An Integrative Literature Review of the Factors That Contribute to Professional Nurses and Midwives Making Sound Clinical Decisions

Abstract

Further understanding about the extent of the impact some factors have on clinical decision making is needed.

Do Personal Differences and Organizational Factors Influence Nurses’ Decision Making? A Qualitative Study

“…These results corroborate previous work that examined the effect of these psychological and physical situations on nurses' decision-making abilities [3,36]. Ham et al (2017) asserted that fatigue/tiredness is considered a physical condition that can reduce nurses' decision-making abilities. Due to fatigue, nurses were stressed out about making rapid patient decisions [3].…”

“…This study echoes evidence from previous similar studies examining decision making that concluded that a positive work environment with adequate human and non-human resources enables nurses to be effective decision makers and to achieve high levels of care [2,3,16,21,40]. Additionally, in this study, all the participants mentioned the challenge of nursing shortages.…”

“…These findings were also reported by Lane and Harrington (2011), who found that the workload and nursing shortages had a significant effect on nurses' decisions when caring for elderly patients [31]. This was similar to the findings of Ham et al (2017), who noted that heavy workloads were identified in the nursing literature as a barrier to sound decision making, resulting in insufficient time to make adequate patient care decisions. Indeed, these important findings were not very encouraging and indicated that the impact of the workload on nurses' DMP should be taken into consideration [3].…”

“…Ham et al (2017) asserted that fatigue/tiredness is considered a physical condition that can reduce nurses' decision-making abilities. Due to fatigue, nurses were stressed out about making rapid patient decisions [3]. These findings are consistent with data obtained from the USA by Shirey et al (2013), who highlighted how frequent exposure to stressful situations might negatively impact nurse managers' health and DMP, which may threaten other professionals, patients, and organizational outcomes [36].…”

An exploratory mixed methods study of urban and rural registered nurses’ experience of clinical reasoning

“…In a quantitative correlational survey study, [27] the researchers found that nurses who worked on medical units engaged in decision-making more often and that education and experience were not related to clinical decision-making. However, in an integrative literature review of the factors that contribute to professional nurses and midwives making sound clinical decisions, tenHam, Ricks, vanRooyen and Jordan [30] found that clinical knowledge and training was the most significant influential factor on clinical decision making followed by organizational factors and patient characteristics. Among environmental factors, time and material resources were factors that could influence clinical decision making aptitudes.…”