UTAH NURSES
By Jan C. Call
A thesis submitted to the faculty of The University of Utah in partial fulfillment of the requirements for the degree of
Master of Science
College of Nursing The University of Utah December 1995
Copyright C Jan C. Call1995
All Rights Reserved
THE UNIVERSITY OF
UTAH GRADUATE SCHOOL
SUPERVISORY COMMITTEE APPROVAL
of a thesis submitted by
Jan C. Call
This thesis has been read by each member of the following supervisory committee and by majority vote has been found to be satisfactory.
Ci13ir.Bet�ghan-Cole
THE
UNIVERSITY OF
UTAH GRADUATE SCHOOL
FINAL READING APPROVAL
'Beth VaughaIl:Qle
Cl1air, Supervisory Conuniltee
" '" '
Apprcved for the Major Department ', "
� '16- {2��-.�A?
..
0 '
Linda
ChairlDean
K. Amos
Approved for the Graduate Council
Ann W. Hart
Dean ofTIle Graduate School
ABSTRACT
Differences have been noted in various studies regarding the way nurses utilize the nursing process and the way they make decisions. This study was part ofa larger, international research project originating in Finland. This portion of the study used an exploratory descriptive design examining relationships between education and experience among Utah nurses ' and decisions made within the nursing process. Participants for this study included 167 Registered Nurses from three Utah hospitals, two local public health departments and two long-tenn care facilities. The participants, who have various levels of nursing education and years of experience, were asked to complete a 56-item questionnaire. The instrument focused on a systematic versus an intuitive approach to clinical decision making. The findings showed Utah nurses employ a systematic approach to decision making while utilizing the nursing process. The sample size, although small, provides a good foundation for a follow-up study.
TABLE OF CONTENTS
ABSTRACT
References: American Nurses ' Association (1980). Nursing: A social policy statement. Kansas City, MO: Author. Barnum, B. 1. (1994). Nursing theoty: Analysis. application. evaluation (4th ed.). Philadelphia: 1. B. Lippincott Co. Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Publishing Company, Inc. Benner, P. & Tanner, C. (1987). Clinical judgement: How expert nurses use intuition. American Journal of Nursing. 87(1), 23-31. Benner, P., Tanner, C. & Chesla, C. (1992). From beginner to expert: Gaining a differentiated clinical world in critical care nursing. Advances in Nursing Science, 14(3), 13-28. Bruner, 1. S. (1963). The process ofeducation. New York: Vintage Books. Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advanced Nursing Science, 1(1), 13-23. Corcoran, S. (1986a). Task complexity and nursing expertise as factors in decision making. Nursing Research, 35, 107-112. Corcoran, S. (1986b). Planning by expert and novice nurses in cases of varying complexity. Research in Nursing and Health. 9, 155-162. dela Cruz, F. A. (1994). Clinical decision-making styles of home health care nurses. IMAGE: Journal of Nursing Scholarship. 26(3), 222-226. del Bueno, D. 1. (1987). Experience, education, and nurses ability to make clinical judgments. Nursing & Health Care. 11(6), 290-294. Deloughery, G. L. (1965). Issues and trends in nursing (2nd ed.). St. Louis: Mosby-Year Book, Inc. 76 Dreyfuss, S. & Dreyfuss, H. (1980). A five stage model of the mental activities involved in a directed skill acgyisition. Berkeley, CA: University of California. Field, P. A. (1987). The impact of nursing theory on the clinical decision making process. Journal of Advanced Nursing. 12, 563-571. Fischbach, F. T. (1991). Documenting care: Communication. the nursing process and documentation standards. Philadelphia: F. A. David Company. Griffith-Kenney, 1. W. & Christensen, P. 1. (1986). Nursing process: Application of theories. frameworks and models (2nd ed.). St. Louis: C. V. Mosby Company. Hall, L. (1955). Quality ofnursing care. Public Health News. New Jersey State De.partment of Health. 36, 212-215. Holzemer, W. L. (1986). The structure ofproblem solving in simulations. Nursing Research. 35,231-236. Johnson, D. (1967). Professional practice in nursing. In The shifting scene: Directions for practice. New York: National League for Nursing. Kelly, L. Y. (1991). Dimensions ofprofessional nursing (6th ed.). New York: Pergamon Press. Kataoka-Yahiro, M. & Saylor, C. (1994). A critical thinking model for nursing judgment. Journal of Nursing Education. 33(8), 351-356. Lane, G. H., Cronin, K. M. & Perce, A. G. (1983). Flow charts: Clinical decision making in nursing. Philadelphia: J. B. Lippincott Company. Lauri, S. (1990b). The teaching of professional values and decision making process to nurses working in hospitals. Scandinavian Journal of Caring Sciences, ~(2), 63-68. Miller, M. A & Malcolm, N. S. (1990). Critical thinking in the nursing curriculum. Nursing & Health Care. 11(2), 67-73. Miller, V. G. & Rew, L. (1989). Analysis and intuition: The need for both in nursing education. Journal of Nursing Education. 28(2), 84-86. 77 National League for Nursing (1979). Working paper on the National League for Nursing task force on competencies of graduates. New York: Author. Pardue, S. F. (1987). Decision making skills and critical thinking ability among associate degree, diploma, baccalaureate, and master 's prepared nurses. Journal of Nursing Education. 26(9), 354-361. Polit, D. F. & Hungler, B. P. (1991). Nursing research: Principles and methods (4th ed.). Philadelphia: 1.B. Lippincott Co. Reilly, D. & Oermann, M. (1992). Clinical teaching in nursing education (2nd ed.). New York: National League for Nursing. Rew, L. (1988). Intuition in decision-making. Image: Journal of Nursing Scholarship. 20(3), 150-154. Rew, L. (1990). Intuition in critical care nursing practice. Dimensions of Critical Care Nursing, 9(1), 30-37. Schwartz, W. B., Gorry, G. A., Kassirer, 1. P., & Essig, A. (1973). Decision analysis and clinical judgment. Amelican Journal of Medicine. 55,459-472. Statistical Package for Social Sciences (SPSS), (1994). Chicago: SPSS ,Inc. Tanner, C. (1987). Teaching clinical judgment. In H. H. Werley & J. J. Fitzpatrick (Eds.), Annual Review of Nursing Research (pp. 153-173). New York: Springer. Tanner, C., Padrick, K., Westfall, U. & Putzier, D. (1987). Diagnostic reasoning strategies of nurses and nursing students. Nursing Research, 36, 358-363. White, J. (1995). Patterns of knowing: Review, critique, and update. Advances in Nursing Science. 17(4), 73-86. Yura, H. & Walsh, M. B. (1983). The nursing process: Assessing. planning. implementing, evaluating (4th ed.) Norwalk, CT: Appleton-Century-Crofts.