الفهرس 
Decision Making ProcessOnly 14 pages are availabe for public view
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Abstract
Clinical decision making is the ability to sift and synthesize information, make decisions and appropriately
implement these decisions in the clinical environment. The nursing discipline’s pursuit of professional recognition relies heavily upon the ability of practicing nurses to correctly define and solve problems which are uniquely nursing in origin
(Facione & Facione, 2007).
Spur-of-moment decision making model for obstetric and gynecological emergencies have been devised to guide good decision, aim to make decision more objective and quantifiable, moreover good decision making requires the correct framing of the question, search evidence and the elucidation of individuals’ value or preference (Sackett et al, 2000 & Bordley, 2001).
Furthermore, spur of the moment decision making are highly complex, and expert nursing care, that including resolution of ethical dilemmas and predictions based on inadequate or ambiguous data with the intention of applications the intuitive processes (Gobet & Chassy, 2008).
The present study aimed to evaluate the ability of the obstetric and gynecological staff nurses to apply spur-ofmoment decision making model in the clinical area. An intervention study was conducted in obstetric and gynecological units of Ain Shams University hospital. As these units include high risk cases that required for application of the selected decision making model.
A simple random sample technique was used for the two subject (nurses and women). 1st subject ”thirty five obstetrics
and gynecology nurses” were included in the study that represent 80% of nurses worked in different units of Ain Shams
Maternity University Hospital at time of data collection. 2nd subject ”one hundred fifty seven women” that represented 10% of the total women admitted to the previous mentioned sitting over one month based on hospital statistical and who received care by those nurses subjected to the study.
Four tools were used for data collection. First one was named obstetrics and gynecology nurses’ knowledge regarding supr of the moment decision making model questionnaire sheet that used to assess ciodemographic characteristics of the obstetrics and gynecology staff nurses. Second tool was women satisfaction scale adopted from Gizmo (2011) that divided into two parts; 1st one used to assess sciodemographic characteristics
and cause of admission of the studied women. 2nd part used to assess women’s satisfaction with caring offered by nurses after application of supr of the moment decision making model.
Third tool was standard performance checklist for clinical decision making according to Huber (2000) that used to assess obstetrics and gynecology nurses’ performance after application of spur of the moment decision making model. Fourth tool was Likert scale adopted from charlotte (2010) that used to assess
nurses’ attitude toward the spur-of-the moment clinical decision making.
The main finding of the present study were:
Nurses’ age is ranging from 22 to 59 years old with the mean
age 41 ± 8.5 years. Concerning place of residence 91.4 % of
them were from the urban. Regarding nurses qualification 97.l
% of them have diploma degree. Concerning years of experience 54.3% of them have more than twenty years of experience.
There is a statistical significant relation between obstetrics and gynecology nurses’ knowledge regarding supr of the moment decision-making model and their age, qualification and years of experience.
There is statistical significance between nurses’ knowledge regarding the spur-of the moment decision-making before and after application of the program.
There is a statistical significant improvement in nurses’ practice after application of the spur-of the moment decisionmaking model program.
Total percentage of nurses’ positive attitude represents 66.6% and 67.4% before and after the program implementation respectively.
There is no statistical significant difference between nurses’ attitude regarding the spur-of the moment decision-making before and after application of the program.
Women’s satisfaction with care offered by nurses based on application of the spur of the moment decision making model
represent 38.9 %, 47.8%, 45.2%, 47.8%, 37.6% of women are satisfied with sharing on decision plan, oriented with
alternative solutions, satisfied with sharing on selected solution, outcome, and satisfied with time of decision
respectively.
Based on the result of present study it is concluded that obstetrics and gynecology nurses’ knowledge regarding spur of the moment decision making model were highly limited before implementation. Moreover, application of the spur of the moment decision making model is significant improvement in nurses’ knowledge and performance. That reflected on increase women’s satisfaction with the following items; sharing on decision plan, oriented with alternative solutions, satisfied with
sharing on selected solution, outcome, and satisfied with time of decision respectively.
In spite of total percentage of nurses’ positive attitude represents 66.6% and 67.4% before and after the program implementation respectively, there is no statistical significant difference between nurses’ attitude regarding the spur-of the moment decision-making before and after application of the
program.
Based on this finding, the researcher recommended;
conduction of awareness sessions about spur of the moment decision making model at different units of Ain Shams
Maternity University Hospital. In addition to integration of the spur of the moment decision making model into nursing practice to improve quality of care.
Further researches are still needed to explore the barriers that confront implementation of the spur of the moment decision making model.