Clinical decision making approaches and associated factors among nurses working in a tertiary teaching hospital

Abstract

Introduction: The clinical decision-making approach is an ongoing process in the nursing clinical setting and has an impact on the survival of the patient under their care. Objective: To assess clinical decision-making approaches among hospital nurses. Methods and materials: An institutional-based cross-sectional study was conducted from March 20 to April 4, 2018. A single population proportion formula for sample size determination and stratified sampling technique was used to select the study participants. The data was gathered using a pretested, structured, self-administered questionnaire and trained data collectors. The data was analyzed using SPSS version 20. To explain the study variables, frequency tables, figures, and percentages were used. Bivariable and multivariable logistic regressions were used to see the association between independent and dependent variables. Results: Among the total participants, 44.3% had intuitive and 55.7% had analytical decision-making approaches. Being at a higher educational level (aOR = 3.49, 95 % CI (1.45, 13.16)), having 10 years experience, having a high workload (aOR = 0.54, 95 % CI (0.37,0.42)) and having training (aOR = 3.11, 95 % CI (1.83, 5.28)) were significantly associated with intuitive clinical decision making. Conclusion: The intuitive decision-making approach was lower as compared to most of the previous studies. Variables such as higher experience, the high workload in the working unit, and talking training in clinical decision-making were significantly associated with the intuitive decision-making approach. Therefore, policymakers ought to implement the standard nurse-to-patient ratio and design training on how to handle the patient in different situations to achieve a good decision-making approach.

Keywords

• Analytic decision-making
• Intuitive decision-making
• Ethiopia