Enhancing Quality of Care and Patient Safety: The Role of Nursing Clinical Judgment in Public Protection

In the United States, the landscape of health care has changed rapidly in recent decades. Telehealth, multi-state licensure and health care reforms are just a few trends that have led to dramatic changes in the health field. As an integral part of the health care team, nurses face many challenges as a result of these changes. With over four and a half million practitioners, nursing is the largest segment of the health care workforce in the U.S. In its Future of Nursing report published in 2010, the Institute of Medicine (IOM) recommended that nurses at all levels practice at their full scope. The ability to carry out competent decision-making and sound clinical judgment is a fundamental aspect of professional nursing. Therefore, entry-level nurses are expected to exercise good clinical judgment just as their more experienced colleagues. Increasing patient acuity, aging population and new government regulations have all contributed to the heightened demand for all nurses, including our novice colleagues.

The NCLEX is an entry-to-practice examination developed by the National Council of State Boards of Nursing (NCSBN). It is the primary licensure examination used by boards of nursing in all fifty states, the District of Columbia and four U.S. territories, thus making the NCLEX an important instrument in nursing regulation and public protection in this country. To ensure that the NCLEX assesses all relevant aspects of entry-level nursing practice, NCSBN is conducting research on nursing clinical judgment and its possible inclusion on the future NCLEX. In addition to their utility in competency assessment, clinical judgment models incorporated with an innovative academic approach in nursing education can be a viable method to ensure public protection by enhancing quality of care and improving patient safety. The speaker of this session is a nursing educator who serves as president of a U.S. state board of nursing and member of the NCSBN examination oversight committee. From his unique perspectives, the speaker will discuss the importance of nursing clinical judgment skills in improving nursing education and its impact on patient safety. He will also highlight practice aspects with the greatest need of improved clinical judgment.