• Title/Summary/Keyword: decision making of clinical nurses

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Public Health Nurses유 Decision Making Models and Their Knowledge Structure (보건간호사의 의사결정 유형과 지식 유형에 관한 실증연구)

  • 최희정
    • Journal of Korean Academy of Nursing
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    • v.31 no.2
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    • pp.328-339
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    • 2001
  • The purpose of this study was to describe decision making model of 180 public health nurses in Korea and their knowledge structure for decision making. The differences of decision making models by nurse's knowledge structure were also tested. Research concepts were measured using the instrument based on systemic and interpretive decision making approaches that were developed by Lauri & Salantera (1995). The results were as follows. 1. The public health nurses turned to, most commonly, a mixed practical-theoretical knowledge structure (45.9%), followed by practical knowledge (32%) and theoretical knowledge (22.1%). 2. The six different decision making models were identified. These were named for decision making theories and nursing process. These were client-oriented decision making, rule-oriented systemic decision making, wholistic and intuitive decision making, decision making depending on subjective view and experience, systemic decision making for defining problems. 3. The public nurses who had practical and practical-theoretical knowledge structure and community health practitioner (CHP) retold that decision making depends on subjective view and experience. Also the public health nurses who had 5~19 years clinical experience represented hypothetico-deductive decision making for defining problems.

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The Relationship between Nursing Professionalism, Clinical Decision Making Abilities, and Job Performance in Advanced Practice Nurses (전문간호사의 전문직업성, 임상적 의사결정능력 및 간호업무성과의 관계)

  • Kim, Young Soon;Park, Jung Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.5
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    • pp.613-621
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    • 2013
  • Purpose: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables Methods: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. Results: The average score for nursing professionalism of study participants was $81.19{\pm}7.56$. for clinical decision making abilities, $140.42{\pm}9.62$ and for job performance, $102.54{\pm}10.30$. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). Conclusion: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

Analysis of Decision-Making in Ethical Dilemma Cases among Clinical Nurses (윤리적 딜레마 사례에 대한 간호사의 의사결정 분석)

  • Kim, Hyun-Gyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.459-480
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    • 2003
  • Purpose: This study was done to analyze the contents of nurses' ethical decision-making in four of hypothetical dilemma cases using the Cameron's Ethical Decision-Making Model of 'Value, Be, Do'. Method: Sixteen nurses who work at ICU at present or worked before, participated from April 10 to May 10 in 2002. The participants were interviewed three times each and for 40 minutes at once, with a structured questionnaire at their working places and locker rooms. The data was analyzed by a procedure of qualitative content analysis into three categories; what should I value, who should I be, what should I do. Result: 1) In consistency, most of subjects showed a unified voice in 'Value, Be, Do'. Exceptionally 8 subjects showed inconsistency such as 3 in active treatment to the incurable patients(case 1), 1 in treatment truth-telling to the terminally ill patients(case 2), 3 in conflict with uncooperative doctors(case 3), 3 in dying patients and euthanasia(case 4). Only one subject showed inconsistency in 3 dilemma cases. 2) Closing the interview procedure, the subjects evaluated Cameron's Model as it would help them build consistent value, carry right action, and cope to conflicts. Conclusion: On the basis of the results, it is recommended that nursing ethics should adopt the ethical decision-making model, and be applied to the curriculum of nursing colleges and continuing education program for clinical nurses.

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The Paradigm Model of VIP Ward Nurses' Decision Making (특실병동 간호사의 의사결정 경험에 관한 패러다임 모형)

  • Park, Hyun-Jeoung;Kim, Duck-Hee;Kim, Chun-Mi
    • Korean Journal of Occupational Health Nursing
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    • v.18 no.2
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    • pp.141-152
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    • 2009
  • Purpose: The purpose of this research was to describe the decision making of nurses in a VIP ward. Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin (1998). The data were collected through an in-depth interview, which were audio-taped and transcribed. The data were collected from 10 nurses from July to November 2007. Results: The core category on VIP ward nurses' decision making was named as "adjusting with flexibility and deepened insight". The causal condition was established by 'the patients who wanted to be treated specially'. The contextual conditions included 'caring patients from various departments', 'differences depending on the nurses' clinical experience', and 'client-centered atmosphere in the VIP ward'. The intervening conditions included 'problem solving styles of nurses', 'attitudes of patients and family members', 'nurse-doctor relationships', and 'accessibility to information'. It was confirmed that nurses changed their action-interaction strategies depending on the intervening conditions, thus resulted in the nurses' role conflict and the need to expand their consciousness. Conclusion: The result of this study indicates that nurse's decision making depends on their experiences and the nature of social context in which nursing occurs.

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Hospital Nurses' Experience of Do-Not-Resuscitate in Korea (심폐소생술 금지와 관련된 병원간호사들의 경험)

  • Yi, Myung-Sun;Oh, Sang-Eun;Choi, Eun-Ok;Kwon, In-Gak;Kwon, Sung-Bok;Choi, Kyung-Mi;Kang, Young-Ah;Ok, Jeong-Hui
    • Journal of Korean Academy of Nursing
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    • v.38 no.2
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    • pp.298-309
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    • 2008
  • Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

Nurses′ Research Activities and Barriers of Research Utilization (임상 간호사들의 연구 관련 활동 실태 및 연구결과 활용의 장애 요인)

  • 오의금;오현주;이윤정
    • Journal of Korean Academy of Nursing
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    • v.34 no.5
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    • pp.838-848
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    • 2004
  • Purpose: This study was to describe nurses' research activities, perceptions and performances of evidence-based practice and barriers to the use of research evidence in nursing practice in Korea. Method: A cross-sectional survey design was used. A questionnaire, except for Barriers Scale, was developed for the study. Data was collected from a convenient sample of 437 registered nurses working at research and education oriented university hospitals. Result: Nurses' research-related activities were relatively low compared to previous studies. Also perceptions and performances of evidence based nursing practice were low. Preferred informational resources for clinical decision making were identified as ward manuals/clinical guidelines, manager/senior nurses, and literature/research. The major barriers to research utilization were a lack of implication for practice along with inadequate facilitation to implement research evidence and difficulty understanding research written in English. Priorities of barriers factor were Administrator, Communication, Adopter, and Research. Conclusion: The findings provide directions for future training, education, and managerial policy to achieve successful evidence based nursing practice.

Effects of Case-Based Learning on Clinical Decision Making and Nursing Performance in Undergraduate Nursing Students (사례기반학습이 간호대학생의 임상 의사결정 능력과 간호수행 능력에 미치는 효과)

  • Jeong, Mi-Eun;Park, Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.3
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    • pp.308-317
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    • 2015
  • Purpose: The aim of this study was to examine the effects of case-based learning (CBL) on clinical decision making and nursing performance. Methods: This research was conducted between September, 2011 and January, 2012 as a nonequivalent comparison group design. The participants were 55 third year nursing students who were enrolled in a college of nursing in a university in Korea. The intervention was the CBL procedures which involved role-play practice videoed by camera and watched on the computer by the students. Questionnaires were used before and after the intervention to measure clinical decision-making. Nursing performance tests were done after the intervention. Results: Statistically significant group differences were observed in clinical decision-making. Nursing performance was significantly higher in the CBL group than in the control group. Conclusion: CBL focused on the solving problem process and clinical cases which are based on clinical setting allowing students to develop efficiency in clinical practice and adaptation to the clinical situation.

Influence of teamwork skill and decision making competency on nursing work performance (간호사의 팀워크스킬과 의사결정역량이 간호업무성과에 미치는 영향)

  • Mun, Mi Yeong;Kim, Mi Yeon
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1361-1373
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    • 2016
  • This study was undertaken to investigate the influence of teamwork skill and decision making competency on nursing work performance. A total of 170 nurses more than one years working experience were recruited from two university hospitals. Data were collected during March, 16 to 25, 2016 using a structured self-report questionnaires. Data were analyzed using the IBM SPSS/WIN 21.0 program. Teamwork skill and decision making competency for nursing work performance showed significant positive correlation. The significant predictors of nursing work performance among nurses were total clinical experience (${\beta}=.23$, p<.001), teamwork skill (${\beta}=.61$, p<.001) and decision making competency (${\beta}=.13$, p=.015). These variables explained 66% of the variance in nursing work performance among nurses. The results indicate that nurses' teamwork skill and decision making competency are factors positively influencing on nursing work performance.

The Influence of Moral Behavior, Moral Anguish, and Critical Thinking Tendency on Clinical Decision-making Ability in Nurse (간호사의 도덕적 행동, 도덕적 고뇌, 비판적 사고성향이 임상적 의사결정능력에 미치는 영향)

  • Je, Nam-Joo
    • Journal of Digital Convergence
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    • v.19 no.2
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    • pp.275-288
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    • 2021
  • This study was attemted to grasp the factors affecting the clinical decision-making ability of nurse. Data were collected from 156 nurse working in hospital in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. The most influential factor on the subjects' clinical decision-making ability was nursing Research 'very interest', critical thinking tendency, 'master/doctor', clinical experience 'more than 20 years and 1 month', moral behavior, nursing research 'important', 'single', clinical work experience '5 years, 1 month-10 years', department work experience '3 years 1 month-5 years'. The explanatory power was 51.4%. It was significant in that it was confirmed that interest and importance, moral behavior, academic background, and career are variables that influence clinical decision-making ability. The results of this study can be utilized as basic data for the development of intervention plans and programs that can increase clinical decision-making ability in the context of an ethical dilemma. In addition, developing and verifying educational programs that can increase clinical decision-making abilities in ethical dilemmas is needed.

Experience of Decision Making about Selective Fetal Reduction among Women Who Conceived through Assisted Reproductive Techniques (보조생식술을 받은 여성의 선택적 태아감소술에 대한 의사결정 경험)

  • Jang, HyeYoung;Chung, ChaeWeon
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.44-55
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    • 2018
  • Purpose: This study aimed to explore and understand the experience of decision making among women undergoing or forgoing selective fetal reduction who have higher-order multiple pregnancies through assisted reproductive techniques. Methods: A qualitative study was conducted from August 1, to October 30, 2013. Eight participants were interviewed and the interviews were audio-recorded and transcribed verbatim. Six persons participated in in-depth interviews in person and two participated over the telephone. A thematic analysis was conducted. Results: Four themes were identified and carefully named: Confusion after higher-order multiple pregnancy; Obstacles to choice: Uncertain safety; Weighing between reality and ideality and; Influences of medical professionals. Conclusion: The results demonstrated a wide range of factors considered by women when making decisions about selective fetal reduction, and mothers' feelings of conflict and distress in the decision-making process. The results suggest that it is important for nurses to provide emotional support and consolation, in addition to sufficient information. These findings will help nurses improve their counseling techniques by understanding the situation of infertile couples.