Determinants of Clinical Decision-Making Among Staff Nurses and Nursing Interns in a District Headquarter Hospital in Mirpurkhas, Sindh, Pakistan

Abstract

Background:   Decision making is a cognitive process of choosing best options to solve problems. In clinical settings, nurses need critical thinking and quick decisions to ensure safe and quality care. Poor decision making often stems from gaps in knowledge, experience, or time management. Barriers in making concrete clinical decision making may cause poor coordination, patient dissatisfaction, medical errors, and increased high risk of mortality. Purpose: The main purpose of this is to access factors influencing clinical decision-making among professionals (Staff nurses and Interns) working in clinical setting and to pinpoint the predictive factors that impact their decision making processes. Objective: To identify the factors influencing the clinical decision-making capabilities of nurses. Methodology: A descriptive cross-sectional study was carried out among healthcare professionals at the District Headquarters Hospital in Mirpurkhas, Sindh. A total of 95 healthcare professionals were chosen by using non-probability convenient sampling. Experts verified the face and content validity of the instrument, while its reliability was confirmed through a test-retest method, yielding a Cronbach's alpha coefficient of 0.9. Results: The findings of the study revealed that overall level of Clinical Decision Making was moderate, with a mean score of (3.10) and (SD+1.25). Among the four measured domains, “Evaluation and Reevaluation of consequences” demonstrated the highest mean score of (3.23±1.25), On the contrary, “Search for information ” demonstrated the lowest mean score of (3.01±1.25 ). Conclusion: The Study discloses that Nurses and interns have moderate level of CMD Competencies, suggesting they are somewhat provide quality of care to patients.)overall mean score was 3.10(± 1.25). This indicates that while nurses are capable of making decisions, their skills in this area are not highly advanced and there is need for enhancement, this research also highlights that nurses typically gather patient information prior to making decisions. However, a significant shortcoming is their limited consideration of alternative options. The study identifies that factors such as experience, educational background, information literacy, and critical thinking have a positive impact on clinical decision-making. On the other hand, elements like workload, extended duty hours, fatigue, stress, and time constraints negatively influence decision-making.