Clinical intuition in the nursing process and decision-making-A mixed-studies review. 2017

Christina Melin-Johansson, and Rebecca Palmqvist, and Linda Rönnberg
Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden.

OBJECTIVE To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. BACKGROUND Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. METHODS An integrative review strengthened with a mixed-studies review. METHODS Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. RESULTS After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. CONCLUSIONS Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. CONCLUSIONS We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise.

UI MeSH Term Description Entries
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D009723 Nurse-Patient Relations Interaction between the patient and nurse. Nurse Patient Relations,Nurse Patient Relationship,Nurse Patient Relationships,Nurse-Patient Relation,Patient Relations, Nurse,Patient Relationship, Nurse,Patient Relationships, Nurse,Relations, Nurse Patient,Relations, Nurse-Patient,Relationship, Nurse Patient,Relationships, Nurse Patient
D009736 Nursing Process The sum total of nursing activities which includes assessment (identifying needs), intervention (ministering to needs), and evaluation (validating the effectiveness of the help given). Process, Nursing,Nursing Processes,Processes, Nursing
D011340 Problem Solving A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal.
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D003657 Decision Making The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D019545 Intuition Knowing or understanding without conscious use of reasoning. (Thesaurus of ERIC Descriptors, 1994)

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