Factors Affecting Nurses’ Clinical Decision-Making at Adult and Paediatric Emergency and Critical Care Units in Orotta National Referral Hospital in Asmara, Eritrea, 2025

Résumé fourni par la source

Background: Clinical decision-making is essential to the advancement of professional nursing practice. Competent nurses must apply sound decision-making skills to deliver safe and effective care. The decisions made by nurses have a direct and immediate impact on patient outcomes, including survival. Objectives: This study aimed to assess the level of clinical decision-making among nurses and identify the factors influencing it within Adult and Pediatric Emergency and Critical Care Units. Methods: An analytical, quantitative cross-sectional study design was conducted from October 2024 to March 2025 at Orotta National Referral and teaching Hospital. Data were collected using an adapted, predesigned, and pre-tested questionnaire comprising demographic variables and decision-making items. Descriptive statistics, independent samples t-test, and one-way ANOVA with Tukey post-hoc test were used for analysis employing SPSS Version 26.0. Result: clinical decision-making scores ranged from a minimum of 40 to76, with a mean score of 56.58. Using the mid-point of the scores as a cut-off, 45.1% of nurses demonstrated high decision-making performance. Notably, 87% of nurses who refrained from adjusting inotropic infusions without a physician’s order reported that such actions were not permitted. Statistically significant differences in decision-making scores were observed based on sex (p<0.001), professional level (p<0.002) and position held (p<0.01). Conclusion Considerable proportion of nurses exhibited limited clinical decision-making capacity. Implication: Understanding the level and determination of nurses’ clinical decision-making is crucial for enhancing nursing practice and informing organizational policies.