Clinical Decision Making

When making clinical judgements, nurses draw from many sources including their formal nursing education and/or from their experience gained over time in practice. [1] Clinical decision making can be defined as choosing between alternatives, a skill that improves as nurses gain experience, both as a nurse and in a specific specialty. [2]
Clinical decision making requires good quality judgment including critical thinking. [3] An earlier definition of critical thinking in nursing is: '…..Critical thinkers in nursing practice the cognitive skills of analysing, applying standards, discriminating, information seeking, logical reasoning, predicting and transforming knowledge'  [4 p357] It has also been highlighted that reflection on practice can be as a result of a breakdown in clinical judgement. [5]
  1. Traynor M, Boland M, Buus N. Professional autonomy in 21st century healthcare: Nurses’ accounts of clinical decision-making. Soc Sci Med. 2010 Oct;71(8):1506-12. Epub 2010 Aug 11.
  2. Banning M. A review of clinical decision making: models and current research. J Clin Nurs. 2008 Jan;17(2):187-95. Epub 2007 Mar 1.
  3. Thompson C, Stapley S. Do educational interventions improve nurses' clinical decision making and judgement? A systematic review. Int J Nurs Stud. 2011 Jul;48(7):881-93. Epub 2011 Jan 15.
  4. Scheffer BK, Rubenfeld MG. A consensus statement on critical thinking in nursing. J Nurs educ. 2000 Nov;39(8):352-9.
  5. Tanner C. Thinking like a nurse: A research-based model of clinical judgment in nursing. J Nurs Educ. 2006 Jun;45(6):204-11.

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Last updated 21 January 2017