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.