LINES OF REASONING IN CLINICAL NURSING DECISIONS.
Contributors: University of Minnesota.
Published: 1992
Number of pages: 192
Subjects: Health Sciences, Nursing.
Description: Ten registered nurses, five experienced and five less experienced, practicing in acute orthopedic settings in four large mid-western hospitals were asked to "think aloud" as they interpreted patient information and determined the nature of the patient's surgical complications following joint replacement. Subjects were also asked to make decisions about physician referral. Research questions were: (1) what lines of reasoning are used by experienced nurses to identify potential post-operative complications following total knee joint replacements and (2) how do these lines of reasoning differ from those used by less experienced nurses?.

The research design was a modified fixed-order simulation in which subjects proceeded through the patient cases in a time-sequenced way. A consulting expert identified critical cues in each simulation. Cues were presented in a fixed order.

The research focused on the variable of lines of reasoning developed in decision-making. Information processing theory served as the basis for the study.

Analysis of verbal protocol data indicated that experienced nurses triggered lines of reasoning related to the patient situation in analyzing cues, elicited domain concepts, and chose further monitoring nursing actions. They were able to interpret critical cues configurally. Two of the five subjects with the most experience reached correct decisions in all three cases. Physician referrals were made in all instances by experienced nurses. Further, experienced nurses knew when to retain and when to abandon a line of reasoning and were able to resolve incongruities in the cues.

Findings from the research also showed differences in the development of lines of reasoning between nurses with much experience and nurses with less experience. Those with less experience were often unable to develop a distinct line of reasoning, or developed incomplete lines of reasoning. In some instances, misunderstanding of cues led these subjects to an incorrect decision.
Notes: Source: Dissertation Abstracts International, Volume: 53-08, Section: B, page: 4032.

Thesis (PH.D.)--UNIVERSITY OF MINNESOTA, 1992.

School code: 0130.