Cognitive and implicit biases in nurses' judgment and decision-making: A scoping review.

Area of Science:

• Nursing
• Healthcare Quality
• Patient Safety

Background:

• Healthcare provider biases can negatively impact patient safety.
• Research on bias has largely focused on physicians' diagnostic decisions, overlooking nurses' roles.
• Nurses' clinical judgment is crucial for patient outcomes but often lacks bias-focused research.

Purpose of the Study:

• To systematically review and map existing evidence on bias in nurses' judgment and decision-making.
• To identify key concepts related to bias in nursing practice.
• To explore interventions aimed at correcting or mitigating these biases.

Main Methods:

• A comprehensive scoping review was conducted using Joanna Briggs methodology.
• Searches were performed in CINAHL, PsychInfo, and PubMed databases.
• Inclusion criteria focused on primary research concerning nurses' bias, nursing decisions/actions, and English language.

Main Results:

• 77 relevant studies were identified, with over half published in the last 12 years.
• Common biases studied include those related to race, obesity, gender, confirmation, attribution, anchoring, and hindsight.
• Only 5 studies tested interventions, and most research relied on vignettes/surveys, potentially missing real-world contextual factors like cognitive load.

Conclusions:

• Bias significantly affects nurses' clinical judgment and patient outcomes.
• There is a critical need for systematic efforts to identify and test debiasing strategies.
• Real-world nursing settings require focused research on interventions to address bias.