Effect of Referential Level of Hospitals on the Model of Decision Making in Nursing

Abstract

Introduction. A review of nursing literature in Poland confirms that studies concerning decision making by nurses are scarce. Knowledge pertaining to decision making is of great importance in the preparation of future nurses for an independent and effective making of clinical decisions.

The objective of the presented study was identification of the models of decision making applied by charge nurses, and the investigation of the relationship between the referential level of the hospital and the model of decision making applied.

Material and method. The research instrument was the Finnish 56-item questionnaire form examining decision making by nurses. This questionnaire was translated and adjusted to Polish conditions, and its psychometric properties were confirmed concerning validity and reliability. The study covered a group of 1631 charge nurses employed in 280 surgical and conservative treatment wards, and intensive care units in 45 hospitals of three referential levels in the Regions of Lublin, Warsaw, and Krakow.

Results. Analysis of the data shows that nurses employed in hospitals of various referential levels apply four models of decision making: analytical, intuitive, analyticalintuitive, and intuitive-analytical. A statistically significant relationship was observed between the model of decision making and the referential level of hospital. The analyticalintuitive model was dominant in the hospitals in the study. The intuitive model was most frequently applied by nurses employed in hospitals of the third referential level, while the analytical model was most often used in hospitals of the third and second referential level.

Conclusions. Nurses employed in hospitals of various referential levels apply both analytical and intuitive models of decision making. The referential level of hospital is among the factors differentiating the decision making models.