Clinical Decision Making of Greek Nurses Working in Health Centers, Emergency Rooms, Medical-Surgical Clinics and ICUs

Abstract

Clinical decision making is an integral part of nursing science and daily clinical nursing practice. Aims:To investigate and compare clinical decisions made by nurses working in Health Centers, Emergency Departments (ERs), Medical and Surgical Clinics and Intensive Care Units (ICU). Methods:Clinical decision-making cards (Q methodology) and a questionnaire were developed to investigate factors that influence clinical decision-making. Results:Nurses working in Health Centers made moderate clinical decisions for dyspnea and incomplete clinical decisions for CPR, while nurses working in ERs made good clinical decisions for MI and moderate for dyspnea. Also, nurses working in Medical Clinics made moderate clinical decisions for all scenarios (CPR, MI, dyspnea, vomiting). Finally, nurses working in Surgical Clinics made good clinical decisions for dyspnea and moderate for CPR, while nurses working in ICU made good clinical decisions for all scenarios. Conclusions:Nurses working in ICU make better clinical decisions than nurses working in Health Centers, ERs, Medical and Surgical Clinics. This is possible due to the better staffing of the ICUs, the implementation of nursing protocols, the high degree of autonomy they have and the severity of the patietns illness they face on a daily basis.