Nurses' clinical thinking and decision making

Abstract

Introduction: Nowadays in health care arena, the nurses are increasingly confronting constantly changing complicated situations. These unreliable and unstable situations require nurses with the ability of decision making. Since decision making became more complex, critical thinking is necessary. Because of the importance of critical thinking and clinical decision making in modern nursing, this study aimed to estimate capacities of nurses and to evaluate the relationship of critical thinking and clinical decision making.

Methods: This research was a cross-sectional descriptive analytic study. The study was planned with the purpose of detection of relationship between critical thinking and clinical decision making of nurses in general and intensive care wards. Furthermore, it was to compare nurses of general wards with nurses of intensive care units. This study was conducted on 140 nurses in two groups (70 nurses from the general wards and 70 nurses from the intensive care units). The samples were selected based on stratified random sampling and the data were collected by a questionnaire. This questionnaire consisted of three parts including demographic characteristics, clinical decision making inventory and California critical thinking skills test. Validity and reliability of the tool were confirmed with content validity, test retest and internal correlation. Data were analyzed with SPSS and descriptive and inferential statistics.

Results: Mean scores of critical thinking and clinical decision making for nurses of intensive care units were 10.61 and 63.27, respectively. For nurses of general wards, they were 10.67 and 61.66, respectively. The results didn't show any difference between mean scores of critical thinking in nurses of intensive care units and those of general wards. Also, there was no difference between mean scores of clinical decision making in nurses of intensive care units and those of general wards. The result didn't show any relationship between critical thinking and clinical decision making in nurses.

Conclusion: The findings showed that mean score of critical thinking in nurses is low. The reason can be due to the defects either during university training or professional ones during working period. Some experts claim that the lack of relationship between critical thinking and clinical decision making is due to lack of an appropriate tool or project to measure them rather than the lack of their relationship.