Organizational justice and clinical decision-making among emergency nurses: A cross-sectional correlational study

Clinical decision making (CDM) is a vital competence required by nurses, particularly emergency nurses. This study aimed to investigate the relationship between organizational justice and CDM among emergency nurses.

A cross-sectional correlational design was used with 221 emergency nurses from three major public hospitals in Hai'l City, Northeastern Saudi Arabia, from April to June 2025. Data were collected using a sociodemographic characteristics survey, Nursing Decision-Making Scale, and Organizational Justice Questionnaire. The direction and strength of the association between nurses' CDM and organizational justice were measured using Pearson's correlation coefficient (r). Multiple linear regression analysis was used to identify predictors of CDM.

Registered nurses, charge nurses, staff working more than five days per week, and staff who reported higher organizational justice demonstrated significantly higher levels of nursing CDM (p < 0.05). In contrast, regular night shifts were significantly associated with lower CDM (p = 0.009). A significant positive correlation was found between nursing CDM and organizational justice (r = 0.320, p < 0.001), with a corresponding linear R² value of 0.102, indicating that approximately 10.2% of the variance in nursing CDM can be explained by organizational justice.

This study demonstrates the vital role of organizational justice in influencing emergency nurses' CDM. The findings indicated that nurses' perceptions of procedural justice significantly influenced their engagement and satisfaction in clinical settings.