title: Nurses' clinical reasoning: processes and practices of medication safety.
abstract: In this article, we describe the depth of knowledge and skill nurses used in making decisions regarding the safe processes and practices of medication administration. Using grounded theory, we identified the essence of medication safety by nurses as the theme of clinical reasoning. Nurses used two medication safety processes within the clinical reasoning theme-maintaining medication safety and managing the environment-together with six categories of patient-focused medication safety practices in the first process and four categories of environmental-focused safety practices within the second process. These processes and practices present an emerging model of safe medication administration developed from the narratives of 50 medical-surgical nurses. This model provides researchers with the basis for the development of systemic policies for safer medication administration for patients. Health care professional educators might also find the results useful in developing curricula focused on patient safety as the foundation of quality care.
authors.affiliation: Rutgers, the State University of New Jersey, Newark, College of Nursing, New Jersey07102, USA. gdickson@rutgers.edu
authors.forename: Geri L
authors.initials: GL
authors.lastname: Dickson
authors.forename: Linda
authors.initials: L
authors.lastname: Flynn
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003142:Communication; D003657:Decision Making; D004777:Environment; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008508:Medication Errors / Q000517:prevention & control*; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology*; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic; D061214:Patient Safety; D017064:Process Assessment, Health Care; D017751:Safety Management / Q000458:organization & administration