Paper
Saturday, July 16, 2005
Decision-Making Process in Clinical Nursing Practice
Kyung Ja Han, RN, PhD1, Hesook Suzie Kim, RN, PhD2, MaeJa Kim1, Kyung JA Hong, RN, PhD3, Sungae Park, RN, PhD4, Soon Nyoung Yun, RN, PhD, MPH1, Misoon Song, RN, PhD1, Yoenyi Jung, RN, PhD5, Haewon Kim, RN, PhD6, DongOak Debbie Kim, RN, PhD7, Heejung Choi, RN, PhD8, and Kyungae Kim, RN, PhD3. (1) College of Nursing, Seoul National University, Seoul, South Korea, (2) College of Nursing, University of Rhode Island, Kingston, RI, USA, (3) College of Nursing, Seoul National University, Seoul, Korea, South Korea, (4) College of Nursing,Seoul National University, Seoul, South Korea, (5) Nursing department, Samsung Medical Center, Seoul, South Korea, (6) college of medicine dept of nursing, Kwandong university, Gangreung city, Gangwon –do, South Korea, (7) Daejeon University/ Department of Nursing, College of Oriental Medicine, Daejeon, South Korea, (8) Department of Nursing, Konkuk University, Chungju, Chungbuk, South Korea
| Learning Objective #1: Disseminate clinical nursing knowledge |
| Learning Objective #2: Share nursing researcher role |
Because decisions must be made when a patients need is determined and when a nursing action is selected to meet that need, decision-making is a major aspect of the nursing and the professional nurses most critical function. Therefore the research related to clinical nursing decision-making has been emphasized. Purposes : The purpose of this study was to describe decision making process of experienced critical care nurses in clinical nursing practice. Study design : Descriptive study was conducted for this study through an think aloud and verbal protocol analysis. Five critical care nurses selected for the study were elicited think aloud in the performing their work of nursing care for 2 hours in the morning on 5 critical care units in a hospital setting. Results and conclusion : Five general modes related to clinical decision making were identified through the initial analysis of TA data. These modes included action, rationalization, consideration, validation, and reviewing. From analyzing them, the pattern of the clinical nursing decision making process was categorized with the short, intermediate, and long form. The pattern was clustered by the degree of steps involved in decision making.. The data showed that there were various patterns with which the five different modes were sequentially combined into processes relative to clinical decision making. These patterns were not related to different nursing tasks in any systematic fashion. We segmented the data into specific action contexts by specifying instances of nurses' clinical decision making as the focal points. These segments were identified in terms of a beginning and an end constituting specific action/thinking sequences. Each task-segment is considered to be a problem-solving situation involving a series of clinical decision-making relative to the task involved in the situation. There were 16 different types of nursing tasks identified in the data, with a total of 39 task-related situations