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Expert nurses' clinical reasoning under uncertainty: representation, structure, and process
1School of Nursing, University of San Francisco.
Proceedings. Symposium on Computer Applications in Medical Care
|January 1, 1992
Summary
Expert nurses use specific reasoning and problem-solving strategies when planning care for high-risk patients with uncertain outcomes. This study reveals their decision-making processes for critical care scenarios.
Area of Science:
- Nursing
- Clinical Decision-Making
- Critical Care
Background:
- Understanding expert nurses' reasoning is crucial for improving patient care in uncertain situations.
- Critical care settings present complex challenges requiring advanced clinical decision-making skills.
Observation:
- A case study of a critically ill elderly patient was presented to ten expert critical care nurses.
- The think-aloud method was employed to capture the nurses' knowledge, reasoning, and problem-solving strategies.
- Verbatim transcripts were systematically analyzed to ensure credibility and traceability of findings.
Findings:
- Experts represented patient problems dynamically during their reasoning process.
- Nurses structured their care plans methodically, utilizing specific reasoning processes and heuristics.
- Strategies focused on resolving patient issues and preventing clinical deterioration were identified.
Implications:
- The findings offer insights into the cognitive processes underlying expert nursing care.
- This knowledge can inform the development of training programs for critical care nurses.
- Understanding these strategies may enhance clinical decision-making and patient outcomes in critical care.