The ability to make adequate clinical decisions is a prerequisite for the delivery of safe and appropriate nursing care. An understanding of the processes involved in clinical care decisions is necessary to teach nurses effective ways of decision making and to develop tools for decision support. This paper analyzes three major theories which have guided research in clinical decision making: (a) information processing theory, (b) decision theory or decision analysis, and (c) Benner's model of clinical expertise based on the Dreyfus theory of skill acquisition. Characteristics of clinical decision making are clarified; it is examined how inferences between patient data, patient problems, nursing interventions, and patient outcomes are described in theories of clinical decision making; research in this area is critically analyzed; and the state of knowledge is summarized with suggestions for future research.
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