Evolving the Assessment of Clinical Judgment: An Individual or Collective Competency?

BACKGROUND: Nurses make decisions about care individually and as part of a team. Collective competence, the effective team management of patient care situations, is partially dependent on nurses' individual confidence and clinical judgment competence. PURPOSE: To describe individual and team-based facilitators and barriers to collective competence in teams of senior baccalaureate-level prelicensure nursing students during a team-based simulation. METHODS: With a cross-sectional design, the study used a 26-item survey based on the National Council of State Boards of Nursing (NCSBN)-Clinical Judgment Measurement Model (CJMM) (α= .86) to assess individual student confidence and perceptions of clinical judgment competence while observation of team dynamics and task completion assessed collective competence. RESULTS: Closed-loop communication and role assignment were facilitators of collective competence when present and barriers when absent. Additional barriers were lack of student confidence and perceived competence with Layers 3 and 4 of the NCSBN-CJMM. CONCLUSIONS: Team-based simulation strategies can be effectively used to assess collective clinical judgment competence.

Advocating for Multimodal Pain Management and Reducing the Need for Opioids in the Acute and Chronic Pain Setting.

The opioid epidemic skyrocketed around 2017 when many pharmaceutical companies guaranteed effective pain relief with nonaddictive properties of prescription opioids. However, this has proven to be inadequate because opioid misuse has increased in the United States. These catastrophic consequences led many providers to take on a different approach to pain management in the acute and chronic setting. In the last few years, a great deal of research has focused more on a multimodal pain management approach, in hopes to decrease the rate of opioid misuse and related overdoses and help assist in putting an end to this public health crisis.