Overview
This lecture explains the difference between the traditional nursing process (ADPIE) and the Clinical Judgment Measurement Model (CJMM), emphasizing how each shapes clinical thinking and decision-making in nursing practice.
The Nursing Process (ADPIE)
- ADPIE stands for Assess, Diagnose, Plan, Implement, and Evaluate.
- It is a linear, sequential process used for care planning and documentation.
- Each step is completed before moving to the next.
- Useful for organizing patient care but less adaptable in urgent situations.
The Clinical Judgment Measurement Model (CJMM)
- CJMM consists of six layers: Recognize cues, Analyze cues, Prioritize hypothesis, Generate solutions, Take action, Evaluate outcomes.
- CJMM reflects real-time, layered thinking rather than stepwise action.
- Steps are ongoing and often happen simultaneously, allowing for constant reassessment.
- Supports clinical reasoning and rapid decision-making in evolving clinical scenarios.
Practical Example: Postoperative Patient
- If a postoperative patient becomes short of breath, nurses use CJMM by:
- Recognizing cues: noticing shortness of breath, anxiety, high respiratory rate.
- Analyzing cues: considering possible causes like pain or pulmonary embolism.
- Prioritizing hypothesis: focusing on the most life-threatening possibility.
- Generating solutions: raising the bed, applying oxygen, calling the provider.
- Taking action and evaluating if interventions are effective.
Comparing ADPIE and CJMM
- ADPIE is best for structured care planning and documentation.
- CJMM is better for fast, in-the-moment clinical judgment and adjustment.
- CJMM enhances, rather than replaces, the traditional nursing process.
Key Terms & Definitions
- ADPIE — A sequential nursing process: Assess, Diagnose, Plan, Implement, Evaluate.
- CJMM (Clinical Judgment Measurement Model) — A layered model guiding real-time clinical reasoning and decision-making.
- Cue — Any piece of data or sign observed in the patient.
- Hypothesis — A possible explanation for a patient’s signs or symptoms.
Action Items / Next Steps
- Review both ADPIE and CJMM models for understanding when to apply each.
- Practice using CJMM in clinical scenarios to build real-time decision-making skills.