Abstract
This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.
Highlights
IntroductionNurses are continually faced with demands to make decisions of care
In the clinical setting, nurses are continually faced with demands to make decisions of care
Since the late 1990s, a third approach to decision making has been discussed in the nursing literature, decision making based on the cognitive continuum theory (CCT) by Hammond [5]
Summary
Nurses are continually faced with demands to make decisions of care. Two approaches dominate in nursing research within the systematic-positivist stance, analytical decision making theory, and information-processing theory. The informationprocessing model is a psychological theory much used in research in medical decision making and characterized by a scientific approach to making decisions [6]. It is termed the hypothetico-deductive approach [1, 4]. According to Benner [9], intuition is rooted in the ability to recognize patterns of cues This is an ability that develops with experience in managing patients in the nursing field. Since the late 1990s, a third approach to decision making has been discussed in the nursing literature, decision making based on the cognitive continuum theory (CCT) by Hammond [5]
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