J Korean Acad Nurs.  2010 Dec;40(6):892-902. 10.4040/jkan.2010.40.6.892.

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

• Kim SY

• KMID: 999491
• DOI: http://doi.org/10.4040/jkan.2010.40.6.892

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.

Keyword

Home healthcare nurse; Decision making; Participation; Competency; Clinical practice guideline

MeSH Terms

Adult
Caregivers/psychology
Community Health Nursing
Home Care Services
*Home Nursing
Humans
Logistic Models
Middle Aged
*Nursing Diagnosis
Odds Ratio
Questionnaires

Figure

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  Figure 1 Conceptual framework.

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