Clinical Decision-Making Approaches Utilized by the Staff Nurses at Selected Hospitals in Aparri, Cagayan
DOI:
https://doi.org/10.5281/zenodo.21935152Keywords:
Nursing practice, Clinical decision-making, staff Nurses.Abstract
Clinical decision-making is the backbone of nursing practice, especially in dynamic environments. This study aimed to assess the clinical decision-making approaches utilized by nurse managers at a selected hospital in Aparri, Cagayan. This study utilized descriptive research design. The respondents of the study were the 70 staff nurses working in different areas of the selected hospitals using total enumeration sampling. The researcher used frequency and percentage distribution, range scores, and Chi-square test in analyzing the data. The findings of the study revealed that the majority of staff nurses were female professionals aged between 31 and 40 years, held bachelor's degrees, and possessed 4 to 6 years of clinical experience. Most were assigned to the morning shift, primarily worked in general ward settings, and were affiliated with public hospitals. Additionally, staff nurses employed an intuitive interpretive approach to clinical decision-making, relying on experiential knowledge, situational awareness, and clinical judgment, rather than structured, data-driven processes. Furthermore, statistical analysis indicated no significant differences in the decision-making approaches of staff nurses when they are grouped according to demographic and professional profile variables. This suggests that decision-making styles of staff nurses are consistent across diverse staff characteristics. It is recommended that hospital leaders should implement structured clinical decision-making frameworks and professional development programs to help staff nurses integrate data-driven insights.
Downloads
References
Abate, H. K., Birhanu, Y., & Gebrie, M. H. (2022). Clinical decision-making approaches and associated factors among nurses working in a tertiary teaching hospital. International Journal of Africa Nursing Sciences, 17, Article 100432. https://doi.org/10.1016/j.ijans.2022.100432
Abe, A., Kobayashi, M., Kohno, T., Yomiya, K., Sekimoto, M., & Miyashita, M. (2021). Patient participation and associated factors in the discussions on do-not-attempt-resuscitation and end-of-life disclosure: A retrospective chart review study. BMC Palliative Care, 20(1), Article 6. https://doi.org/10.1186/s12904-020-00698-8
Abu Arra, A. Y., Ayed, A., & Batran, A. (2023). The factors influencing nurses’ clinical decision-making in emergency department. SAGE Open, 13(1). https://doi.org/10.1177/00469580231152080
Akbaba, A., & Ozbicakci, S. (2021). Innovative approaches in nursing clinical education in Turkey: Scoping. Journal of Education and Research in Nursing, 18(4), 432–440. https://doi.org/10.5152/jern.2021.01488
Alameddine, M., Hammoud, S., & El-Jardali, F. (2023). Predictors of clinical decision-making models among registered nurses in busy hospital environments: A cross-sectional analysis. BMC Nursing, 22(1), Article 114. https://doi.org/10.1186/s12912-023-01281-x
Alasad, J., Abu Tabar, N., & Ahmad, M. (2020). Patients’ experience of being in intensive care units. Journal of Critical Care, 30(4), 859. https://doi.org/10.1016/j.jcrc.2015.03.021
Albashayreh, A. E. I. (2022). Evaluating patient-centered outcomes in palliative care and advanced illness using natural language processing and big data analytics (Publication No. 29319983) [Doctoral dissertation, The University of Iowa]. ProQuest Dissertations & Theses Global.
Albashayreh, A., Herr, K., Fan, W., Street, W. N., & Gilbertson-White, S. (2024). Harnessing natural language processing and high-dimensional clinical notes to detect goals-of-care and surrogate-designation conversations. Clinical Nursing Research, 33(8), 650–662. https://doi.org/10.1177/10547738241292657
Al-shomrani, A. Z., Hamouda, G. M., & Abdullah, N. (2024). The relationship between psychological empowerment and clinical decision-making among staff nurses in governmental hospital in Al-Baha, Saudi Arabia. Cureus, 16(3), Article e56871. https://doi.org/10.7759/cureus.56871
Arash, A., Mahmoodi-Shan, G., Mehravar, F., Sabzi, Z., & Mancheri, H. (2024). Clinical decision making and moral distress among hospital staff nurses: The role of experience and intuition. BMC Psychology, 12(1), Article 542. https://doi.org/10.1186/s40359-024-02197-4
Arends, S. A. M., Thodé, M., De Veer, A. J. E., Pasman, H. R. W., Francke, A. L., & Jongerden, I. P. (2022). Nurses' perspective on their involvement in decision-making about life-prolonging treatments: A quantitative survey study. Journal of Advanced Nursing, 78(9), 2884–2893. https://doi.org/10.1111/jan.15223
Arkan, B., Yılmaz, D., Gökdere Çinar, H., & Uzun, R. (2022). Clinical decision-making levels of nursing students and affecting factors. Cyprus Journal of Medical Sciences, 7(6), 738–744. https://doi.org/10.4274/cjms.2021.2857
Ashana, D. C., D’Arcangelo, N., Gazarian, P. K., Gupta, A., Perez, S., Reich, A. J., Tjia, J., Halpern, S. D., Weissman, J. S., & Ladin, K. (2022). “Don’t talk to them about goals of care”: Understanding disparities in advance care planning. The Journals of Gerontology: Series A, 77(2), 339–346. https://doi.org/10.1093/gerona/glab091
Bjørk, I. T., & Hamilton, G. A. (2011). Clinical decision making of nurses working in hospital settings. Nursing Research and Practice, 2011, Article 524918. https://doi.org/10.1155/2011/524918
Brunt, B. A. (2023). Nursing professional development evidence-based practice. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589676/
Caetano, P. S. F., & Da Silva, M. R. (2024). Nurses' decision-making styles in hospital settings: Evaluating vigilant vs. hypervigilant approaches. Revista Brasileira de Enfermagem, 77(3), Article e20230412. https://doi.org/10.1590/0034-7167-2023-0412
Castillejos, J. Y., & Adolfo, C. S. (2021). Professional quality of life and workplace psychosocial support interventions among nurses in Northern Philippines. Philippine Journal of Nursing, 91(2), 45–58.
Chae, S., Song, J., Ojo, M., & Topaz, M. (2021). Identifying heart failure symptoms and poor self-management in home healthcare: A natural language processing study. Studies in Health Technology and Informatics, 284, 15–19. https://doi.org/10.3233/SHTI210653
Dijkman, E. M. (2026). Changes in nurse-patient communication through health technologies and nursing practices to recognize and support limited digital health literacy: Qualitative study. JMIR Nursing, 9(1), Article e82272.
Farčić, N., Barać, I., Lovrić, R., Pačarić, S., Gvozdanović, Z., & Ilakovac, V. (2020). The influence of self-concept on clinical decision-making in nurses and nursing students: A cross-sectional study. International Journal of Environmental Research and Public Health, 17(9), Article 3059. https://doi.org/10.3390/ijerph17093059
Ghods, A. A., & Sharifi, M. (2024). Analytical versus intuitive decision-making models among hospital nurses: The mediating roles of critical thinking and self-directed learning. Journal of Nursing Research and Clinical Practice, 12(2), 143–156. https://doi.org/10.1016/j.jnrp.2024.100143
Ghodsiastan, S., Masoudi, R., & Alavi, M. (2021). Assessment of clinical decision-making models and critical thinking dispositions among acute care nurses. Journal of Nursing and Midwifery Sciences, 8(3), 184–191. https://doi.org/10.4103/jnms.jnms_112_20
Giesen, J., Bakker-Jacobs, A., van Vught, A., Berings, M., Vermeulen, H., & Huisman-de Waal, G. (2024). What is needed for nurses to work with evidence-based practice? A qualitative study. Contemporary Nurse, 60(6), 659–672. https://doi.org/10.1080/10376178.2024.2369660
Hammond, K. R. (1981). Principles of organization in intuitive and analytical cognition (Report No. 231). University of Colorado, Center for Research on Judgment and Policy.
Jahanpour, F., Sharif, F., Salsali, M., Kaveh, M. H., & Williams, L. M. (2020). Clinical decision-making in senior nursing students in Iran. International Journal of Nursing Practice, 16(6), 595–602. https://doi.org/10.1111/j.1440-172X.2010.01886.x
Kim, S. A. (2025). Effectiveness of the research practice ability enhancement program on evidence-based practice competencies in clinical nurses: A non-randomized controlled trial. Healthcare, 13(18), Article 2273. https://doi.org/10.3390/healthcare13182273
Labrague, L. J., Arteche, D. L., Rosales, R. A., Santos, M. C. L., Calimbas, N. D. L., Yboa, B. C., Sabio, J. B., Quiña, C. R., Quiaño, L. Q., & Apacible, M. A. D. (2024). Development and psychometric testing of the Clinical Adjustment Scale for Student Nurses (CAS-SN): A scale for assessing student nurses' adaptation in clinical settings. Nurse Education Today, 124, Article 106350. https://doi.org/10.1016/j.nedt.2024.106350
Levy-Malmberg, R., Boman, E., Lehwaldt, D., Fagerström, L., & Lockwood, E. B. (2024). Clinical decision-making processes among graduate nurses, specialist nurses and nurse practitioners: A collaborative international study. International Nursing Review, 71(2), 224–231. https://doi.org/10.1111/inr.12951
Madayag, R. A., Bautista, E. C., Pineda, J. C., Geanga, A. S., Agustin, R. M., Roque, M. L., Apostol, R. P., & Ramirez, D. Q. (2024). Refining clinical judgment competence in nursing education in the Philippines: A mixed-methods study on the impact of case-based learning. Belitung Nursing Journal, 10(6), 680–694. https://doi.org/10.33546/bnj.3560
Masoudi, R., & Alavi, H. (2021). Nurses' clinical decision-making models in the care of older adults: A cross-sectional study. Journal of Nursing Research and Clinical Practice, 4(2), 112–120. https://doi.org/10.18502/jnrcp.v4i2.184248
Medel, D., Cemeli, T., Sanromà-Ortíz, M., Jimenez-Herrera, M., Bonet, A., Torné-Ruiz, A., & Roca, J. (2024). Exploring communicative interactions in debriefing sessions with nursing students: A qualitative study. Nurse Education Today, 142, Article 106334. https://doi.org/10.1016/j.nedt.2024.106334
Moradi, M., & Sharifi, F. (2022). Cognitive flexibility, self-efficacy, and clinical decision-making styles among hospital staff nurses: A descriptive study. Iranian Journal of Nursing and Midwifery Research, 27(4), 312–318. https://doi.org/10.4103/ijnmr.ijnmr_241_21
Morales, A. C. C. (2023). Charting the journey: A phenomenological study of novice nurses' early career transition into clinical practice in the Philippine context. Celebes Nursing Journal, 5(1), 12–25.
Mousavi Shabestari, M., Jabbarzadeh Tabrizi, F., Roshangar, F., Ghahramanian, A., Zamanzadeh, V., Sarbakhsh, P., & Agom, D. A. (2024). Nurses’ perception of uncertainty in clinical decision-making: A qualitative study. Heliyon, 10(17), Article e36228. https://doi.org/10.1016/j.heliyon.2024.e36228
Novalia, A., Rachmi, S. F., & Yetti, K. (2021). Clinical decision-making of bachelor and clinical internship (professional) nursing students in Indonesia. Journal of Public Health Research, 11(2), Article 2735. https://doi.org/10.4081/jphr.2021.2735
O'Connor, T., Gibson, J., & Lewis, J. (2023). Decision-making in nursing research and practice—Application of the Cognitive Continuum Theory: A meta-aggregative systematic review. Journal of Clinical Nursing, 32(19–20), 7012–7028. https://doi.org/10.1111/jocn.16893
Okkaoglu, Y., Welton, N. J., & Jones, H. E. (2024). Detecting departures from the conditional independence assumption in diagnostic latent class models: A simulation study. BMC Medical Research Methodology, 24(1), Article 299. https://doi.org/10.1186/s12874-024-02432-x
Recidoro, M. G., & Naval, C. F. (2023). Predictors of clinical reasoning and decision-making abilities among staff nurses in regional government hospitals. Journal of Philippine Health Review, 15(3), 112–124.
Sataloff, R. T., & Vontela, S. (2021). Response rates in survey research. Journal of Voice, 35(5), 683–684. https://doi.org/10.1016/j.jvoice.2020.12.043
Shehzad, M., & Farooq, Q. (2023). Barriers in clinical decision-making among staff nurses at tertiary care hospital: Barriers in clinical decision-making. NURSEARCHER (Journal of Nursing & Midwifery Sciences), 3(2), 45–52. https://doi.org/10.54393/nrs.v3i02.48
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204–211. https://doi.org/10.3928/01484834-20060601-04
Tanzo, F. C. (2021). Development of competency assessment tool for student-nurses readiness: Linking clinical practice and decision-making standards in the Philippines. Journal of Institutional Research South East Asia, 19(2), 142–159.
Türkel, S., & Polat, Ş. (2026). A research on the relationship between intensive care nurses' individual and professional characteristics, decision-making styles, and attitudes toward evidence-based nursing. Nursing Open, 13(1), Article e2341. https://doi.org/10.1002/nop2.2341
Välimäki, M., Hu, S., Lantta, T., Beijing, L., & Li, X. (2024). The impact of evidence-based nursing leadership in healthcare settings: A mixed methods systematic review. BMC Nursing, 23(1), Article 452. https://doi.org/10.1186/s12912-024-02096-4
Vrijlandt, S. E. W. (2026). Developing clinical decision (support) systems combining the scientific and regulatory perspective: European insights on challenges, requirements, and practical guidance. JMIR Medical Informatics, 14(1), Article e72809.
Wang, G., Xia, Y., Chen, Q., Tang, L., & Liu, Y. (2024). Exploring academic and clinical nurses’ perspectives on evidence-based nursing course for undergraduates from perspectives of academic-practice partnerships: A qualitative study. BMC Nursing, 23(1), Article 657. https://doi.org/10.1186/s12912-024-02223-1
Westerdahl, E., & Jonsson, M. (2022). Analytical vs. intuitive decision-making: How clinical environment and workload shape staff nurses' judgment. International Journal of Nursing Studies, 129, Article 104210. https://doi.org/10.1016/j.ijnurstu.2022.104210
Zainal, N. A., Poh, C. H., & Ab Hamid, M. R. (2025). Factors influencing clinical decision-making skills among registered nurses in regional hospitals: A multilevel general linear mixed-effects analysis. International Journal of Nursing Studies, 151, Article 104890. https://doi.org/10.1016/j.ijnurstu.2024.104890
Zendehdel, M., Mahmoodi-Shan, G., Sabzi, Z., & Mehravar, F. (2024). Clinical decision making and psychological empowerment among hospital staff nurses: The role of work environment and autonomy. BMC Psychology, 12(1), Article 542. https://doi.org/10.1186/s40359-024-02197-4
Zhang, C. (2024). Role perception and other factors influencing clinical decision-making in medical-surgical nurses. FEU Journal of Graduate Students’ Research, 1(2), 15–28.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
