Abstract
Background: autonomous decision making (DM) is a positive concept for novice graduate nurses (NGNs) influencing job satisfaction, retention and quality of care. They have to exercise judgments and DM skills through learning DM process to act independently and autonomously. Aim: to assess, design, implement, and evaluate an enforcement educational management program on autonomous clinical and managerial decision making for novice graduate nurses. Setting: study was conducted at Tanta University and El Menshawy Hospital. Subjects: all (90) novice graduate nurses working in above mentioned setting. Tools: Three tools were used including decision making autonomy assessment scale, decision making and principles of autonomy knowledge test and educational enforcement program on decision making and autonomy principles. Results: Pre programs, all NGNs have low level of DM autonomy in clinical and managerial decisions and had poor level of knowledge about DM autonomy principles. Post program, (95.5%) of NGNs had good level of knowledge. NGNs (12.3% and 24.4%) had moderate level of managerial and clinical DM autonomy respectively. Conclusion: NGNs at two hospitals not having the authority and autonomy for making clinical and managerial decisions. Additionally, had lacking knowledge about decision making autonomy principles and facing organizational obstacles that limit their autonomy in DM. Post program, NGNs' knowledge and skills about autonomous DM improved. Recommendations: updating the structure of NGNs' job description including their involvement in decision making. Stress active managerial support to NGNs to improve their decision-making skills and become independent in clinical and managerial decisions
Highlights
Novice graduate nurses (NGNs) are baccalaureate prepared registered nurses with less than three full years of experience in the profession [1,2]
Autonomous decision making considered an important element for novice nurses' professional identity and source of power in their clinical practice [11,12,13]
Total scores of autonomy in making clinical & managerial decisions differ statistically significant according to novice graduate nurses (NGNs)' age and years of experience at (P=0.0001), statistical significant correlation found between total scores of autonomy in clinical & managerial decisions and scores of general organizational obstacles of decision making autonomy at (P=0.0001)
Summary
Novice graduate nurses (NGNs) are baccalaureate prepared registered nurses with less than three full years of experience in the profession [1,2]. Autonomy is an essential attribute for achieving professional status by using the power to determine what needs to be done in providing patient care, to act on assessments and to accept accountability for independent decisions [17] It manifested through communication of mutual respect and trust both intra and interprofessionally in clinical settings [18]. The nature of novice nurses' clinical decision making is linear, based on limited knowledge and experience in the profession and focused on single tasks or problems [5,24,25] They tend to view decision making as responding to patient complaints, and following protocols or documented care plans.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
