Clinical decision making in Iranian nurses: systematic review

Clinical decision making is one of the most important processes which nurses always use to care for patients. Appropriate decisions help to improve the quality of care, reduce the duration of illness and disability, reduce costs and make optimal use of resources. Therefore, the purpose of this research was to review studies conducted in the field of clinical decision making of Iranian nurses and its related factors.

The present study was a systematic review conducted in 2021. In this research, articles published in databases of Magiran, Iran doc, SID, Science Direct, Pub med, Scopus, web of science, and Google Scholar in both Persian and English without any time limit were examined. For this purpose, the keywords “clinical decision making” and “nurse” in Persian sources and “clinical decision making”, “nurse”, “Iran” and their MeSH equivalents in English articles were applied using OR and AND operators. Conducting research in Iran was the most important inclusion criterion. Accordingly, out of a total of 144 articles related to clinical decision making of nurses in Iran, 49 ones remained after applying the inclusion and exclusion criteria, and by eliminating duplicate cases, 21 articles were finally included in the study. STROBE tool was used to evaluate the quality of articles.

Out of 144 initial articles, 21 studies were analyzed. The results of the analysis of 21 articles showed that nurses' participation in clinical decision making was moderate and their decision making was intuitive analytical. Nurses with older ages, more work experiences and employed formally and contractually had better clinical decision making. There was also a statistically significant positive association between clinical decision making and the variables of self-efficacy, the thinking style and emotional intelligence.

In order to improve the quality of nursing, health system officials should pay attention to the employment and arrangement of nurses, their type of decision making, state of emotional intelligence, self-efficacy and style of thinking. In addition, nursing managers should employ nurses with older ages, and more work experiences, as well as formally employed ones for wards and posts which require more and better clinical decision making