Determining Clinical Judgment Among Emergency Nurses During a Complex Simulation.

Area of Science:

• Nursing
• Patient Safety
• Clinical Skills

Background:

• Clinical judgment is crucial for emergency nurses managing acutely ill patients.
• Suboptimal clinical judgment in emergency departments increases the risk of medical errors and failure to rescue.

Purpose of the Study:

• To evaluate the clinical judgment of practicing emergency nurses during simulated patient care.
• To identify deficits in the noticing and application phases of clinical judgment.

Main Methods:

• A descriptive observational study utilized the Lasater Clinical Judgment Rubric.
• Nurses performed a task simulating recognition of patient deterioration and appropriate care.

Main Results:

• 18 emergency nurses completed only 44.6% of patient assessments, indicating low clinical judgment.
• Nurses primarily focused on task completion, with minimal use of clinical judgment, leading to errors.
• Experience and education did not correlate with observed clinical judgment levels.

Conclusions:

• A significant breakdown in the noticing phase of clinical judgment was observed.
• Emergency nurses require dedicated time and training to develop and effectively utilize clinical judgment.
• Assumptions about nurses' inherent clinical judgment abilities are not supported by the findings.