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

Journal of Korean Academy of Nursing 2010³â 40±Ç 6È£ p.892 ~ 902
KMID : 0806120100400060892
±è¼¼¿µ ( Kim Se-Young ) - À»Áö´ëÇб³ °£È£´ëÇÐ

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.

Conslusion: 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.
KeyWords

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