Effects of reflection on clinical decision-making of intensive care unit nurses

Razieh, Shahrokhi; Ghafari, Somayeh; Haghani, Fariba

doi:10.1016/j.nedt.2018.03.009

Cited by 27 publications

(23 citation statements)

References 7 publications

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“…Quality nursing requires a cognitive decision-making process that allows a correct understanding of a client's problem and selection of the optimum nursing behaviour. Previous studies of nursing decision-making have consistently shown that this process is significantly affected by the information and knowledge held by the decision-maker (Banning 2008;Razieh et al 2018). Specifically, nurses with higher levels of knowledge and clinical competency were found to make clinical decisions more intuitively (Abdi et al 2015;Effken 2001).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies of nursing decision‐making have consistently shown that this process is significantly affected by the information and knowledge held by the decision‐maker (Banning ; Razieh et al. ). Specifically, nurses with higher levels of knowledge and clinical competency were found to make clinical decisions more intuitively (Abdi et al.…”

Section: Introductionmentioning

confidence: 99%

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Registered Nurses (RNs)’ knowledge sharing and decision‐making: the mediating role of organizational trust

Yoo

Zhang

Yun

2019

International Nursing Review

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Aim This study study aimed to investigate the effects of explicit and tacit knowledge sharing on clinical decision‐making abilities and the mediating role of trust among registered nurses at Korean hospitals. Background Decision‐making abilities comprise a key area of nursing practice and link nurses’ perceptions with behaviours. Introduction Tacit knowledge is embedded within an individual and cannot be expressed or transmitted to other people in a specific form. Over time, new nurses gradually gain experience and tacit knowledge and become experts. Trust, an organizational characteristic, may serve as a potential mediator in the association between knowledge sharing and decision‐making abilities among nurses. However, few studies have investigated the mediatory role of trust in this association. Method The data were collected from 210 nurses selected via random sampling. The research instrument in the model included Knowledge‐Sharing Behavior, Trust, and Clinical Decision‐Making in Nursing Scale. Structural equation modelling was used to analyse the collected data. Findings The study findings showed that explicit knowledge sharing directly affects decision‐making abilities, whereas tacit knowledge sharing is only associated with decision‐making abilities when trust plays a mediating role. Discussion A higher level of organizational trust can improve clinical decision‐making abilities via tacit knowledge sharing. Conclusion This study demonstrated that unlike explicit knowledge, which is shared more easily, tacit knowledge sharing does not directly lead to clinical decision‐making abilities. A higher level of organizational trust leads to a stronger beneficial effect of tacit knowledge sharing on clinical decision‐making abilities. Implications for nursing and health policy These findings concerning the mediatory role of trust on the association between knowledge sharing and clinical decision‐making abilities provide new knowledge that will allow nurses, managers, and researchers to support the clinical decision‐making abilities of nurses.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Registered Nurses (RNs)’ knowledge sharing and decision‐making: the mediating role of organizational trust

Yoo

Zhang

Yun

2019

International Nursing Review

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“…These studies are supported by the study of Olle et al, 2018 who brings that, an effective clinical reasoning process should incorporate analytical reflective mental process. Razieh et al 2018., highlight that 'reflection-structured reflection improves the clinical decision-making of the critical care nurses, and it should be integrated into all health care practices and nursing clinical teaching plans'. Schmidt and Mamede 2015 comments that 'deliberate reflection' as a tool for learning and teaching clinical reasoning skills for health care practitioners.…”

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confidence: 99%

Enhancing Clinical Reasoning Skills through Structured Reflection Models

Almomani¹,

Attallah²

2020

Preprint

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Background:Clinical reasoning is an essential skill to all health care practitioners. McGlynn et al, 2015 mention that lower level of clinical reasoning skills are associated with higher rates of medical and diagnostic errors.. To enhance the clinical reasoning through reflection Hamad Medical Corporation (HMC) – Qatar established a new educational initiative under the title of reflective learning conversation and debriefing.Method:A prospective cross sectional exploratory of mixed methodology research conducted at Qatar- Hamad Medical Corporation (HMC) – In the critical care and trauma units. Anonymous self-reported questionnaires were collected from 236 critical care and trauma nurses who attended the reflective learning conversation and debriefing activities. Semi structured Interviews conducted for 10 nurses who facilitated the reflective learning conversation and debriefing activities. Content analysis and thematic analysis were applied.Results:Attending the reflective learning conversations and debriefing educational activities have a significant positive impact on the clinical reasoning skills of the critical care and trauma nurses. Moreover, attending the group level reflection, feeling threatened, are limitations and barriers for the reflective learning conversation and debriefing. Additionally, reflective practice can be encouraged and enhanced through; having reflective conversation and debriefing models and guidelines, and reflecting on both good and bad experiences.Conclusion:There is a positive correlation between the clinical reasoning and the structured reflections in the format of reflective learning conversation and debriefing. Reflective practice can be enhanced through attending the reflective learning conversation and debriefing activities. There are some limitations and challenges to the reflective learning conversation and debriefing method.

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“…Evaluasi terhadap efek dari penerapan metode refleksi Tanner hasilnya menunjukan bahwa penerapan metode refleksi Tanner dapat secara signifikan meningkatkan skor rata-rata dan tingkat pengambilan keputusan klinis perawat ICU (Razieh, Somayeh, & Fariba, 2018)dan evaluasi terhadap pengalaman perawat dalam menggunakan National Early Warning Score (NEWS)hasilnya yaitu perawat melaporkan bahwa NEWS mudah digunakan, tidak menambah beban kerja dan meningkatkan kemampuan perawat untuk mengidentifikasi pasien yang memburuk (Fox, 2015). Dalam perawatan pasien di rumah sakit termasuk di ruangan ICU belum digunakan sistim pendukung keputusan klinis bagi perawat.…”

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Dady¹,

Erika²,

Rachmawaty³

2020

jik

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Pendahuluan:Keputusan klinis yang dibuat perawat harus didukung dengan data yang akurat serta lengkap dan sistim yang baik. Namun dalam pelaksanaan perawatan pasien, pembuatan keputusan klinis oleh perawat tidak didukung dengan sistim pendukung keputusan klinis di rumah sakit.Tujuan:untuk mengetahui sistim pendukung keputusan klinis yang dapat mendukung pembuatan keputusan klinisoleh perawat bagi pelayanan pasien di rumah sakit.Metode: Pencarian sistematis dilakukan dibeberapa database yaitu PubMed, ProQuest, dan Science Direct dengan kata kunci Support SystemClinical Decision AND Clinical Decision Making AND Nurses. Kriteria inklusi yaitu publikasi dalam 5 tahun terakhir dari 2015 sampai 2019, full text, membahas penggunaan sistim pendukung keputusan klinis oleh perawat, semua metode penelitian baik kualitatif, kuantitatif, metode campuran, kohort maupun survey dan menggunakan bahasa inggris.Hasil: Diperoleh enam artikel penelitian sesuai dengan kriteria inklusi Terdapat dua studi tentang pengembangan sistim pendukung keputusan klinis, dua studi tentang evaluasi efek dan pengalaman perawat dalam menggunakan sistim pendukung keputusan klinis, satu studi tentang akurasi diagnostik sistim pendukung keputusan klinis dan satu studi tentang hambatan penggunaan sistim pendukung keputusan klinis. Diskusi: Sistim pendukung keputusan klinis (CDSS) yang dapat digunakan untuk mendukung keputusan klinis perawat adalah NEWS dan metode refleksi Tanner akan tetapi harus terlebih dahulu diuji coba dan disosialisasikan terkait manfaat serta cara penggunaannya kepada perawat, harus aman bagi pasien dan tidak merugikan pasien serta rumah sakit.

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Effects of reflection on clinical decision-making of intensive care unit nurses

Cited by 27 publications

References 7 publications

Registered Nurses (RNs)’ knowledge sharing and decision‐making: the mediating role of organizational trust

Registered Nurses (RNs)’ knowledge sharing and decision‐making: the mediating role of organizational trust

Enhancing Clinical Reasoning Skills through Structured Reflection Models

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