Author Affiliations: Associate Dean for Program Evaluation (Dr Lee), University of Missouri-Kansas City School of Nursing and Health Studies; and Assistant Professor (Dr Wessol), Saint Luke's School of Nursing, Rockhurst University, Kansas City, Missouri.
Nurse Educ. 2022;47(1):51-55. doi: 10.1097/NNE.0000000000001059.
Medication errors occur at alarming rates. Safe medication administration practices require more than observing patient safety rights and psychomotor skills. The purpose of this study was to explore the relationships between clinical judgment skills and reasoning processes and safe medication practices in senior nursing students.
Using a cross-sectional design, 29 students from 3 schools of nursing watched a video simulation of a nurse administering medications in a clinical setting. At predetermined times, reflections on the medication administration practices were journaled. Journals were scored for clinical reasoning processes and clinical judgment using the Clinical Judgment Rubric-Reflective Journal (CJR-RJ) and for medication administration best practices.
Students scored low on the CJR-RJ (mean [SD], 5.2 [1.7]). We found a positive relationship between clinical judgment skills and safe medication practices (r = 0.39, t27 = 2.94, P = .018). The clinical reasoning process of Interpreting was a significant indicator of best practices (b = 1.4, t28 = 2.81, P = .010).
Our findings suggest that students struggle to connect theory to practice, emphasizing the need to plan experiential learning opportunities for students to develop clinical reasoning, particularly in Interpreting, and judgment skills to prevent medication errors upon entry to practice.
用药错误的发生率令人震惊。安全用药实践需要的不仅仅是遵守患者安全权利和心理运动技能。本研究的目的是探讨临床判断技能和推理过程与高年级护理学生安全用药实践之间的关系。
采用横断面设计，来自 3 所护理学校的 29 名学生观看了护士在临床环境中给药的视频模拟。在预定的时间，学生记录了对给药实践的反思。使用临床判断量表-反思日志（CJR-RJ）对日志进行临床推理过程和临床判断评分，并对给药最佳实践进行评分。
学生的 CJR-RJ 评分较低（平均值[标准差]，5.2[1.7]）。我们发现临床判断技能与安全用药实践之间存在正相关关系（r = 0.39，t27 = 2.94，P =.018）。解释的临床推理过程是最佳实践的重要指标（b = 1.4，t28 = 2.81，P =.010）。
我们的研究结果表明，学生难以将理论与实践联系起来，这强调了需要为学生规划体验式学习机会，以培养临床推理、特别是在解释方面的推理技能，以防止学生进入实践后发生用药错误。
