Nursing Studies and Patient Care

Clinical Reasoning as a Key Element of Preventing Iatrogenic Harm in the Process of Nursing Care

Published on: 2018-12-22


Nursing incorporates independent and collaborative care of people regardless of age, family, group, community, and health condition. It promotes health, prevents sickness, cares for the sick, and manages the disabled and the dying.
Healthcare professionals have the primary concern to give their level-best service to all patients, regardless of socio-economic status. The conduct of this study drew its basis on the increasing cases of medical conditions brought about iatrogenic harm to various patients under the care of nurses.
The cross-sectional design using descriptive survey, taking nurses at Dr. Soliman Fakeeh Hospital in Jeddah, Saudi Arabia as respondents. The baseline information was collected from a Demographic Performa while clinical reasoning skills were assessed through a Script Concordance Test. Script Concordance Test assessed the clinical reasoning in uncertain situations and allowed real life situation testing. Quantitative data were gathered with the use of structured questionnaire while qualitative data were accessed through interviews that brought in observation for simplified data. The summary of data is in form of frequency and percentage.
Iatrogenic harm was mostly accounted by the respondents for medication errors (78.02%). While mismanagement was identified by 14.28% of the respondents, a total of 6 or 6.59% of them answered combination of medication and mismanagement. A respondent considered medication, laboratory testing, diagnostic, and mismanagement as the causes of iatrogenic harm. Data revealed the relevance of clinical reasoning in the prevention of iatrogenic harm.
Results suggest that utilization of clinical reasoning with participants in this study and iatrogenic harm could both happen in the clinical setting. Notwithstanding the high percentage of participants who never experienced iatrogenic harm, addressing it through clinical reasoning could not be established in this study.
The researcher drew inspiration from healthcare professionals and practitioners in nursing research who incessantly contributed to the pool of knowledge which addresses various challenges in the profession, particularly in improving nursing practice.


Clinical Reasoning; Iatrogenic Harm; Nursing Care; Key Element