Clinical Reasoning to Advance Medication Safety by Senior Nursing Students

Abstract

Nursing students in their final year of their nursing education program are expected to administer medications to patients safely and competently. Currently, there is a lack of research with regard to how senior nursing students are using clinical reasoning to support medication safety in the clinical setting. This qualitative descriptive case study explored how senior nursing students applied critical thinking and clinical reasoning to support medication safety in their final clinical practicums. The study took place in 2019 and consisted of 13 face-to-face interviews with senior nursing students in their final clinical rotation. Six themes emerged from the interviews. Students described a) administering medications safely by recognizing and clustering cues, b) administering medications safely to the right patient in the context of care, c) administering medications safely by determining the correct action, d) administering medications safely to patients for the right reason, e) reflecting on clinical reasoning experiences that supported medication safety, and f) unit culture impact clinical reasoning about medication safety. Nursing students described how they used their clinical reasoning to support safe medication management and administration in clinical settings. Based on the findings from this study, we recommend that nursing education programs enhance opportunities for students to develop and reflect on their clinical reasoning about safe medication administration in clinical settings.