Investigating clinical decision-making in bleeding complications among nursing students: A longitudinal mixed-methods...

Area of Science:

• Nursing Education
• Clinical Decision-Making
• Patient Safety

Background:

• Post-procedural bleeding is a common complication requiring strong nursing decision-making.
• Current understanding of nursing students' clinical decision-making in bleeding scenarios is limited.
• The evolution of these decision-making skills throughout nursing education is largely unknown.

Purpose of the Study:

• To describe undergraduate nursing students' clinical decision-making in post-procedural bleeding scenarios.
• To explore changes in their decision-making from the first to the final year of study.

Main Methods:

• A longitudinal mixed-methods study using the Recognition-Primed Decision Model.
• 59 students responded to vignettes on post-hip surgery and post-cardiac catheterization bleeding.
• Content analysis of student responses, focusing on cues, goals, actions, and expectations.

Main Results:

• Students primarily focused on 'Bleeding' and 'Instability and Shock' categories.
• Fewer students addressed secondary categories like 'Pain' or 'Wound Infection'.
• Students often prioritized immediate actions over cause assessment; final-year students showed more focused instability assessment.

Conclusions:

• Nursing students tend to prioritize immediate bleeding control, sometimes neglecting underlying causes or broader care goals.
• Concept-based learning and reflection on long-term outcomes may enhance clinical decision-making.
• Further research can refine educational strategies for critical post-procedural care.