CLINICAL DECISION-MAKING IN THE NURSING PROFESSION: A REVIEW OF THE LITERATURE

• DOI: https://doi.org/10.22533/at.ed.1594532406064

• Palavras-chave: Decision-making, clinical nursing, critical thinking

• Keywords: Decision-making, clinical nursing, critical thinking

• Abstract:

  Introduction: Professional nursing practice involves the daily use of decision-making skills. It is of fundamental importance in professional acting since its use has direct clinical-care implications for patients. Adequate decision-making skills are therefore essential, especially considering that the health care setting leaves little or no margin for error. Training in this area, with an established methodology, could have important spillovers in clinical risk management. The objective of the study is to identify the current theoretical framework of decision-making and how the professional dimension of nursing is framed within that conceptuality.
  Metodology: Systematic literature review by consulting the 5 major medical databases with search strings appropriately formulated.
  Results: Currently, internationally, decision-making is identified in three models: the systematic-positivist, or analytic, model, which theorizes a process of rational analysis of the situation in which prior knowledge is crucial; Benner's intuitive-humanistic model, based on intuition, thus neither rational nor logically defensible, grounded in prior experience; and Hammond's cognitive continuum model, which combines the previous two models and sees them not as one antithesis of the other but extremes of a continuum in which decision-making processes are positioned according to the structure of the task.
  Conclusions: There is extensive literature about decision-making models in nursing, but not all studies agree in content. Currently, considering the conceptuality theorized by Hammond, nurses tend to use both analytical and intuitive approaches on individual and environmental grounds. Experience is acknowledged to play a key role, but it can not be generalized, as there may be various types, about which, however, little literature exists.