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Effects of critical thinking and nursing practice environment on clinical decision making among nurses

비판적 사고와 간호근무환경이 간호사의 임상적 의사결정에 미치는 영향

  • Received : 2018.11.27
  • Accepted : 2019.02.20
  • Published : 2019.02.28

Abstract

This study was a cross-sectional study done to determine the relevance and impact factors of critical thinking and nursing practice environment on clinical decision making among nurses. A survey was conducted for April 2017 with self-report questionnaire. Participants were 261 registered nurses working in one tertiary hospital. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis with SPSS/WIN(21.0). Factors affecting clinical decision making included age, educational background, position, work shift, clinical career. Clinical decision making had a positive correlation with critical thinking and nursing practice environment. And position, critical thinking and nursing practice environment accounted for 35.8% of the variance in clinical decision making. Therefore, quality management for developing nursing professionalism and administrative support for effective staffing and resource adequacy in addition improving critical thinking increase nurses'clinical decision making.

본 연구는 간호사의 비판적 사고 및 간호근무환경과 임상적 의사결정의 관련성을 확인하고 임상적 의사결정에 미치는 관련요인을 확인하기 위한 서술적 조사연구이다. 대상자는 서울시내 일개 상급 종합병원에서 근무하는 간호사 261명으로 자가보고식 설문지를 이용하여 자료수집 하였다. 자료분석은 SPSS 21.0 프로그램으로 기술적 통계, independent t-test, one-way ANOVA, Pearson's correlation coefficients, 위계적 회귀분석을 시행하였다. 임상적 의사결정은 연령, 학력, 직위, 교대근무, 임상경력에 따라 통계적으로 유의한 차이를 보였다. 임상적 의사결정은 비판적 사고 및 간호근무환경과 정의 상관 관계를 보였다. 임상적 의사결정에 대해 영향을 미치는 요인은 직위, 비판적 사고 중 임상적 의사결정, 간호근무환경 중 양질의 간호를 위한 기반 및 인적 물적 자원의 적절성으로 이를 통해 임상적 의사결정의 35.8%를 설명하였다. 그러므로 비판적 사고 향상과 더불어 간호의 전문성 향상을 위한 질 관리, 효과적 인적 물적 자원 관리를 위한 행정지원은 간호사의 임상적 의사결정능력을 향상시킨다.

Keywords

Table 1. General Characteristics of Participants

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Table 2. Mean Scores for Nursing Practice Environment, Critical-Thinking Competencies and Clinical Decision Making

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Table 3. Differences in Critical-Thinking Competencies, Nursing Practice Environment and Clinical decision making according to General Characteristics

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Table 4. Correlations of Critical-Thinking Competencies, Nursing Practice Environment and Clinical decision making

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Table 5. Influencing Factors on Clinical decision making

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