5 Clinical judgement in nursing and how to use it

Using a problem-solving approach as a basis for nursing practice requires the use of critical thinking and decision-making. Some experts have referred to that thinking more recently as clinical reasoning. The 2020 NCLEX-RN® Test Plan identifies the nursing process as one of five integrated processes which is defined as “a scientific, clinical reasoning approach to client care that includes assessment, analysis, planning, implementation, and evaluation” (NCSBN, 2019, p.5). Note that this definition does not include Diagnosis; rather the second step of the nursing process is labeled as Analysis.

National Council of State Boards of Nursing (NCSBN). (2018). NCLEX-RN® Examination: Test plan for the National Council Licensure Examination for Registered Nurses. Chicago, IL: Author.

This means as you plan care, you are looking for and clustering data that goes together. You then take that data and analyze it to make a clinical decision. We will be using AAPIE in this course instead of ADPIE. We still will use the nursing process, however, the focus is more on critical thinking. Therefore: AAPIE assessment, analysis, planning, implementation and elevation. This gets you read for clinical judgement and shows you how you draw on previous practice and knowledge to make decisions.

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