Challenges in Clinical Decision-Making for Nurses in Neonatal Intensive Care Unit (NICU): A Qualitative Study

Area of Science:

• Nursing
• Healthcare Management
• Clinical Decision-Making

Background:

• Clinical decision-making is a critical yet challenging aspect of neonatal intensive care unit (NICU) nursing.
• Nurses in the NICU encounter numerous difficulties caring for neonates with complex conditions, low birth weight, and physiological instability.

Purpose of the Study:

• To explore the specific challenges faced by nurses in clinical decision-making within the NICU setting in southern Iran.

Main Methods:

• A qualitative study employing conventional content analysis.
• Data collected through individual, in-depth, semi-structured interviews with 21 NICU nurses.
• Interviews focused on identifying challenges in clinical decision-making for NICU nurses.

Main Results:

• Three primary themes emerged: inadequate clinical competence, poor self-efficacy, and resistance to change.
• Inadequate clinical competence included lack of knowledge, skills, experience, and staff shortages.
• Poor self-efficacy encompassed low confidence, stress, and motivation issues, while resistance to change involved physician-centeredness and lack of support.

Conclusions:

• Lack of knowledge and skills negatively impacts nurses' confidence and decision-making abilities.
• Organizational culture and lack of support reduce nurses' motivation to enhance competence and participate in decision-making.
• Managers should foster supportive environments and improve nurses' skills to encourage participation in clinical decision-making.