The NCSBN (2019b) defined clinical judgment as “the observed outcome of critical thinking and decision making” (p. 1). Nursing clinical judgment is an essential nursing skill in the modern health care environment, as nurses manage a wide variety of information and select actions to provide safe, Show components of the clinical judgement measurement model - incorporates clinical judgment process incorporates clinical judgment process cue recognition, hypothesis generation, hypothesis evaluation, taking actions, and evaluating outcomes identifies diff types contextual factors
--Internal contextual factors: education, experience, knowledge, communication, consequences/risks, emotions/perceptions defines nonlinear process nurse may repeat components of the process one or more times to continually move toward outcome improvement: recognizing cues, generating hypotheses, judging hypotheses, taking action, and evaluating outcomes requires clinical judgment skills acknowledges that because a nurse has knowledge, it does not necessarily mean the nurse has good clinical judgment skills -observation - layer 0 Layer 0: Client needs (initiate the process of clinical judgment) and clinical decisions (end the process of clinical judgment) ---Layer 1: Clinical judgment, defined by the observable aspects from layer 0 and the unobservable cognitive aspects of layers 2 and 3 Layer 4: Outlines contextual factors that can influence cognitive operations throughout the CJMM. Steps involved in putting the CJMM into action ---The CJMM is not a linear process, so the nurse does not necessarily progress through the layers in order. ---Educating the patient/family about the necessary care techniques and precautions Clinical judgment is defined as the observed outcome of which processes? Critical thinking Clinical judgment is defined as the observed outcome of critical thinking and decision making. Decision making Clinical judgment is defined as the observed outcome of critical thinking and decision making. Match the type of contextual factor influencing clinical judgment with the appropriate examples. Education, experience, knowledge Match the layers of the Clinical Judgment Measurement Model with the concept addressed in each layer. Observation clinical needs clinical judgment - critical thinking and decision making Which components are addressed by layer 1 of the Clinical Judgment Measurement Model (CJMM)? Unobservable cognitive operations Layer 1 is a cognitive layer of the CJMM that includes unobservable cognitive operations. Observable outcome of critical thinking Layer 1 is a cognitive layer of the CJMM that includes the observable outcome of critical thinking. Which characteristic describes patient needs as they relate to layer 0 of the Clinical Judgment Measurement Model? Are influenced by clinical decisions Clinical decisions made at the completion of the clinical judgment process affect patient needs. Which activities would the nurse perform when a clinical situation occurs according to layer 1 of the Clinical Judgment Measurement Model? Seek new knowledge. Respond appropriately. Consider influencing factors.. Recognize what is happening. Interpret the meaning of the situation. layer 2 - hypothesis , refine hypothesis, and evaluate outcomes use cues evaluating outcomes Which aspect describes the second function in layer 2 of the Clinical Judgment Measurement Model (CJMM)? Refinement of hypotheses Once the hypotheses are developed, the nurse refines the hypotheses to ensure that the patient’s priority needs are met in the most appropriate manner. Which aspect describes the final function of layer 2 of the Clinical Judgment Measurement Model (CJMM)? Making a judgment about whether or not change has occurred Evaluation, the final step of layer 2 of the CJMM, requires the nurse to make a judgment as to whether or not change has occurred. 3 functions: recognize and analyze cues prioritize hypotheses take action and eval outcomes Which sources would the nurse use to collect objective patient cues? lab report, med records, phys assessment Which step of layer 3 of the Clinical Judgment Measurement Model involves organizing and linking cues to the patient’s clinical condition? Analyze cues During the “analyze cues” step of layer 3, the nurse organizes and links cues to the patient’s actual or potential clinical condition, much like putting pieces of a puzzle together. The nurse places similar or related “puzzle pieces” (cues) together to form a picture (hypothesis). Which characteristic describes the influence of context on clinical judgment? Affects the understanding of the patient situation Context is defined as aspects that influence the understanding of an event, circumstance, or condition. Which description best explains how contextual factors affect the way nurses communicate? Encourage the nurse to recognize new insights Consideration of context during communication allows the nurse to recognize new insights that are shared during the conversation. Match the functions from layer 3 of the Clinical Judgment Measurement Model with the expected nursing behaviors of a nurse caring for a pediatric diabetic patient based on potential contextual factors from layer 4. Avoid
glucose Which characteristics describe the Clinical Judgment Measurement Model (CJMM)? - requires cue recognition Layer 1 of the Clinical Judgment Measurement Model (CJMM) focuses on which concept? Which questions can the nurse ask to complete the evaluation function of layer 2 of the Clinical Judgment Measurement Model (CJMM)? - should plan care be revised Which variables would the nurse consider when prioritizing hypotheses in layer 3 of the Clinical Judgment Measurement Model? urgency Which competencies did the American Nurses Association (ANA) identify as essential for evaluating outcomes? -include pt perspective Which statements describe the benefits of considering context when making nursing decisions during layer 4 of the Clinical Judgment Measurement Model (CJMM)? -nurse consider approp resources Which statement describes the impact of experience on clinical judgment? -new and experienced nurse both expected apply clinical judgment prevent pt events Which concepts are examples of internal contextual factors that influence clinical judgment? emotions, knowledge, comms, Which concept is addressed in layer 0 of the Clinical Judgment Measurement Model (CJMM)? Which statement describes a characteristic of clinical judgment in nursing practice? its foundation of safe, competent practice Which aspects describe layer 2 of the Clinical Judgment Measurement Model (CJMM)? -eval pt outcomes Place the three functions of layer 2 of the Clinical Judgment Measurement Model in the order in which they occur. -formulate hypotheses Match the type of nursing intervention with the appropriate example. Inserting a Foley catheter Which concept is the focus of layer 4 of the Clinical Judgment Measurement Model (CJMM)? Which concepts are examples of external contextual factors that influence clinical judgment? interruptions, task complexity, professional autonomy What is clinical judgement in nursing practice?Clinical judgment is the accumulation of knowledge and skills over time, which contributes to the nurse's ability to analyze and synthesize the patient presentation, objective and subjective data, and then provide evidence-based nursing interventions to improve patient outcomes; clinical decision making.
What are the key elements of clinical judgement?Clinical judgement is developed through practice, experience, knowledge and continuous critical analysis. It extends into all medical areas: diagnosis, therapy, communication and decision making.
Which of the following best describes clinical judgment?Clinical judgment is the interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision whether or not to take action.
What is nursing judgement in nursing?Charged with making decisions to protect and enhance patient well-being, a nurse relies on nursing judgment to render effective patient care. Nursing judgment is the culmination of education, experience, and insight that allows nurses to execute the best action possible on behalf of patients.
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