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Impacts of Critical Thinking Disposition and Nursing Work Environment on Nurses' Clinical Decision Making Abilities

간호사의 비판적 사고성향과 간호업무환경이 임상적 의사결정 능력에 미치는 영향

  • Received : 2016.04.05
  • Accepted : 2016.07.16
  • Published : 2016.08.31

Abstract

Purpose: The purpose of this study was to explore the relationships of critical thinking disposition (CT), nursing work environment (NWE), and clinical decision making ability among nurses. Methods: A cross-sectional, descriptive study design was conducted on 192 nurses who had worked for more than six months in five general hospitals. A self-reported questionnaire was used to collect data, which included demographics, CT, NWE, and clinical decision making ability. Results: The mean score of CT was 3.5. The highest score was on the objectivity of CT and the lowest on systematicity. The mean score of NWE was 2.3. The highest score was on the collegial nurse-physician relations of NWE and the lowest on the staffing and resource adequacy. The mean score of clinical decision making ability was 3.3. In hierarchical multiple regression, affecting factors on clinical decision making ability were CT and NWE. Conclusion: The findings showed that clinical decision making ability is associated with CT and NWE. To improve clinical decision making ability, it is important to improve CT. In addition, it should be considered to improve NWE where the nurses can make a decision with their job through critical thinking.

Keywords

References

  1. Aiken, L. H., Clarke, S. P., Sloane, D. M., & Cheney, T. (2008). Effects of hospital care enviroment on patient mortality and nurse outcome. Journal of Nursing Adminstration, 38, 223-229. https://doi.org/10.1097/01.NNA.0000312773.42352.d7
  2. Cho, E., Choi, M., Kim, E., Yoo, I. Y., & Lee, N. (2011). Construct validity and reliability of the Korean version of the practice environment scale of nursing work index for Korean nurses. Journal of Korean Academy of Nursing, 41(3), 324-325.
  3. Choi, H. (2004). The effects of PBL (Problem-Based Learning) on the metacognition, critical thinking, and problem solving process of nursing students. Journal of Korean Academy of Nursing, 34(5), 712-721. https://doi.org/10.4040/jkan.2004.34.5.712
  4. Choi, H. R., & Cho, D. S. (2011). Influence of nurses' performance with critical thinking and problem solving process. Korean Journal of Women Health Nursing, 17(3), 265-274. https://doi.org/10.4069/kjwhn.2011.17.3.265
  5. Clark, R. (1996). Clinical decision making by beginning nurses. Unpublish doctoral dissertation, Virginia University, Charlottesville.
  6. Facione, P. A., & Giancarlo, C. (2001). A look across four years at the disposition toward critical thinking among undergraduate students. Journal of General Education, 50(10), 29-54. https://doi.org/10.1353/jge.2001.0004
  7. Gillespie, M. (2010). Using the situated clinical decision-making framework to guide analysis of nurses' clinical decision-making. Nurse Education in Practice, 10, 333-340. https://doi.org/10.1016/j.nepr.2010.02.003
  8. Girot, E. A. (2000). Graduate nurses: Critical thinkers or better decision makers? Journal of Advance Nursing, 31(2), 288-297. https://doi.org/10.1046/j.1365-2648.2000.01298.x
  9. Greeley, H., (2010). Is the relationship between your hospital and your medical staff sustainable? Journal of Healthcare Management, 55, 158-173. https://doi.org/10.1097/00115514-201005000-00005
  10. Her, H. J. (2014). Comparison of clinical decision making ability, role conflict and job satisfaction in emergency room nurses and general ward nurses, Unpublished master's thesis, The Catholic University of Daegu. Daegu.
  11. Jenkins, H. M. (1985). A research tool for measuring perceptions of clinical decision making consistency. Research in Nursing and Health, 13, 189-197.
  12. Kang, K., Kim, E., & Ryu, S. (2011). Factors influencing clinical competence for general hospital nurses. The Journal of the Korea Contents Association, 11(1), 284-293. https://doi.org/10.5392/JKCA.2011.11.1.284
  13. Kang, S., & Seo, Y. (2004). Determinants of organizational creativity at nursing care units of university hospitals in Korea. Korean Journal of Hospital Management, 9(4), 1-20.
  14. Kim, I. (2013). Decision making influence factors of nurses, Unpublished master's thesis, Kyung Hee University, Seoul.
  15. Kim, M., Bae, S., & Seo, B. (2014). The effect of human resource management and the individual's needs for achievement on the organizational commitment of women employees in general hospital: Moderating effect of job satisfaction. Korean Journal of Business Administration, 27(2), 311-325.
  16. Kim, S. S., Chae, G. S., Kim, K. N., Park, K. O., & Seong, S. M. (2010). Survey on nursing care delivery systems of university affiliated hospitals in Korea. Journal of Korean Clinical Nursing Research, 16(1), 167-175.
  17. Kwon, J., & Kim, E. (2012). Impact of unit-level nurse practice environment on nurse turnover intention in the small and medium sized hospitals. Journal of Korean Nursing Administration, 18(4), 414-423. https://doi.org/10.11111/jkana.2012.18.4.414
  18. Kwon, M. (2011). The influence of self-directed learning & critical thinking disposition on clinical competence in nursing students. The Journal of Korean Academic Society of Nursing Education, 17(3), 387-394. https://doi.org/10.5977/JKASNE.2011.17.3.387
  19. Lake, E. T. (2002). Development of the practice environment scale of the nursing work index. Research in Nursing and Health, 25, 176-188. https://doi.org/10.1002/nur.10032
  20. Lake, E. T., & Friese, C. R. (2006). Variations in nursing practice environments: Relation to staffing and hospital characteristics. Nursing Research, 55(1), 1-9. https://doi.org/10.1097/00006199-200601000-00001
  21. Lee, Y., Gang, M., & Jung, M. S. (2013). Impact of professional autonomy and nursing work environment on clinical decision making of clinical nurses. Korean Journal of Occupational Health Nursing, 22(4), 285-294. https://doi.org/10.5807/kjohn.2013.22.4.285
  22. Lee, J. Y., & Park, S. Y. (2014). Relationship between the practice environment of nursing and critical thinking disposition of nurses in local general hospitals. Journal of Korean Nursing Administration, 20(2), 145-153. https://doi.org/10.11111/jkana.2014.20.2.145
  23. Martin, C. (2002). The theory of critical thinking of nursing. Nursing Education Perspectives, 23(5), 243-247.
  24. Park, J. A. (2012). Critical thinking disposition and clinical decision making of emergency nurses department of nursing, Unpublished master's thesis, Ajou University, Suwon.
  25. Park, S. M., & Kwon, I. G. (2007). Factors influencing nurses' clinical decision making-focusing on critical thinking disposition. Journal of Korean Academy of Nursing, 37(6), 863-871. https://doi.org/10.4040/jkan.2007.37.6.863
  26. Scheffer, B. K., & Rubenfeld, M. G. (2000). A consensus statement on critical thinking in nursing. Journal of Nursing Education, 39(8), 352-359.
  27. Sung, M., & Eum, O, B. (2010). Professional autonomy and clinical decision making ability in clinical nurses. Korean Journal of Fundamentals of Nursing, 17(2), 274-281.
  28. Yoo, K. H. (2012). Factors affecting a nurse's knowledge sharing behavior and clinical decision making in nursing scale, Unpublished master's thesis, Kyung Hee University, Seoul.
  29. Yoon, J. (2004). Development of an instrument for the measurement of critical thinking disposition: In nursing, Unpublished doctoral dissertation. The Catholic University of Korea, Seoul.
  30. Van Bogacrt, P., Clarke, S., Vermeyen, K., Meulemans, H., & Van de Heyning, P. (2009). Practice environments and their associations with nurse-report outcomes in Belgian hospitals: Development and preliminary validation of a Dutch adaptation of the Revised Nursing Work Index. International Journal of Nursing Studies, 46(1), 54-64.

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