Wednesday, July 11, 2007
Nursing Intuitive Clinical Decision-Making: Development and Testing of the McCurry Synergistic Process Model
|Learning Objective #1: identify three factors that influence expert nursing intuitive clinical decision-making globally.|
|Learning Objective #2: describe the impact operationalizing intuitive clinical decision-making will have on evidence-based nursing practice, research and education. |
Purpose: Clinical decision-making is the observable manifestation of nursing knowledge and intuitive clinical decision-making is upheld as a key factor of expert nursing practice globally. Nurses are accountable for professional decisions within their scope of practice; consequently it is important that they be able to describe how these decisions are made. By operationalizing nursing knowledge, nurses will be able to advance evidence-based patient care, improve inter-disciplinary collaboration, link the professionís impact to patient outcomes, and increase the visibility of expert nursing decision-making to other professionals. The purpose of this research was to develop and test a model of the process of nursing intuitive clinical decision-making
Methods: This study involved a review of the extant, international nursing research to cluster and summarize the antecedents, attributes, and consequences of intuition, insight, tacit knowing, synergy, and clinical decision-making. Definitions of intuition, insight, and tacit knowing were developed and used as the foundations for the model. The model was advanced beyond current knowledge by translating and applying groundbreaking data from the fields of neurophysiology, biochemistry, psychology, and mind-body medicine into nursing. Factors influencing intuitive knowing were identified as individual nurseís personality, nurse-patient relationship, and a supportive environment. Using a sample of 70 expert nurses, proposed relationships in the model were tested using a randomized experimental, pretest-posttest, control group design.
Results: Descriptive statistics were computed. Pearson correlations were significant for relationships between individual nurseís personality, the nurse-patient relationship and intuitive decision-making.
Conclusions and Implications: Nurses who reported higher levels of intuitiveness and nurses who scored higher on patient empathy were more likely to use intuitive decision-making. Findings also suggest that gender might be another factor that influences intuitive knowing. Further development and testing of this model of the process of nursing intuitive clinical decision-making will enhance expert nursing decision-making and positively impact evidence-based nursing practice.