Clinical Reasoning, Judgment, and Safe Medication Administration Practices in Senior Nursing Students.

Area of Science:

• Nursing Education
• Patient Safety
• Clinical Skills Development

Background:

• Medication errors are a significant concern in healthcare.
• Safe medication administration involves complex cognitive skills beyond basic observation.
• Current nursing education may not adequately prepare students for real-world medication safety challenges.

Purpose of the Study:

• To investigate the link between clinical judgment and reasoning skills and safe medication practices in senior nursing students.
• To identify specific reasoning processes that influence medication administration best practices.

Main Methods:

• A cross-sectional study involving 29 nursing students from three schools.
• Students observed a medication administration simulation and journaled their reflections.
• Journals were assessed for clinical judgment, reasoning processes, and adherence to best practices using the Clinical Judgment Rubric-Reflective Journal (CJR-RJ).

Main Results:

• Students demonstrated low scores on the CJR-RJ (mean [SD], 5.2 [1.7]).
• A positive correlation was found between clinical judgment skills and safe medication practices (r = 0.39, P = .018).
• The 'Interpreting' reasoning process significantly predicted best practices (b = 1.4, P = .010).

Conclusions:

• Senior nursing students face challenges integrating theoretical knowledge with practical application.
• Experiential learning opportunities are needed to enhance clinical reasoning and judgment skills.
• Focusing on the 'Interpreting' skill is vital for improving medication administration safety and reducing errors.