Development of a Korean clinical decision-making ability scale for hospital nurses

Background: A hospital nurse's clinical decision-making ability is an important core competency that identifies and solves patient problems in nursing practice. This study aimed to develop a Korean clinical decision-making scale for hospital nurses, and verify its validity and reliability.

Methods: A methodological design that develops a scale was used. A total of 71 Preliminary items on clinical decision-making of hospital nurses were selected using concept validity analysis of and expert opinion on 51 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 371 nurses who in direct nursing and decision-making. The collected data were analyzed using exploratory factor analysis and confirmative factor analysis with SPSS 23.0 and AMOS 24.0 program.

Results: Exploratory factor analysis was performed with principal axis factor analysis and Varimax rotation. Nine factors that accounted for 65.5% of the total variance were identified by deleting the items that not meet the condition that the commonality should be 0.30 or more and the factor loading over 0.50. The correlation coefficient between this scale and the Jenkins' clinical decision-making perception scale was r = 0.70 (p < 0.001), which determined concurrent validity. The internal consistency for the scale was Cronbach's α = 0.84, and this was developed with a total of 36 items.

Conclusion: A Korean clinical decision-making ability scale for hospital nurses was developed consisting of nine factors and 36 items with a five-point Likert. The Korean clinical decision-making ability scale for hospital nurses can measure clinical decision-making ability from various aspects that were not previously reflected.