Clinical decision-making approach and associated factors among nurses working in inpatient units of public hospitals, Addis Ababa, Ethiopia: a cross-sectional study

Nurses need to make accurate clinical decisions congruent with the patient’s diagnoses. The nurse’s ability to make an efficient clinical decision affects the quality of care provided to the patients. This study aimed to assess the clinical decision-making approach and identify factors affecting nurses' clinical decision-making. This institutional-based multi-center cross-sectional study included 405 participants selected using a simple random sampling technique. A nursing decision-making instrument was used to assess nurses’ decision-making approach. Data analysis was done using SPSS version 26. Bivariate and multivariable logistic regression analysis were used. Among the total respondents, 59.5% were scored in the analytical decision-making category, and the rest, 40.5%, were intuitive decision-makers. Respondents aged ≥ 34 years (AOR = 1.83, P = 0.039), with a master's degree (AOR = 0.50, P = 0.032), more than 10 years of work experience (AOR = 2.21, P = 0.005) and trained on clinical decision-making (AOR = 1.28, P = 0.05) were associated with intuitive clinical decision-making of nurses. The findings of this study showed that intuitive decision-making was slightly low, and the analytical decision-making approach was high compared to previous studies. The findings suggest that healthcare organizations should design and provide continuous professional development, mentorship programs, and ongoing clinical decision-making training for nurses to enhance their decision-making skills and improve the quality of patient care. Future research could explore the impact of different clinical decision-making approaches on patient outcomes and investigate strategies to optimize the integration of analytical and intuitive processes in multi-center settings, especially in private and rural health sectors of nursing practice.