Investigation On Ability Of Clinical Decision-making And Its Influencing Factors For Junior Nurses In The General Hospitals In Shanghai City

Objective:To understand the status and influence factor of the clinical decision making ability of Junior nurses, To provide reference for nurse manager and educator find the best training method improving clinical decision making ability, to provide reference for targeted continuing education.Methods:This study mainly includes two parts. The first part: qualitative interview. purposive sample of 14 junior nurses who have graduated and working in hospital(≤3) were interviewed by in-depth interview, With phenomenological analysis, we extracted the relevant factor of clinical decision making ability in junior nurses; The second part: cross-sectional study. a convenience sample of 633 junior nurses were investigated in the general hospitals at the level of grade 2 in Shanghai City, establish Study variables and measure instrument, including the dependent variable :the status of clinical decision making ability(clinical decision making inventory); Predictor variables : demographic questionnaire,working environment(PES)、clinical decision realization(CDMNS)、Critical Thinking Disposition Inventory(CCTDI) Chinese version. With the descriptive statistics, single factor analysis, correlation analysis and multiple regression analysis, analyzed the status and influence factors of clinical decision making ability in junior nurses.Results:(1)the status of clinical decision making in junior nurses. The overall mean score of clinical decision making ability was(78.51±10.49), the split of each dimension as follows:the ability of finding problems(22.27±3.84)、Targeting capacity(8.50±1.67)、Decisions program capacity(26.65±5.25) Embodiments capacity(14.27±2.37)and Evaluation feedback capability(6.77±1.29);(2)the influencing factors of clinical decision making ability in junior nurses. Single factor analysis showed: there were significantly differences in working time、department、hospital level、professional ranks、degree、marital status、 employment types、salary、academic activities、relationship between nurses and patients、whether do nursing work、departments case reviews; Correlation analysis showed: there was a significantly positive correlation between clinical decision making ability and decision realization、working environment、Critical Thinking(P<0.05); Multiple regression analysis showed: the influence factors of clinical decision making including Critical Thinking、professional ranks、employment types、salary、departments case reviews, 5 factors can explain 23.1%.Conclusion:junior nurse‘s clinical decision making ability remains to be improved, the scoring rate of decision—programme ability Dimension Wag the highest and that of decision —implement ability dimension the lowest. the influence factors of clinical decision making including Critical Thinking、professional ranks、employment types、salary、departments case reviews. nursing administrators and educators should focus on different features of junior nurses, intervent the controllable factors, make up for the training gap, Teaching communication skills, enhanced nursing clinical decision-making ability, improve the quality of nursing service.