A descriptive correlational design based on an adapted model of Donabedian’s Structure, Process, Outcome model and Benner’s Novice to Expert theory was used to examine the clinical decision-making of nurses regarding elder abuse. The relationship of the nurses applied knowledge (assessment cues) of elder abuse; demographic questions (e.g. years of experience as a Registered Nurse (RN) and their clinical level of practice status), the use of intuition in nursing practice; and clinical decision outcomes (interventions) for patients in cases of suspected elder abuse was examined. A convenience sample of RNs who worked in the emergency department (ED) in three acute care hospitals, in southeastern United States were asked to complete questionnaires on education about elder abuse, their intuition use, demographic information, applied knowledge of elder abuse, and clinical decision outcomes for suspected elder abuse. The majority of the nurses had participated in the clinical level of practice status program.The convenience sample of 84 RNs consisted of 68 females (81%) and 16 males (19%). The average age of the respondents was 41.43 years. The mean number of years worked as a RN was 13.87 years. Multiple regression results indicated an overall model of two predictors (RNs applied knowledge (assessment cues) and years worked as a RN) significantly predicted clinical decision outcomes (interventions). The model accounted for 25.1% variance in clinical decision outcomes. The t-test revealed there was no difference (applied knowledge (assessment cues) of elder abuse, intuition use in nursing, years working as a RN, clinical level of practice status, and clinical decision outcomes (interventions)) between RNs who received elder abuse education at orientation and those who did not receive the education. The study results suggest that years of working as a nurse supported elder abuse recognition and intervention. The clinical level of practice status of nurses was found not to be a sensitive indicator. Elder abuse education during orientation varied between the hospital settings. The results indicate the educational need for nurses regarding suspected elder abuse
