Penerapan Penilaian Klinis dalam Pelayanan Keperawatan di Instalasi Gawat Darurat : Application of Clinical Assessment in Nursing Services at the Emergency Department

Siti Nurlaelah; Yovitasari; Suleli Rekso; Arcellia Farosyah Putri

doi:10.25077/njk.v20i1.40

Authors

Siti Nurlaelah RSUPN Dr Cipto Mangunkusumo
Yovitasari RSUPN Dr Cipto Mangunkusumo
Suleli Rekso RSUPN Dr Cipto Mangunkusumo
Arcellia Farosyah Putri RSUPN Dr Cipto Mangunkusumo

DOI:

https://doi.org/10.25077/njk.v20i1.40

Keywords:

Clinical Judgement, Cognitive, Model, Nurses

Abstract

The ability of nurses in clinical judgments in emergency departments is really important. One reason is that the judgments can affect response time and patients’ condition. However, the ability to conduct such judgments among nurses varies. Therefore, continuously improving nurses' ability in clinical judgments is important. This article is a discussion conceptual-application paper. The aim of this article was to explain the concept of clinical judgment based on the NCSBN Clinical Judgement Measurement Model (NCJMM) and its implementation in the emergency department. The model consists of six cognitive processes: (1) recognize cues, (2) analyze cues, (3) prioritize hypotheses, (4) generate solutions, (5) take action, and (6) evaluate outcomes. The NCJMM model can be used to improve nurses’ ability in clinical judgments in emergency settings and others.

References

American Nurses Association (ANA). (2015). Nursing: Scope and Standard of Practice. https://www.nursingworld.org/~4af71a/globalassets/catalog/book-toc/nssp3e sample-chapter.pdf

Betts, J., Muntean, W., Kim, D., Jorion, N., & Dickison, P. (2019). Building a Method for Writing Clinical Judgment Items for Entry-Level Nursing Exams. Journal of Applied Testing Technology, 20(S2), 21–36. Retrieved from https://www.jattjournal.net/index.php/atp/article/view/143674

Bussard, M.E. et al. (2024). Current practices for assessing clinical judgement in nursing students and new graduates: a scoping review. Nurse Education Today 134, 1-11. https://doi.org/10.1016/j.nedt.2023.106078

Connor, J., Flenady, T., Massey, D., & Dwyer, T. (2022). Clinical judgement in nursing - An evolutionary concept analysis. Journal of Clinical Nursing. https://doi.org/10.1111/JOCN.16469

Dickison, P., Haerling, K. A., & Lasater, K. (2019). Integrating the National Council of State Boards of Nursing Clinical Judgment Model Into Nursing Educational Frameworks. The Journal of Nursing Education, 58(2), 72–78. https://doi.org/10.3928/01484834-20190122-03

Emergency Nurses Association (ENA). (2011). Emergency Nursing: Scope and Standard of Practice. Illinois: ENA.

Ignatavius, D.D., & Silvestri, L. (2023). Getting ready for the next generation NCLEX (NGN): How to shift from the nursing process to clinical judgment in Nursing. https://evolve.elsevier.com/education/expertise/next-generation-nclex/ngn-transitioning-from-the-nursing-process-to-clinical-judgment/

Kavanagh, J. M., & Szweda, C. (2017). A Crisis in Competency: The Strategic and Ethical Imperative to Assessing New Graduate Nurses’ Clinical Reasoning. Nursing Education Perspectives, 38(2), 57–62. https://doi.org/10.1097/01.NEP.0000000000000112

Kwame, A., Petrucka, P.M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20, 158. https://doi.org/10.1186/s12912-021-00684-2

Martin, B., Greenawalt, J. A., Palmer, E., & Edwards, T. (2020). Teaching circle to improve nursing clinical judgment in an undergraduate nursing program. Journal of Nursing Education, 59(4), 218–221. https://doi.org/10.3928/01484834-20200323-08

National Council of State Boards of Nursing (NCSBN). (2023). https://www.nclex.com/clinical-judgment-measurement-model.page

Nursing and Midwifery Board of Australia (NMBA). (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Nursing and Midwifery Council (NMC). (2018). Future nurse: standards of proficiency for registered nurses. https://www.nmc.org.uk/globalassets/sitedocuments/education-standards/future-nurse-proficiencies.pdf

Oermann, M. H., & Gaberson, K. B. (2019). Evaluation and Testing in Nursing Education. Evaluation and Testing in Nursing Education. https://doi.org/10.1891/9780826135759

Pérez-Perdomo, A., & Zabalegui, A. (2023). Teaching Strategies for Developing Clinical Reasoning Skills in Nursing Students: A Systematic Review of Randomised Controlled Trials. Healthcare (Basel, Switzerland), 12(1), 90. https://doi.org/10.3390/healthcare12010090

Perhimpunan Dokter Paru Indonesia (PDPI). (2023). Penyakit Paru Obstruktif Kronis (PPOK): Pedoman Diagnosis dan Tatalaksana di Indonesia.

Reay, G., Rankin, J.A., & Then, K.L. (2016). Momentary fitting in a fluid environment: a grounded theory of triage nurse decision making. International Emergency Nursing, 26, 8–13. https://doi.org/10.1016/j.ienj.2015.09.006

Robinson, L., Mulvey, B. K., & Aller, L. (2024). Early Prelicensure Nursing Students' Perceptions of Case Studies Through the Lens of the Clinical Judgment Measurement Model. Nurse Educator, 49(1), E12–E16. https://doi.org/10.1097/NNE.0000000000001539

Wenner, T.A. (2024). Using the NGN clinical judgment slide: a strategy for adjunct formative evaluation. Teaching and Learning in Nursing, 19(1), 20-22. https://doi.org/10.1016/j.teln.2023.06.005