الفهرس 
• Background about decision makingOnly 14 pages are availabe for public view
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Abstract
Good decision making is an essential skill to become an effective leader and for a successful career. Decision making is the study of identifying and choosing alternatives based on the values and preferences of the decision maker. Making a decision implies that there are alternative choices to be considered, and in such a case we want not only to identify as many of these alternatives as possible but to choose the one that has the highest probability of success or effectiveness and best fits with our goals, desires, lifestyle, values, and so on (Ellis and Hartey, 2000).
Decisions are made at all levels of the hierarchy in organizations. Nurses, from the bedside to top administration, need to make decisions frequently. Decision-making is a complex cognitive process of developing a commitment, to a particular course of action. Organizational performance is largely dependent on the decision-making process that a particular organization uses. Numerous factors affect decision making; internal factors such as physical and emotional state, and personal philosophy, experience, knowledge and attitude, as well as external factors such as time, resources and institutional policy.
The aim of this study was to investigate the factors affecting decision-making among head nurses at Nasser institute hospital.
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This descriptive study was carried out at Nasser Institute Hospital, affiliated to Specialized Medical Centers. It involved The head nurses’ total number was 54 head nurses. All head nurses met the criteria for inclusion in the main study sample (experience more than one year at managerial position). A self-administered questionnaire was used in data collection. It assessed heads nurses’ agreements upon the various factors affecting their decision-making, including structure, process, outcome and personal factors. It was validated through experts’ opinions and its reliability was measured in a pilot study. The fieldwork lasted from January to September 2014.
The main study findings were as follows:
The head nurses’ age ranged between 28 and 51 years; 72.2% of them had a bachelor degree, and 53.7% attended training in decision-making.
The structure factors with the highest agreement were those of the presence of a clear regulatory structure that defines the responsibilities and authorities, of job descriptions that define the tasks and responsibilities and authorities of each function, of a system of incentives and rewards, and of policies and procedures in each section.
The process factors with the highest agreement were those of regular rounds in department to help know the problems, needs and time management.
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There were generally low percentages of head nursesagreement upon the outcome influencing their decision making.
The personal factors with the highest agreement were those of trusting own ability to make a decision, having a sense of belonging and loyalty to the workplace.
The head nurses’ agreement was highest for personal factors (57.4%) and lowest for process factors (35.2%).
Overall, 44.4% expressed their agreement upon the total factors influencing their decision-making.
No statistically significant relations between head nurses’ agreement upon structure or process factors and any of their socio-demographic characteristics.
Statistically significantly more head nurses who attended training in decision-making agreed upon outcome factors.
The percentage of head nurses’ agreement upon personal factors was higher among those with ten or more experience years.
Statistically significant weak to strong positive correlations were revealed among the scores of head nurses’ agreement upon the various types of factors influencing their decision-making.
In multivariate analysis, the attendance of training courses in decision-making was the only statistically significant
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independent predictor of the score of agreement upon the total factors.
In conclusion, the head nurses view the personal factorsas the most influential on their decision-making, whereas the process factors are the least influential. The agreement upon all four factors is inter-correlated. Only the attendance of training courses in decision-making has a significant independent influence on head nurses’ agreement upon the total factors.
The study recommends more frequent and in-depth training courses in decision-making, and this should be a pre-requisite for promotion to managerial positions. The hospital administration work on the factors identified as influencing decision-making among head nurses. The nurse managers should encourage their subordinates to make decisions independently, endorse their decisions, and use proper delegation to build ”second-line” leaders. More research is suggested to investigate the effectiveness of training interventions accompanied by improvement of the factors influencing decision-making on the actual practice of decision making.