Clinical Reasoning among Registered Nurses in Emergency Medical Services: A Case Study. (September 2022)

• Record Type: Journal Article
• Authors: Andersson, Ulf; Andersson Hagiwara, Magnus; Wireklint Sundström, Birgitta; Andersson, Henrik; Maurin Söderholm, Hanna
• Is Part Of: Journal of cognitive engineering and decision making. Volume 16:Number 3(2022)
• Page Start: 123
• Page End: 156
• Publication Date: 2022-09
• Subjects: Clinical reasoning -- decision-making -- problem-solving -- naturalistic studies -- field study -- healthcare delivery -- emergency medical services; Human-computer interaction -- Periodicals; User-centered system design -- Periodicals; 004.019
• DOI: 10.1177/15553434221097788
• Languages: English
• ISSNs: 1555-3434

Abstract

In emergency medical services (EMS), the clinical reasoning (CR) of registered nurses (RNs) working in ambulance care plays an important role in providing care and treatment that is timely, accurate, appropriate and safe. However, limited existing knowledge about how CR is formed and influenced by the EMS mission hinders the development of service provision and decision support tools for RNs that would further enhance patient safety. To explore the nature of CR and influencing factors in this context, an inductive case study examined 34 observed patient–RN encounters in an EMS setting focusing on ambulance care. The results reveal a fragmented CR approach involving several parallel decision-making processes grounded in and led by patients' narratives. The findings indicate that RNs are not always aware of their own CR and associated influences until they actively reflect on the process, and additional research is needed to clarify this complex phenomenon.