Literature accounting for nursing students
Introduction
In the hospital setting, nurses encounter many instances whereby they are supposed to make informed decisions. These decisions play a vital role in the delivery of care and the efficiency of treatment. Due to the complexity and delicacy of health, nurses should make sound clinical decision making every day. This paper aims to review relevant literature accounting for nursing students and clinical decisions. The topic is of interest since decision-making in health care is mandatory and should include no room for error. Throughout history, nurses fall short in terms of efficient decision making and quality of care. Since it is a major issue of concern, we seek to identify what researchers have on the topic, their differences, and existing gaps.
Research questions tend to investigate the factors that influence decision making amongst student nurses. The main themes consist of individual and environmental factors, which are the main influences of decision making. Under individual themes, there is experience and knowledge, education level, and hypothesis updating. There is task complexity, time pressure, interruptions, and area of specialty sub-themes under the environment. Clinical decision making comprises the determination of the best method that will meet the patient’s needs. In this case, literature should investigate analytical and intuitive processes of decision making that enhance clinical judgment.
The methodology comprises of observations and well-controlled experimentation to facilitate data collection. The findings should indicate the factors that affect efficient decision making and how to improve the situation. It is evident that the improvement of skills, experience, time, and pressure enhances the sound mind and thinking by individuals. A similar situation applies to nurses who face challenging conditions in the health care setting.
Theme A: Individual factors
- Characteristics of the individual factors theme
The efficiency of work delivery and sound decision making depends on various individual factors. Major commonalities in individual factors involve the experience and skill set of a person. However, differences in research arise in influence between age and the experience of a person. Mostly an individual can have experience but lack adequate exposure to critical decision-making situations. The knowledge level will influence the output of a particular individual. Overall slight differences arise in terms of explaining the individual factors and how they influence decision making.
- Experience and knowledge
- Nibbelink and Brewer (2018)
The research question seeks to understand the factors and processes related to registered nurses and their decision making towards patient care in the medical-surgical environment. The research is similar to other studies in this category since its main objective is finding the factors that influence decision making. The method comprises collecting data from published articles and previous researches. They were derived from online databases such as PubMed and CINAHL. Further, variables such as education, understanding, organization, and situation awareness influence experienced nurses’ decision-making. Findings indicate that nursing experience influences decision making in the health care setting.
- Maharmeh, Alasad, Salami, Saleh and Darawad (2016).
The research question seeks to evaluate the decision-making process in natural care settings. The research focuses on the decision activities of the critical care nurses in the hospital setting. The methodology is the use of interviews and observations to collect data. The participant includes twenty-four nurses with at least three years of experience in the natural clinical setting. The researchers spent approximately 150 hours while observing the nurses in eh critical clinical setting. The findings reveal that experience is the main factor that enhances the quality of decision-making in health care. Nurses with adequate experience could make better and informed decisions that led to the delivery of quality care.
iii. Krishnan (2018)
The research question seeks to evaluate the process of decision making in health care and the factors that affect the delivery of informed judgment. The methodology involves reviewing of two predominant theoretical perspectives to describe the content of clinical decision-making, including; systematic-positivism and intuitive-humanistic model. The findings cognitive processes achieved through experience in service delivery are neither completely analytical nor intuitive. In this case, decision making is a complex process that requires adequate knowledge and conjunction with intuition to facilitate good deliverables.
- Education level
- Voldbjerg, Grønkjær, Wiechula and Sørensen (2017).
The research question seeks to investigate decision making amongst newly graduate students and their source to derive knowledge. The methodology comprises of ethnographic study whereby the researchers use participant observation criteria. They formulate interviews that enhance data collection from nine newly graduated nurses. The findings show that education preparation is the main factor that enhances decision making amongst the nurses. It enabled;les them to transition on to the hospital setting while using their knowledge to make critical decisions. However, the study finds a gap in an experience that they claim is necessary to facilitate good decision-making.
- Heidari, M., & Ebrahimi (2016).
The research question aims to evaluate the decision-making skills of medical students and their relationship with critical-thinking ability. The methodology consists of the use of questionnaires to; medical emergency students in SHahrekord, Iran. The use of descriptive and analytical statistical tests is relevant to enhance the analysis of the data. The findings revealed that the students’ critical-thinking abilities were positively correlated to decision-making skills. In this case, education plays a vital role in enhancing decision-making in the health care setting.
iii. White, K. A., Fetter, M. E., & Ruth-Sahd (2019)
The research question aims to investigate the influence of external student’s programs on decision making. The methodology consists of the use of a quasi-experiment to establish nursing anxiety and self-confidence. The researchers use a clinical decision-making scale to carry out the experimental measurements. The findings show that students’ external programs improved overall decision-making by reducing anxiety and enhancing self-confidence.
Theme B: Environmental factors
- Time pressure
- Copanitsanou, P., Fotos, N., & Brokalaki (2017).
The research questions seek to evaluate nurses’ parameters that influence their delivery of quality care and decision-making. The method consists of reviewing ten different studies to understand the parameters of the work environment. The findings show that a conducive work environment that has limited pressure enhances the quality delivery of services. The outcomes of care will improve when nurses have adequate time to make critical decisions and informed research on patients’ health.
- Goldsby, Goldsby, Neck and Neck (2020).
The research aims to analyze how pressure, time management, and self-leadership influence decision-making amongst nurses in health care. The method comprises of search and review of similar literature work in the past. The findings show that time pressure is a significant factor that causes poor decision making in health care. Organizations should employ time management practices and self-leadership concerns to enhance good decision making in a heath care setting.
- Interuptions
- Bower, R. A., Coad, J. E., Manning, J. C., & Pengelly (2018).
The research seeks to investigate the influences of interruptions on nurses’ decision-making during the administration of medication in health care. The methodology consists of the use of non-participants observation and conducting interviews with nurses. The findings reveal that interruptions reduce concentration, focus, and awareness during care delivery by nurses. Interruptions result in poor judgments hence damaging the patient’s health. It is critical to include medication processes that are free from interruptions and timely to deliver efficient care.
- Laustsen, S., & Brahe (2018).
The study seeks to understand how nurses cope with interruptions in health care during the delivery of care. The researchers use ethnographic fieldwork to collect data. The hermeneutical phenomenological approach was effective in enhancing the validity and collection of data. The findings show that the nurses are capable of managing interruptions depending on their competency and working environment. The main causes of interruptions include working procedures and the lack of matching of expectations through dialogue. Solutions include enhancing culture work and matching nurses’ expectations to reduce interruptions at all care delivery levels.
Conclusion
The literature identifies various factors that affect nurses’ decision-making during clinical practice. Through a review of various studies, the paper highlights solutions to identified problems in decision making. The literature provides vital approaches to ensuring the improvement of the decision-making process. The recommendations are crucial for management and individuals to understand to ensure they enhance their decision-making criteria. Further, the literature recommends implementing multidisciplinary cooperation approaches to reduce interruptions in the health care setting. With the right measure in place, health care providers can increase the value of decision making and enhance quality patient care.
The overall strength of the literature emanates from its identification of factors that influence decision making. Solving these factors will enhance nurses and health organizations to improve the delivery of care. Therefore, the literature meets its objective of solving the existing problem of poor decision making by nurses during clinical practices. The research collects information from peer-reviewed studies hence validating the relevance of the findings.
The research’s weaknesses consist of a lack of comprehensive data collection from many health care organizations to enhance the validity of the information. It purely depends on previous researches on the same topic and their findings regarding nurses’ decision making. The research eliminates valuable variables such as nurses’ age and remuneration as vital factors influencing personal decision-making.
The research fails to evaluate individual factors such as emotions and perceptions vital in the decision-making process. The study did not identify how individual traits and character affect the decision-making process. Further gaps include relationships between the nurse and the patients and how perception influences their decisions concerning medication.
Future research should focus on a holistic evaluation of the nursing profession and medical providers in the health care sector. The research should address confounding variables such as age and remuneration of nurses, affecting decision-making during practice. Moreover, individual factors such as emotions and perceptions are vital to address since they affect the overall individual performance. Other relevant topics include cognitive abilities and behavior towards and motivation towards the delivery of patient care.