Decision-making in clinical nursing: investigating contributing factors
Background. This article describes the results of a study which investigated the
contextual factors influencing clinical decision-making. Education and experience
have been suggested by some as having a positive effect on clinical decision-making,
and have been listed as being of high importance. Values, knowledge, clinical setting
and stress have also been identified as being important to decision-making, with
various rankings given by different researchers.
Aim. The study was undertaken to determine relationships between occupational
orientation (value to role), educational level, experience, area of practice, level of
appointment, age and clinical decision-making in Australian nurses. The predictive
ability of each factor on clinical decision-making was determined.
Method. This correlational study examined Australian nurses’ decision-making
about some common nursing interventions and ‘occupational orientation’, educational
level, experience, level of appointment, area of clinical speciality and age. A
model was constructed using stepwise selection regression to predict the ‘weight’ of
each variable in clinical decision-making.
Results. Education and experience were not significantly related to decision-making.
The factor that accounted for the greatest variability to clinical decision-making
was holding a professional occupational orientation, followed by level of appointment,
area of clinical speciality, and age in that order.
Conclusion. In contrast to other studies, experience and educational level were not
found to influence decision-making strongly, the value of role was the most significant
predictor. The model developed, however, only accounted for a low amount
of variability in decision-making. The findings indicate that there are other factors
affecting clinical decision-making that still require identification.