The Structure of Clinical Judgment until the Nurse Decides a Fall Prevention Plan

Abstract

The purpose of this study is to clarify the structure of the clinical judgment until the responsible nurse decides a fall prevention plan for an in-patient. A semi-structural interview method was performed in 18 nurses with at least 3 years experience working on the general ward of a general hospital. The interview data was qualitatively analyzed, and the following results were obtained.

The clinical judgment until the responsible nurse decided the fall prevention plan was composed of five categories. The five categories were : 1)concern that the nurse turned, 2) situation of the patient caught by the nurse, 3)content of the fall prevention plan, 4)resource that the nurse used, 5)one that existed on the basis that the nurse prevented the fall.

"Concern that the nurse turned" was an environment, patients' behavior, a body situation, an acknowledgment situation, and an event. The nurse had been deciding the content of the fall prevention plan based on the "situation of the patient caught by the nurse" based on these. The resource used by the nurse was grounds of "concern that the nurse turned", and the "content of the fall prevention plan" was derived from the "situation of the patient caught by the nurse". In addition, "one that existed on the basis that the nurse prevented the fall" was used as the basis for deciding the fall prevention plan for the concern to the patient. It was suggested that the "resource that the nurse used" and "one that existed on the basis that the nurse prevented the fall" be the one that had been cultivated from the nurse's experience.

In the future, it is important to clarify how the experience related to the fall forms a resource that the nurse uses and one that exists on the basis that the nurse prevents the fall.