Factors Influencing Clinical Decision Making Among Nurses; Adapted Systematic Review.

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Date
2023-11-21
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Saudi Digital Library
Abstract
Background: In the evolving healthcare sector, nurses play a pivotal role, in delivering patient centered care that relies on well-informed clinical decision making. This adapted systematic review explores the factors that influence nurses' decision-making processes. Given the evolution of healthcare, it is crucial to comprehend the elements that influence nurses’ clinical decision making. This study acknowledges that expertise, organizational dynamics, cultural context, patient preferences, and evidence-based practice all shape clinical decision making. By unraveling these intricacies, insights can be gained that guide evidence-based strategies, policy development, and educational approaches. This knowledge is needed to empower nurses as they make decisions in their roles. Methods: A comprehensive systematic review was conducted from October 2022 to April 2023 to examine the existing literature and ascertain the elements that impact the process of clinical decision making among nurses. The aim of this investigation was to find the latest and trustworthy evidence related to the subject, subsequently subjecting it to a thorough examination employing the Critical Appraisal Skills Programme tool (Public Health Resource Unit 2012). This review provides a narrative account that incorporates a thematic synthesis of existing research to critically evaluate the current body of data pertaining to the many elements that influence clinical decision making. Objectives To investigate the existing literature and determine the factors that influencing clinical decision making. Result: The systematic review yielded a total of 16 studies that met the criteria for eligibility. These studies encompassed ten quantitative studies, five qualitative studies and one mixed-methods study. The findings revealed that the factors influencing nurses’ clinical decision-making included their level of experience and expertise; the availability of colleagues for consultation; their degree of autonomy in making decisions; the pressures of their workload and time constraints; access to information; and various organizational aspects such as staffing levels and available resources. Notably, experience emerged as one of the determinants at an individual level. Conclusion: This systematic review highlighted the factors that affect the decision-making process of nurses. Among these factors were the experience level of nurses, collaboration, and access to information. It is important to note that contextual elements like workload, staffing and available resources within healthcare organizations also play a role in this process. Extensive meta-analysis, on a large scale encompassing various geographical locations, is still required to gain a more comprehensive understanding of how these factors interact in clinical practice.
Description
This dissertation presents a study on the factors influencing nurses' clinical decision-making in the evolving healthcare sector. It emphasizes the importance of understanding these elements, including expertise, organizational dynamics, cultural context, patient preferences, and evidence-based practice, to guide policy development and educational approaches. The methods section details a comprehensive systematic review conducted from October 2022 to April 2023, using the Critical Appraisal Skills Programme tool to analyze relevant literature. The review aims to provide a thematic synthesis of existing research to evaluate factors affecting clinical decision making. The results show 16 eligible studies, including quantitative, qualitative, and mixed-methods research. Key influencing factors identified are nurses' experience and expertise, availability of consultative colleagues, decision-making autonomy, workload pressures, time constraints, information access, staffing levels, and available resources, with experience noted as a critical individual-level determinant. The conclusion highlights that nurse experience, collaboration, and information access significantly impact decision-making. Contextual elements like workload and organizational resources also influence this process. The study suggests the need for more extensive meta-analysis across different geographical locations to better understand these factors in clinical practice.
Keywords
Decision Making, Clinical Reasoning, Clinical Judgment
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