Assessment Of Clinical Decision Making Among Nurses Working In Hospitals Of Addis Ababa Ethiopia 2017

Background: - Decision making at clinical level is the way in which nurses perceived to arrivernat appropriate decisions in practical nursing situations. And these decisions have a direct impactrnon the health status of the patients, poor clinical reasoning skill leads to increasing numbers ofrnadverse patient outcomes. Nurses are required to make decisions with multiple foci for example,rndiagnosis, intervention, interaction and evaluation in dynamic contexts, using a diversernknowledge base decisional pattern. However, inability to recognize clinical situation is the majorrncause of errors in decisions.rnObjectives: - To assess nurse’s clinical decision making approach in hospital settings, AddisrnAbaba, Ethiopia, 2017.rnMethods: - Institution based cross-sectional descriptive study was conducted on 390 nurses. Torndetermine the sample size a single proportional formula was used. Self-administered Englishrnversion questionnaire (theoretical framework developing instrument by Lauri and SannarnSalanterä, included Hammond’s CCT) was used. The instrument used to investigate nurses’rnclinical decision making patterns at clinical practice level. To explain study population in relationrnto relevant variables, descriptive statistics like: frequencies and percentages were calculated. Multirnnominal logistic regression was used to show the association between CDM and associated factorsrnamong nurses. Permission was obtained from IRB. Information obtained from participants was keptrnsecured and confidential.rnResult: Clinical decision making score in this study ranges from 46 to 82 (mean = 65.5, SD =rn4.5). Two hundred sixty two (67.2%) of the participant scored in analytical decision makingrncategory. One hundred twenty five of respondents (32.1%) scored in the category of quasirndecision making which is a combination of both analytic and intuitive decision making process.rnOut of the total 390 respondents only three (0.8%) of them categorized as using intuitive decisionrnmaking method when dealing with patient. Organizational type/private sectors (p=0.021),rnclinical simulation (P=0.031) and ICU department (P=0.025) were factors associated withrnclinical decision makingrnConclusion and recommendation: This study found that there was clinical nurses inclination tornthe use of analytical decision making to the most part, So, health delivery organizations tornencourage nurses in particular clinical situation enable them to make decision that is timely andrnaccurate as possible and also the use of quasi rational decision making method in there day todayrnnursing practice with only a very few of them making intuitive decision making method.rnOrganizational type (private sector), clinical simulation and ICU department were factorsrnassociated with CDM.rnKeys Words: - Clinical decision making, Nurses, Intuition, and Analytical, Quasi-rational.

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