• Lisa Wolf.
• University of Massachusetts, Amherst.
• Int J Nurs Knowl. 2013 Feb 1;24(1):49-53.

PurposeTo explore the relationship between multiple variables within a model of critical thinking and moral reasoning.MethodsA quantitative descriptive correlational design using a purposive sample of 200 emergency nurses. Measured variables were accuracy in clinical decision-making, moral reasoning, perceived care environment, and demographics. Analysis was by bivariate correlation using Pearson's product-moment correlation coefficients, chi square and multiple linear regression analysis.FindingsThe elements as identified in the integrated ethically-driven environmental model of clinical decision-making (IEDEM-CD) corrected depict moral reasoning and environment of care as factors significantly affecting accuracy in decision-making.ConclusionsThe integrated, ethically driven environmental model of clinical decision making is a framework useful for predicting clinical decision making accuracy for emergency nurses in practice, with further implications in education, research and policy.Practice ImplicationsA diagnostic and therapeutic framework for identifying and remediating individual and environmental challenges to accurate clinical decision making.© 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

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