The Factors Influencing Nurses’ Clinical Decision-Making in Emergency Department

Abstract

In an emergency, making the correct decision is vital. It is a necessary element of professional nursing care, and the ability of nurses to make successful clinical decisions is the most critical element influencing care quality. The purpose of this study was to assess the factors influencing nurses’ clinical decision-making in the emergency department of Palestinan hospitals. A cross-sectional study was targeted at all nurses working in emergency departments at the Palestinian hospitals. The study was completed with 227 nurses, and collecting data was performed with the Clinical Decision Making in Nursing Scale. Results of the study revealed that the average score for the total clinical decision-making score was 3.3 (SD = 0.23). The subscales of clinical decision making were “search for alternatives or options,” “canvassing of objectives and values,” “evaluation and reevaluation of consequences,” and “search for information and unbiased assimilation of new information.” Furthermore, multiple linear regression analysis revealed that degree and work hours accounted for 11.7% of the variance in clinical decision-making. The study confirmed the average score for clinical decision-making was slightly higher than the average score. Also, it approved that nursing degree and work hours were predictors of clinical decision-making among nurses in emergency departments.

Palestinian Nursing Students’ Perspective of Clinical Decision-Making

“…The inability to make appropriate clinical decisions may lead to nurses missing opportunities to enhance clients’ health (Abu Arra et al, 2023 ; Potter et al, 2021 ). Inadequate CDM methods are responsible for over half of all clinical errors ( Tomlinson, 2015 ).…”

Clinical reasoning skill of nurses working in teaching medical centers in dealing with practical scenarios of King’s model concepts

“…The dynamic, and variable conditions of nurses’ workplace plus patients’ uncertain and changing situations require nurses to be competent decision-makers who can combine their technical skills and professional knowledge to make accurate and correct clinical judgments about patients’ health status and identify and solve patients’ nursing-related problems within a multidisciplinary team [ 3 ]. Clinical decision-making skills can affect the quality of care more than any other factor [ 4 ]. Clinical reasoning is among the most essential features of care that focus on simulating and analyzing clinical situations to facilitate better decisions for and management of patients [ 5 ].…”

“…Clinical reasoning in nursing is defined as a cognitive process and strategies used to understand information, identify patients’ problems, and a way of clinical thinking about clinical skills [ 7 ]. Everyone knows that nurses make important clinical decisions with significant effects on patient care and their professional practice [ 4 ]. Clinical reasoning is based on recognizing the right key points, which can be found in physiological and psychological changes in patients, or through physical examination, and patient history, and are understandable according to the body of knowledge and philosophical beliefs.…”

A Concept Analysis of Nurses` Clinical Decision Making

“…Continuous improvement and innovation in nursing practice is a permanent challenge for every health care organization. The ability to make sound and effective clinical decisions requires nurses to be able to gather information, identify problems, generate alternatives, design and implement innovations that will help their` units meet expected patient care outcomes while increasing efficiency and decreasing costs (Alnutaifi, 2021, Abu-Arra et al, 2023. Clinical decision-making nurtures professional nursing knowledge for maintaining the life and promoting the health of a patient.…”