Nurses' clinical reasoning and decision-making during initial assessments in primary care (PINPOINT)

The project investigates RNs’ clinical decision-making and communication with patients during initial assessments in primary healthcare.

  • Period: 2023-01-01 – 2027-12-31
  • Funder: Internal funding, Swedish Research Council for Health, Working Life and Welfare


The patient's first care contact and RNs' initial assessment can be decisive for the patient's continued care and health, and incorrect assessment can have serious consequences. This project therefore aims to investigate perspectives and practices for patient-nurse consultations in primary care. The study is a prospective multicenter study. Selection is made of physical patient-nurse consultations within primary care. Data will be collected with validated instruments for estimating the patients' expectations of, experiences of, and satisfaction with the visits to the nurses. Observations with audio recordings of the communication during patient-nurse consultations will take place. The interviews aim to explore nurses' clinical reasoning and judgment during consultations that they have carried out through stimulated recall. Later, focus group interviews will also be conducted, where results from the individual interviews are used to explore challenges and conditions for priorities and goal conflicts in nurses' assessments.

Portrait of project leader Inger Holmström against a light background.

Inger Holmström

Mälardalen University; University of Borås; The Netherlands Institute for Health Services Research

Project leader: Annelie J Sundler
Co-investigators: Inger Knutsson Holmström, Malin Östman, Karin Bergman, Sofia Östensson, Lena Hedén, Sandra van Dulmen