioncontrasting

confidence: 77%

“…They completely neglect planning for improvement or patient satisfaction. [12,14,17] Incompatible to previous results, Potgieter, in 2012, highlighted that the use of CJ with its four phases among nurses is an essential issue that helps them to collect, comprehend, relate and analyze patient problems. It is an obligation in a critical job like nursing.…”

Section: Discussionmentioning

confidence: 89%

“…This manner of thinking fits with understandable relationships in clinical situations and surrounding circumstances that leads to suitable and valid decisions. [11][12][13] Also, Van Graan et al, in 2014 and 2016, discussed that professional nurses should have advanced thinking talents of CJ that are fundamental elements necessary in preparing them in dealing with scientifically progressive technology and more multifaceted nursing roles. Preceptors and clinical instructors are responsible for equipping recently competent nursing graduates with all CJ knowledge and experiences.…”

Section: Discussionmentioning

confidence: 99%

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Clinical judgment among nursing interns

Ibrahim

Aly

2018

CNS

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Clinical judgment (CJ) is considered a vital and crucial ability for nurses that can help them to improve their practical or clinical capabilities, particularly in the internship period. Nursing interns pass through a transient period with significant job responsibilities. They face multifaceted issues, dilemmas, and problems that oblige them to use CJ skills. CJ is a talent and clever skill which should be acquired by nursing interns. The current study is a quantitative study that aims to determine CJ knowledge and skills among nursing interns in nursing practice. A descriptive exploratory design was used. A systematic random sample of 150 nursing interns out of 305 was selected and assigned as a survey group. The data was collected in internship training hospitals in Damanhur, Egypt (Damanhur Medical National Institute, El Raee El Saleh, El Farok and Kafer El Dawar Hospitals). One tool was used for data collection, the Clinical Judgment Evaluation Sheet (CJES), which included two parts. The first part was the Clinical Judgment Knowledge Test that was developed by the researchers to collect the necessary data regarding the CJ knowledge needs of nursing interns. The Lasater Clinical Judgment Rubric (LCJR) 2009 was the second part. It was developed based on Tanner's work in 2006 and included eleven skills in the four phases delineated with CJ developmental skills (noticing, interpreting, responding, and reflecting). Results revealed that the nursing interns have a serious lack of knowledge about the concept of CJ in nursing practice. Additionally, they have a great deficiency in the knowledge about all phases of the CJ process in nursing practice. As well, they suffered from observed insufficiently CJ skills in the nursing practice, respectfully. These findings confirmed that the nursing interns in Damanhur governorate have necessitated to an educational program about CJ knowledge skills. In conclusion, there is an obvious and serious lack of nursing interns' CJ knowledge and skills in nursing practice in Egypt. Therefore, CJ teaching programs or self-learning references are important for them for developing and improving CJ knowledge and skills. Nurse educators and preceptors should take initiative steps in developing teaching sessions, models, and instructional aides to empower their nursing intern's students in CJ practice.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Clinical judgment among nursing interns

Ibrahim

Aly

2018

CNS

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“…Several studies identified the most frequent nursing diagnoses in different populations, but none in patients with liver cirrhosis [19][20][21][22] . In addition, few studies of clinical reasoning have been conducted in a practice setting 23 , and no studies focusing on clinical reasoning in patients with liver cirrhosis where published. The impetus of the study is to identify the priority focus of care for patients with a chronic condition using a clinical reasoning web, with the aims of reducing patients' length of stay, the risks associated with healthcare, and to improve patient's outcomes.…”

Section: The Casementioning

confidence: 99%

Application of the Outcome Present State Test Model in a Patient with Liver Cirrhosis: A Case Study

2015

American Research Journal of Nursing

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This paper presents the case study of a 74 year old man with liver cirrhosis and consumptive syndrome. Data was collected in a Brazilian university hospital. The case study approach used was outcomepresent state test (OPT) model. The assessment was made by using the Conceptual Model of Wanda Horta. Also, the NANDA-I, Inc., Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) linkages were used to capture accurate nursing care plan. The keystone nursing diagnosis was: Imbalanced nutrition: less than body requirements. The NOC outcomes chosen were Nutritional Status: Food and Fluid Intake; and Weight: Body Mass Control. The NIC interventions chosen for the patient were: Enteral Tube Feeding and Fluid Monitoring. The findings support that the use of a clinical reasoning web helps nurses to identify the priority focus of care in patients with complex health problem, and to prevent future complications associated with the evolution of disease. Future researches are needed to determine the NANDA-I, NOC, and NIC linkages based on a clinical reasoning model to capture accurate nursing care plan for all patients with chronic condition, in order to provide competent and safe care, thus improving patient outcomes.

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