Implementation of the Lasater Clinical Judgment Rubric as a Progress Review Tool

The organization determined there was a lack of a standardized progress review tool to objectively evaluate nurses’ clinical judgment during orientation. Further assessment determined gaps in communication between the preceptors and unit-based nursing education specialists (NESs), and a perceived lack of value in progress reviews. Tanner’s (2006) review of nearly 200 nursing research articles determined a nurse’s clinical judgments impact patient outcomes, making it imperative that organizations ensure their nurses have adequate clinical judgment to protect patients. Lasater’s clinical judgment rubric (LCJR), based on Tanner’s (2006) clinical judgment model was the only published tool found for assessing nurses’ clinical judgment. A pilot project aims to implement the LCJR as a progress review tool to improve communication between preceptors and NESs, perceived value of the progress review process, and objective evaluation of nurse orientees’ clinical judgment. The evidence demonstrates the LCJR is a valid and reliable tool which provides objective evaluation of a nurse’s clinical judgment, a shared language, and value to the progress review process. NESs will educate preceptors on six pilot units for the use of the LCJR as a progress review tool, then trial the LCJR on the units for three months with newly hired nurses. Surveys designed to measure the three outcomes will be administered prior to implementation and three months after implementation to determine change. Qualitative data collected from open-ended questions on the post-pilot survey will provide data triangulation for quantitative data. If the LCJR is successful in improving value, communication, and objective evaluation, the plan is to implement across the department of nursing as a standard evaluation process for nurse orientees. The LCJR and Tanner’s (2006) clinical judgment model would be integrated into preceptor training across the department