NURSES ABILITIES OF CRITICAL THINKING AND CLINICAL DECISION-MAKING CORRELATED WITH QUALITY OF NURSING HANDOVER

Abstract

Background: Effective nursing handovers are essential for patient safety and continuity of care. Critical thinking and clinical decision-making are vital cognitive skills that ensure structured, accurate, error-free handovers. Despite their importance, research on how these cognitive abilities influence nursing handovers in Pakistan is limited. Objective:This study aims to evaluate the relationship between critical thinking, clinical decision-making, and the quality of nursing handovers among nurses in tertiary care hospitals in Lahore, Pakistan. Study Design:A descriptive cross-sectional study was conducted. Settings: The study was conducted at Services Hospital Lahore and Fatima Memorial Hospital Lahore, both tertiary care hospitals in Lahore, Pakistan. Duration of Study: The study was conducted September 2023 to February 2024. Methods: A total of 171 nurses were recruited using a convenience sampling technique. Data were collected using structured questionnaires, including the California Critical Thinking Disposition Inventory (CCTDI), the Clinical Decision-Making in Nursing Scale (CDMNS), and the Handover Evaluation Scale (HES). Statistical analysis was performed using SPSS version 26, applying descriptive statistics and Pearson’s correlation and regression analysis to assess the associations between the variables. A p-value ≤0.05 was considered statistically significant. Results: The study found that 50.9% of nurses acknowledged the role of critical thinking in nursing handovers, while only 38.6% expressed confidence in their decision-making abilities. A significant positive correlation was observed between critical thinking and clinical decision-making (r = 0.470, p < 0.001) and between decision-making and handover quality (r = 0.528, p < 0.001). Nurses with higher critical thinking scores reported improved handover accuracy and fewer communication errors. However, only 35.1% of nurses had received formal critical thinking training, indicating a significant gap in nursing education. Conclusion: The study confirms that critical thinking and decision-making skills significantly enhance the quality of nursing handovers. The findings highlight the importance of structured training programs and standardised handover protocols in Pakistani hospitals. Integrating evidence-based communication tools like SBAR (Situation, Background, Assessment, Recommendation) into clinical practice is crucial. Future research should focus on interventional studies evaluating the impact of critical thinking training on patient outcomes.