Nurses' judgments regarding seclusion and restraint of psychiatric patients: A social judgment analysis

Clinical judgment of psychiatric nurses was investigated using judgment ana lysis within the framework of social judgment theory. Nine nurses at a shor t-term psychiatric care facility made recommendations concerning restraint and seclusion for 80 patients described on paper in terms of 17 characteris tics (cues). Nurses generally favored close observation of patients over se clusion and restraint, and information about current behavior and functioni ng had more impact on nurses' judgments than did patient history. Nurses ha d good insight into the nature of their own judgments. However, individual differences in cue utilization and inconsistency in strategy usage led to d isagreement among nurses about specific recommendations for particular pati ents. No one patient received identical recommendations from all nurses, an d nurses agreed with each other on specific recommendations only about a th ird of the time. The lack of agreement has implications for development of staff training programs and further research on the clinical judgment proce sses of nurses. (C) 1999 John Wiley & Sons, Inc.