BJHMR 12476
BJHMR 12476
BJHMR 12476
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
29. I am often prevented from carrying out
my decisions about patient care because 12 (40%) 18 (60%) 3.17 .791
nursing staff on the unit tell me to do
something different.
33. My knowledge of the nursing process
(assessment, intervention, and 9 (30%) 21 (70%) 2.90 1.125
evaluation) does not really influence my
decision making regarding patient care.
34. I feel confident about making decisions 25 (83.3%) 5 (16.7%) 4.07 .907
regarding patient care.
36. I make decisions about patient care that 16 (53.3%) 14 (46.7%) 3.43 .858
count.
The instrumentation of the results involves the integral study of assessing the decision- making
capability of nursing interns. Out of 103 expected responses, 30 active responses on the intern
nurses are collected for the survey. This makes the response rate 60%. The sample size for the
two-tailed test shows that the significant characteristic between the dimensions and effect size
is 0.5. These results show that the study was appropriate in producing the nominal size effect
and the exponential power of statistical analysis, which was sufficient for the correlations and
differences. The majority of the participants perceived that they are confident that the clinical
decision-making is inclined towards a practical approach and understanding its impact on the
quality service of healthcare service. The majority of the dimensions were related to Healthcare
Administration; this can help achieve the direct and indirect impact of the skills possessed by
the individual nursing student.
Table 4 Percentage distribution and means of study sample according their perception of
Cognitive ability
Items SA A S D SD Mean Std.
My use of intuition or 'gut feeling' 18 (60%) 12 (40%) 3.66 .857
results in my best decisions about
patient care.
The theory related to problem 20 (66.7%) 10 (33.3%) 3.73 .868
solving and decision making that I
learned in the nursing program
influences me as I make decisions
about
patient care.
Table 5 Percentage distribution and means of study sample according their perception of
Experience
Items SA A S D SD Mean Std.
Students with previous 24 (80%) 6(20%) 4.03 .850
health related work
experience make better
decisions about patient care
than those who don't have
this
experience
My clinical nursing 12 (40%0 18 (60%) 3.13 1.196
experiences thus far have
not assisted me in
developing decision-
making skills.
. In my latest clinical 11 (36.7%) 19 ( 63.3%) 3.18 .945
rotation, the nursing staff
on the unit encouraged
students to make decisions
regarding
patient care.
The best predictor of 19 (63.3%0 11 (36.7%0 3.63 .928
"sound" decision making is
clinical nursing experience.
My previous life 20 ( 66.7) 10 (33.3%) 3.80 .761
experiences have
strengthened my ability
to make sound decisions
about patient care.
The clinical instructor in 21 (70%) 9 (30%) 3.67 .922
my most recent clinical
experience was a positive
role-model in decision-
making
regarding patient care.
The clinical instructor in 13 (43.3%) 17 (56.7%) 3.13 1.074
my most recent clinical
experience undermined
(did not support) the
decisions I made
regarding patient care
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
Table 6 Percentage distribution and means of study sample according their perception of
Management
Items SA A S D SD Mean Std.
The experience of 4 (13.3%) 26 (86.7%) 2.57 .898
developing and writing out
nursing care plans does not
influence my
ability to make decisions
about patient care.
The fact that I am evaluated 24 (80%) 6(20%) 3.93 .604
in the clinical setting
influences the
decisions I make about
patient care.
The fact that I am evaluated 22 (73.3%) 8 (26.7%) 3.33 1.061
in the clinical setting
influences the decisions I
make about
patient care.
The participants perceived those eight essential clinical learning elements describe the
rationale of nurses learning the functional assessments, documenting care, and listing the skills.
A similar study was conducted emphasizing the gender factor proposed that the females are
most likely to be confident, compared to the males. This shows the clinical decision making in
females is more likely to be perceived by females than males. Based on the extended survey, it
is evident that the self-efficacy and the importance of the nursing interns were grouped
according to the graduated age group, gender, training hospital, and length of internship period
(A. Aboshaiqah & Qasim, 2018). This is a primary study that caters all the reliability, testing,
and correlation coefficient that is similar to our study is many aspects. Also, the instruments
presented in the research questionnaire are similar to the framework presented in our study.
Table 7 Percentage distribution of study sample according their perception of Clinical quality
Items SA A S D SD Mean Std.
When I am caring for a 24 (80%) 6 (20%) 4.10 0.712
patient. I feel I am
responsible for making the
decisions about their care.
Table 8 Percentage distribution of study sample according their perception of Instructions
Items SA A S D SD Mean Std.
I consider what my instructor say when I think 15 (50%) 15(50%) 3.33 .994
about possible choices 1 would could make in
patient care
The first part of the study deals with translating cultural adaption, validation, and data
reliability that leads to effective decision making among nursing students. Besides, the study
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
Table 10 Percentage distribution and means of study sample according their perception of
Stress
Items SA A S D SD Mean Std.
The stress I feel in the 19 (63.3%) 11 (36.7%) 3.77 1.073
clinical setting, affects my
ability to make
sound decisions about
patient care.
I find that my clinical 19 (63.3%) 11 (36.7%) 3.73 .980
experience is stressful.
Experience as a dimension is employed as an essential factor in decision-making among nurse
interns. Research by Nibbelink & Brewer (2018) shows that the experienced decision- making
use the classical approach in real-life circumstances. Comparative to the decision- making
patterns, experience as a dimension is based on critical factors, such as uncontrolled, time-
limited, and high-stress circumstances. Table 5 represents the Percentage distribution and
means of the study sample according to their perception of Experience. The study findings
represented that ranking of highest mean was given to: “Students with previous health-related
work experience make better decisions about patient care than those who do not have this
experience” with 4.03 ±0.850. Second is the “my previous life experiences have strengthened
my ability to make sound decisions about patient care” 3.80 ± 0.761. The third is the “the clinical
instructor in my most recent clinical experience was a positive role-model in decision-making
regarding patient care” with 3.67 ±0.922. While the lowest mean was given to: “the best
predictor of "sound" decision making is clinical nursing experience” has 3.63 ±0.928. The
second lowest is “in my latest clinical rotation, the nursing staff on the unit encouraged students
to make decisions regarding patient care” with 3.18 ±0.954. Lastly, “the clinical instructor in
my most recent clinical experience undermined (did not support) the decisions I made
regarding patient care” with 3.13 ±1.07.
Table 11. Percentage distribution of participants according to their perception DM
Items SA A S D SD Mean Std.
Modelling as dimension 270 (45.45%) 210 (48.6%) 3.52 0.688
Cognitive ability as a 90 (15.15%) 30(6.9%) 3.70 0.446
dimension
Experience as a 120(20.20%) 90 (20.8%) 3.51 0.612
dimension
Management as 50 (8.4%) 40 (9.25%) 3.28 0.574
dimension
Clinical quality as 24 (4.04%) 6 (1.39%) 4.10 0.712
dimension
Instructions as a 15 (2.52%) 15 (3.47%) 3.33 .994
dimension
Stress as dimension 38(6.39%) 22 (5.1%)
Social skills as dimension 11 (1.85%) 19 (4.39%) 3.57 0.774
total 594 432 3.13 0.601
Services for Science and Education – United Kingdom 10
Alharbi, M., AlQurashi, N. & Yehia, H. (2022). The Perception of Decision-Making During Patient Care Among Nurse Interns at Umm Al Qura
University. British Journal of Healthcare and Medical Research, 9(4). 1-16.
Nursing management comprises a major portion of the healthcare sector. It is a practice that
advances various evidence-based practices and technology. Although there are several
challenging factors that contribute to the demographic dynamics, a study from Nageshwar et
al. (2016) indicates a similar framework related to the post-operative framework among the
nursing staff. Compared to other results, as indicated in Table 6, it represents that percentage
distribution and means of study sample according to their perception of Management, the study
findings represented the ranking of means as: “the fact that I am evaluated in the clinical setting
influences the decisions I make about patient care is found” to have a mean of 3.93 ± 0.604.
Secondly, “the fact that I am evaluated in the clinical setting influences the decisions I make
about patient care” has 3.33 ± 1.06. Lastly, “the experience of developing and writing out
nursing care plans does not influence my ability to make decisions about patient care” has 2.57
± 0.898.
Table 12. Difference in DM according to gender
Items Female male
Z P
Mean Sum of Mean rank Sum of
rank Ranks Ranks
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
Perception of clinical quality is a fundamental factor that indicates that the percentage
distribution is indicated in Table 7 and mean of study sample according to their perception
Clinical quality, the study findings represented that (80%) of the study sample were strongly
agreed and agree about "When I am caring for a patient. I feel I am responsible for making the
decisions about their care" by 4.10 ± 0.712. Table 8 represents the Percentage distribution and
mean of the study sample according to their perception of Instructions. The study findings
represented that (50%) of the study sample were strongly agree and agree about " I consider
what my instructor say when I think about possible choices 1 would make in patient care " by
(3.33 ± 0.994). Also, Table 9 represents the percentage distribution and mean of study sample
according to their perception of social skills; the study findings represented that (63.3 %) of the
study sample were strongly agree and agree about " My relationship with the clinical instructor
in my most recent clinical experience negatively affected my attempts at decision making about
patient care " by (3.57 ± 0.774). Table 10 shows represent the percentage distribution and
mean of the study sample according to their perception of Stress. The study findings
represented that (63.3 %) of the study sample were strongly agreed and agree about “The
stress I feel in the clinical setting affects my ability to make sound decisions about patient care".
Furthermore, "I find that my clinical experience is stressful" by (3.57 ± 0.774).
Table 13. Percentage distribution of Choose 3 that influence you the LEAST and rank them
Items Most Moderate Mild Sometime least
influential
n % n % n % n % n %
1 my previous life experience 21 (70%) 9 (30%)
2 my previous nursing 23 (76.7%) 7(23.3%)
experience
3 the environment on the unit 23 (76.7%) 7(23.3%)
4 hospital policies 18 (60%) 12 (40%)
5 the attitude of the staff 23 (76.7%) 7 (23.3%)
6 my knowledge of the nursing 19 (63.3%) 11 (36.7%)
process
7 my relationship with the 19 (63.3%) 11 (36.7%)
instructor
8 my status as a student 15 (50%) 15 (50%)
9 the consequences of my 19 (63.3%) 11 (36.7%)
decision
10 my knowledge of patients and 24 (80%) 6 (20%)
their condition
11 my 'gut' feelings about the 19 (63.3%) 11 (36.7%)
situation (instincts)
12 my level of self confidence 21 (70%) 9 (30%)
13 my observations of other staff 20 (66.7%) 10 (33.3%)
members
14 the knowledge that I was being 18 (60%) 12 (40%0
evaluated
15 the time constraints I had to 17 (56.7%) 13.(43.3%)
work within
16 fatigue 15 (50%) 15 (50%)
Services for Science and Education – United Kingdom 12
Alharbi, M., AlQurashi, N. & Yehia, H. (2022). The Perception of Decision-Making During Patient Care Among Nurse Interns at Umm Al Qura
University. British Journal of Healthcare and Medical Research, 9(4). 1-16.
Items Most Moderate Mild Sometime least
influential
n % n % n % n % N %
1 my previous life experience 3 (10%) 14 (46.7%) 13
(43.3%)
2 my previous nursing experience 5 10 (33.3%) 15
(16.7%) (50%)
3 the environment on the unit 4 16 (53.3%) 10(33.3
(13.3%) %)
4 hospital policies 2 (6.7%) 16 (53.3%) 12
(40%)
5 the attitude of the staff 4 10 (33.3%) 16
(13.3%) ( 53.3%
6 my knowledge of the nursing 1(3.3%) 18 (60%) 11
process (36.7%)
7 my relationship with the 5 18 (60%) 7
instructor (16.7%) (23.33%
)
8 my status as a student 9 (30%) 11 10
(36.7%0 (33.3%)
9 the consequences of my 3 (10%) 19 (63.3%) 8
decision (26.7%0
10 my knowledge of patients and 7 12 (40%) 11
their condition (23.33% (36.7%)
)
11 my 'gut' feelings about the 6 (20%) 15 (50%) 9 (30%)
situation (instincts)
12 my level of self confidence 30(10%) 12 (40 %) 15
(50%)
13 my observations of other staff 4 17 (56.7%) 9 (30%)
members (13.3%)
14 the knowledge that I was being 4 14 (46.7%) 12
evaluated (13.3%) (40%0
15 the time constraints I had to 2 18 (60%) 10(33.3
work within (607%) %)
16 fatigue 2 (6.7%) 12 (40%) 16
(53.3%)
DISCUSSION
A study on the perception by Ibrahim & Aly (2018) indicates the cognitive ability and
prevalence of intellectual skills on the decision-making capability. The research indicates that
the preceptors and educational training of the nurses tends to affect the cognitive ability in
decision-making. Comparing the percentage distribution and the study sample according to the
perception, it was found that 93.3% of the mean is related to the “I best problem to make a
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
decision is to analyze all information available to me and before forming conclusion”. However,
dimension, such as intuition of decision-making about patient care narrows –down to the
53.5% of strong disagreement among the nurse interns. Perception about the distribution of
study according to the interns’ experience is well-explained by A. E. Aboshaiqah et al. (2018),
which indicates that the development of self-confidence and the utilization of rationale is found
to effective in decision-making. The research work has proved that experience includes the
negative and positive factors that lead to appropriate decision-making. For instance, the
utilization of confidence-oriented communication and decision-making plays a critical role in
nursing practices. This leads to protocols that are essential for patient care and influences their
nursing practices' capability. Upon comparing the research results, it is proved that 80% of the
interns strongly agree of that student with previous health related work experience make
better decisions about patient care than those who don't have this experience. In contrast,
63.3% interns strongly disagree that in their latest clinical rotation, the nursing staff on the unit
encouraged students to decide patient care.
Nursing interns’ perception of the management practices is research by Abdel Kader,
Mohamed, & Abood (2012). It is evident from their findings that management practices and
their related education play a critical role in effective decision making. Besides improving the
situational awareness among professionals, it is helpful to cater to the patient’s management
and influence the effective interventions of dealing with emergencies and supporting abilities
that increases self-confidence. In our study, it is evident that 86.7% of interns strongly disagree
with the fact that the experience of developing and writing out nursing care plans does not
influence my ability to make decisions about patient care; however, 72.3% indicate that the fact
that I am evaluated in the clinical setting influences the decisions I make about patient care.
Since all this affect the percentage distribution of clinical quality is defined by all the above
factors; therefore, 80% of the interns believe that when they are caring for a patient, they feel
they are responsible for making the decisions about their care.
To date, the most comprehensive argument on the supplementary class of residency program
is influenced by direct instructions in promoting graduate critical thinking (Mousa, Menssey, &
Kamel, 2017). The critical analysis of the percentage distribution of the study sample in
accordance to the perception of instructions indicates that 50% of the interns strongly agree
and 50% strongly disagree with the fact that we consider what my instructor say when we think
about possible choices, we will make in patient care. Besides, the percentage of sample
perception of social skills strongly agrees with the 63.3% of the relationship with the clinical
instructions in recent clinical experiences negatively affect the attempt at decision making
about patient care. This shows that focusing on professional growth requires instructions and
both social skills. Perceptions of the stress related to decision-making in nursing interns are
assessed by the study (Sperling, 2020). This indicates that the preceptors that intern's guidance
and evaluation is necessary during the increased stress. This can either be related to interns
lacking skills and clinical knowledge, leading to subtle skills. Comparing to our research, the
percentage distribution according to the perception of stress indicates that there is a 63.3%
strong agreement and 36.7% strong disagreement for both the stress that interns feel in the
clinical setting, as it affects the ability to make sound decisions about patient care, and they find
that clinical experience is stressful, respectively.
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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 4, August - 2022
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