Clinical judgment performance of nurses in the application of the nursing process

Abstract

Objective: To verify the applicability of the Lasater Clinical Judgment Rubric (LCJR) instrument to rate nursing professionals’ performance regarding the development of clinical judgment in the application of the Nursing Process (NP).Materials and methods: Descriptive survey using the LCJR instrument —consisting of four phases and 11 dimensions— to classify clinical judgment.Results: Thirty-four nurses from a public hospital in western Santa Catarina, Brazil, distributed in six sectors, participated in the study. Nurses were classified by performance levels in relation to the ability of clinicaljudgment in the application of the steps of the NP. It was observed that at the “beginner” level there is a higher prevalence of professionals related to the dimensions Search for information, Recognizing deviations from expected standards, and Technical skills, linked to the intensive care unit (ICU) clinic. As for the “exemplary” level, none of the sectors scored on the analyzed dimensions. Moreover, it was found that a longer time of clinical experience and of systematic application of the steps of theNP fosters a better classification in almost all dimensions.Conclusions: Through this research, we verified the assertiveness of the use of the instrument to evaluate the clinical judgment of nurses regarding the application of the steps of the NP. Thus, the use of the LCJR is encouraged as a tool to evaluate the effectiveness of educational interventions performed to nurses and, consequently,stimulate clinical judgment.