Clinical Judgment: Nursing Actions and Measurable Indicators

Sommer, Sheryl; Sommer, Sheryl

Every day nurses make patient care decisions that require clinical judgment skills, however this is often challenging for new graduates. The National Council of State Boards of Nursing’s 2015 RN Practice Analysis identified that Clinical Judgment (CJ) was linked directly to more than 46% of tasks performed by entry-level nurses (NCSBN, 2018). This prompted the NCSBN to develop a Clinical Judgment Model. However, there is a lack of evidence-based research to facilitate development of CJ skills and evaluate student performance of such skills.

This study identified actions associated with the performance of CJ, and measurable indicators providing evidence that CJ is occurring. Twelve experienced nurse educators identified measurable actions and indicators for each cognitive operation of the NCSBN clinical judgment model, assessed by the survey in this study. A survey asking respondents to identify important skills related to CJ for each cognitive operation and activities indicating that a student possesses them was sent to 664 nurse educators in the fall of 2018 and remained open for 15 days. Completed survey responses were received from 97 nurse educators out of 664 who received the email invite (14.6% response rate). Respondents were educators trained on ATI products and who are identified on their campus as a faculty resource for product integration and use.

Data analysis identified nursing actions and measurable indicators associated with NCSBN’s clinical judgment cognitive operations. Research findings that may be used by educators to guide the development of clinical judgment skills as well as the related measurable indicators will be presented.

Results from this study provide valuable information for educators. Nursing actions may be incorporated into instruction and student assignments, to facilitate the development of clinical judgment skills. In addition, measurable indicators may be used to evaluate the use of clinical judgment skills in the provision of nursing care.