Practice Rationale Care Model: The Art and Science of Clinical Reasoning, Decision Making and Judgment in the Nursing Process

Abstract

Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients' positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.

Moving and Handling Children After Death: An Inductive Thematic Analysis of the Factors That Influence Decision Making by Children's Hospice Staff

“…Practitioners with more experience on caring for children in cool rooms seemed more comfortable in not using equipment and in offering flexible postmortem care to the body, based on intuition, reflecting their perceived needs of the bereaved family. These findings correlate with the work of Guerrero 27 discussing the art and science of nursing decision making and clinical judgment, concluding that new nurses can find decision making around judgments and reasoning difficult because of unconsolidated experience of autonomy, proficiency and skill, and the tendency of more experienced nurses to use intuition as a basis for decision making 11 . The paper supports the concept of providing staff with an evidence base on which to base practice, supported with education, and professional collaboration, which includes nursing leadership.…”

Prevention of Nursing Interruption Disputes in Obstetrics and Gynecology Based on Nursing Process Reengineering

“…With the improvement of nurses' educational qualifications, the risk assessment scores of nursing interruption events have an upward trend, and there is no statistical difference. Studies have shown that the level of nurses' educational background will have an impact on nursing interruption events [25]. Nurses with lower educational backgrounds make more mistakes in dealing with interrupting events.…”

Nursing process from theory to practice: Evidence from the implementation of "Coming back to existence caring model" in burn wards

“…To perform a clinical decision‐making process, it is necessary to examine and identify the problem, evaluate the existing solutions, and ultimately select the best option; this process is carried out at the clinic through the nursing process, and in fact, a nursing process is a tool for helping the nurse to make appropriate clinical decision‐making and critical thinking (Guerrero, 2019 ). The nursing process model involves assessing, planning, implementing and evaluating patient situations, with the ultimate goal of preventing or resolving problematic situations (Benedet et al., 2018 ).…”

“…out at the clinic through the nursing process, and in fact, a nursing process is a tool for helping the nurse to make appropriate clinical decision-making and critical thinking (Guerrero, 2019).…”