Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지
DOI QR코드

DOI QR Code

A Study on Participation in Clinical Decision Making by Home Healthcare Nurses

가정전문간호사의 임상적 의사결정 참여도에 관한 연구

  • Received : 2010.05.05
  • Accepted : 2010.12.28
  • Published : 2010.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.

Keywords

References

  1. Anthony, M. K. (1995). The relationship between decentralization and expertise to participation in decision making: Among staff nurses working in acute care hospitals. Unpublished Doctoral Dissertation, Case Western Reserve University, Cleveland, USA.
  2. Bakalis, N. (2006). Clinical decision-making in cardiac nursing: A review of the literature. Nursing Standard, 21(12), 39-46.
  3. Bakalis, N., & Watson, R. (2005). Nurses's decision-making in clinical practice. Nursing Standard, 19(23), 33-39.
  4. Boney, J., & Baker, J. (1997). Strategies for teaching clinical decision- making. Nurse Education Today, 17, 16-21. https://doi.org/10.1016/S0260-6917(97)80074-3
  5. Bucknall, T., & Thomas, S. (1997). Nurses' reflections on problems associated with decision making in critical care settings. Journal of Advanced Nursing, 25, 229-237. https://doi.org/10.1046/j.1365-2648.1997.1997025229.x
  6. Caputo, L., & Mior, S. (1998). The role of clinical experience and knowledge in clinical decision making. Topics in Clinical Chiropractic, 5(2), 10-18.
  7. Chi, S. A., & Yoo, H. S. (2000). Concept analysis of professional nurse autonomy. Journal of Korean Academy of Nursing, 31, 781-792.
  8. Choi, H. J. (1997). A study on nurse's decision making process and related factors for patient care. Unpublished doctoral dissertation, Seoul National University, Seoul.
  9. Chun, M. H. (2005). A study on the decision making process of emergency department nurses. Unpublished master's thesis, Kyeongsang University, Jinju.
  10. Davies, N. (1997). Nurse-initiated extubation following cardiac surgery. Intensive and Critical Care Nursing, 13, 77-79. https://doi.org/10.1016/S0964-3397(97)80152-8
  11. dela Cruz, F. A. (1994). Clinical decision-making styles of home healthcare nurses. Journal of Nursing Scholarship, 26, 222-226. https://doi.org/10.1111/j.1547-5069.1994.tb00318.x
  12. Hansen, A. C., & Thomas, D. B. (1968). A conceptualization of decision making: Its application to a study of role and situationrelated difference in priority decisions. Nursing Research, 17, 436-443.
  13. Illinois General Assembly. (2009, April). Illinois Compiled Statutes. (225 ILCS 65/) Nurse Practice Act. Retrieved December 17, 2010 from http://ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1312&ChapterID=24
  14. Jenkins, H. M. (1985). A research tool for measuring perceptions of clinical decision making. Journal of Professional Nursing, 1, 221-229. https://doi.org/10.1016/S8755-7223(85)80159-9
  15. Kim, H. Y. (2008, November). The alternatives for vitalization of home healthcare. In Y. S. Kim (Chair), Home Healthcare Symposium. Symposium conducted at the meeting of the Korean Homecare Nurses Association and Korean Academic Society of Home Care Nurses, Seoul, Korea.
  16. Kim, S. J., Yi, M. S., Eun, Y., Ko, M. H., Kim, J. H., Kim, D. O., et al. (2006). Role-identity of home care nurse practitioners. Journal of Korean Academy of Nursing, 36, 103-113.
  17. Kim, S. Y., & Park, S. A. (2009). A study for evaluating the performance of a community-based home care services model. Journal of Korean Academy of Community Health Nursing, 19, 673-683.
  18. Kim, T. S., Choi, M. K., & Lee, M. H. (1997). The relationships of decentralization, expertise and decision-making perceived by clinical nurses. Chungnam Medical Journal, 24, 89-100.
  19. Krairiksh, M., & Anthony, M. (2001). Benefit and outcome of staff nurses' participation in decision making. Journal of Nursing Administration, 31, 16-23. https://doi.org/10.1097/00005110-200101000-00005
  20. O'Neil, E. (1996). An exploratory study of clinical decision making in home healthcare nursing. Home Healthcare Nurse, 14, 362-368. https://doi.org/10.1097/00004045-199605000-00006
  21. Park, M. S. (2006). The level of professional autonomy and clinical decision making abilities of advanced practice nurses. Unpublished master's thesis, Ulsan University, Ulsan.
  22. Shu, M. J., Kim, S. S., Shin, K. R., Kang, H. S., Kim, K. S., Park, H. R., et al. (1997). A study on the lived experiences of home care nurses. Journal of Korean Academy of Nursing, 30, 84-97.
  23. Simon, H. A. (1977). The new science of management decision (Rev. ed.). Englewood Cliffs, N. J.: Prentice Hall.
  24. Tingle, J. (1997). Clinical guidelines and the law. In Wilson J. (Ed). Integrated care management: The path to success? Butterworth Heinemann, Oxford, 70-71.
  25. Yang, B. M. (1997). Mobilizing visiting nurse program in Korea. Korean Journal of Public Health, 34, 110-116.
  26. Yi, Y. J. (2001). The causal relationships of the variables to decisionmaking of clinical nurses. Unpublished doctoral dissertation, Yonsei University, Seoul.
  27. Yu, M. (2007). A study of nurse manager's decision-making on human resource management. Journal of Korean Academy of Nursing Administration, 13, 82-97.

Cited by

  1. 일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석 vol.25, pp.3, 2010, https://doi.org/10.22650/jkcnr.2019.25.3.275
  2. 간호사의 임상의사결정능력 구조모형 vol.49, pp.5, 2010, https://doi.org/10.4040/jkan.2019.49.5.601
  3. 가정전문간호사가 실무에서 경험한 어려움과 대처 vol.31, pp.2, 2010, https://doi.org/10.12799/jkachn.2020.31.2.143
  4. 도뇨관 관리를 위해 가정간호에 의뢰된 환자의 요로감염실태 vol.28, pp.2, 2010, https://doi.org/10.22705/jkashcn.2021.28.2.178