The Effect of Emergency Department Nurses' Core Self-Evaluations on Their Perceptions of Clinical Decision-Making: A...

Nurses in emergency departments (EDs) typically face time and resource constraints when they make clinical decisions. Furthermore, core self-evaluations, a fundamental, deep-seated personality trait, represent a key factor influencing work motivation, job performance, and other behavioral outcomes. However, the relationship remains unclear between ED nurses' core self-evaluations and their perceptions of clinical decision-making.

This study aims to explore the impact of ED nurses' core self-evaluations on their perceptions of clinical decision-making.

A cross-sectional survey design was used.

This cross-sectional study surveyed 578 registered ED nurses from 30 public hospitals in Beijing, China. Data were collected via online and on-site questionnaires, including sociodemographic characteristics, the Core Self-Evaluations Scale, and the Clinical Decision-Making in Nursing Scale. Statistical analyses included independent samples t tests, analysis of variance (ANOVA) with Welch's correction for heterogeneity of variance, Pearson correlation analysis, and multiple linear regression analysis.

The ED nurses reported moderate levels of core self-evaluations (39.16 ± 6.38) and relatively high perceptions of clinical decision-making (150.12 ± 18.32). The statistically significant positive correlation was found between core self-evaluations and perceptions of clinical decision-making (r = 0.567, p < 0.001). Multiple linear regression indicated that head nurse/nurse manager position (β = 0.079, p = 0.049), perceived uncertainty (β = -0.085, p = 0.032), and dissatisfaction (β = -0.074, p = 0.019) with the ED working environment were significantly associated with clinical decision-making perceptions.

This study demonstrated that enhancing the core self-evaluations of ED nurses may improve clinical decision-making quality. Nursing managers should establish targeted incentive systems, provide relevant resource support, and encourage critical thinking and self-reflection during training. These measures can strengthen ED nurses' self-efficacy and value recognition, ultimately advancing decision-making competence and care quality.