LibGuides: Nursing: Clinical Judgement

Clinical Judgement

What is Clinical Judgement?

"Clinical judgment is defined as the observed outcome of critical thinking and decision making. It is an iterative process that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern and generate the best possible evidence-based solutions in order to deliver safe client care"

Clinical Judgment Measurement Model. (2019). Next Generation NCLEX News, Winter 2019, 1. https://www.ncsbn.org/NGN_Winter19.pdf

NGN Winter 2019
Clinical Judgment Measurement Model. (2019). Next Generation NCLEX News, Winter 2019. https://www.ncsbn.org/NGN_Winter19.pdf

History

Here is a brief look at the recent history of Clinical Judgement.

The articles can be found either in the RCBC databases with a link to the corresponding database or freely available online. Articles in the RCBC databases need a registered library barcode to be able to view articles.

Scholarly Articles

Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing Tanner, Christine A,PhD., R.N. (2006). Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing. Journal of Nursing Education, 45(6), 204-11. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/scholarly-journals/thinking-like-nurse-research-based-model-clinical/docview/203965102/se-2

Scholarly Articles

Clinical Judgment Development: Using Simulation to Create an Assessment Rubric Lasater, Kathie,EdD., R.N. (2007). Clinical Judgment Development: Using Simulation to Create an Assessment Rubric. Journal of Nursing Education, 46(11), 496-503. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/scholarly-journals/clinical-judgment-development-using-simulation/docview/203910278/se-2
Critical Assumptions: Thinking Critically About Critical Thinking Riddell, Thelma, MScN,R.N., C.O.H.N.(C. (2007). Critical Assumptions: Thinking Critically About Critical Thinking. Journal of Nursing Education, 46(3), 121-6. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/scholarly-journals/critical-assumptions-thinking-critically-about/docview/203948831/se-2
Guide for Reflection Using the Clinical Judgment Model Nielsen, Ann,M.N., R.N., Stragnell, Susan,M.S., R.N., & Jester, Priscilla,M.N., R.N. (2007). Guide for Reflection Using the Clinical Judgment Model. Journal of Nursing Education, 46(11), 513-6. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/scholarly-journals/guide-reflection-using-clinical-judgment-model/docview/203963529/se-2

Scholarly Articles

Reflective Journaling for Clinical Judgment Development and Evaluation Lasater, Kathie, EdD,R.N., A.N.E.F., & Nielsen, Ann,M.N., R.N. (2009). Reflective Journaling for Clinical Judgment Development and Evaluation. Journal of Nursing Education, 48(1), 40-4. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/scholarly-journals/reflective-journaling-clinical-judgment/docview/203951143/se-2

Trade Journals

How do we know when PACU patients are ready for the surgical ward? Lethbridge, L.,B.Nurs B.Nurs. (2009). How do we know when PACU patients are ready for the surgical ward? Acorn, 22(1), 21-22,24. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/trade-journals/how-do-we-know-when-pacu-patients-are-ready/docview/2068958064/se-2

Scholarly Articles

Clinical judgment: The last frontier for evaluation Lasater, K. (2011). Clinical judgment: The last frontier for evaluation. Nurse Education in Practice, 11(2), 86-92. https://doi.org/10.1016/j.nepr.2010.11.013

Magazine Articles

Evidence or instinct? Evidence or instinct? (2011, Aug 15). NursingTimes.Net, http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/magazines/evidence-instinct/docview/883487441/se-2

Magazine Articles

Using computerised decision-support systems Using computerised decision-support systems. (2013, Sep 09). NursingTimes.Net, http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/magazines/using-computerised-decision-support-systems/docview/1430919768/se-2

Magazine Articles

"We need to use assessments wisely, not hide behind them" Charalambous, L. (2015, Feb). "We need to use assessments wisely, not hide behind them": NT. Nursing Times, 111, 11. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/magazines/we-need-use-assessments-wisely-not-hide-behind/docview/1656629587/se-2

Trade Journals

Three Essential Skills Every New Nurse Needs Duvall, Adrianne, DPN, APRN,C.N.Ecl, F.N.P.-B.C. (2020). Three Essential Skills Every New Nurse Needs. The Oklahoma Nurse, 65(1), 15. http://ez-srv.rcbc.edu:2048/login?url=https://www.proquest.com/trade-journals/three-essential-skills-every-new-nurse-needs/docview/2387319554/se-2

Scholarly Articles

Perceptions of final year nursing students transer of clinical judgement skills from simulation to clinical practice: A qualitative study Dix, S., Morphet, J., Jones, T., Kiprillis, N., Monica O’Halloran, Piper, K., & Innes, K. (2021). Perceptions of final year nursing students transer of clinical judgement skills from simulation to clinical practice: A qualitative study. Nurse Education in Practice, 56, 103218. https://doi.org/10.1016/j.nepr.2021.103218

Scholarly Articles

Factors influencing nursing students’ ability to recognise and respond to simulated patient deterioration: A scoping review Gillan, P. C., Delaney, L. J., Tutticci, N., & Johnston, S. (2022). Factors influencing nursing students’ ability to recognise and respond to simulated patient deterioration: A scoping review. Nurse Education in Practice, 62, 103350. https://doi.org/10.1016/j.nepr.2022.103350

Clinical Judgement

Tables below are from: Clinical Judgment Measurement Model. (2019). Next Generation NCLEX News, Winter 2019, 1. https://www.ncsbn.org/NGN_Winter19.pdf

Comparison of the Nursing Process with Tanner’s Clinical Judgment Model and the NCSBN Clinical Judgment Measurement Model (NCJMM)

Nursing Process (ADPIE/AAPIE)	Tanner’s CJ Model	NCJMM
Assessment	Noticing	Recognize Cues
Diagnosis/Analysis	Interpreting	Analyze Cues
Diagnosis/Analysis	Interpreting	Prioritize Hypotheses
Planning	Responding	Generate Solutions
Implementation	Responding	Take Action
Evaluation	Reflecting	Evaluate Outcomes

Nursing Process Step	NCJMM Cognitive Skill
Diagnosis/Analysis: The nurse identifies the actual and potential client problem(s) based on review and interpretation of the client data.	Analyze Cues: The nurse reviews the relevant client data and determines what they mean. For example, the nurse may identify certain data that are consistent with common diseases or disorders. Or, the nurse may identify potential complications for which the client is at risk based on the assessment data.
Implementation: The nurse performs appropriate interventions to meet the desired client outcomes. For example, if the client reports acute postoperative ORIF pain of 8/10, the nurse might administer an analgesic.	Take Action: The nurse performs an action which could be an intervention or an assessment. For example, if a client reports acute postoperative ORIF pain of 8/10, the nurse might perform a neurovascular assessment of the extremity to determine if the pain is due to decreased peripheral perfusion or the surgical incision. While that action is an assessment, it is also an action or intervention.