Mader-e-Milat International Journal of Nursing and Allied Sciences

Concept Analysis: Clinical Decision Making

Sobia Batool — 2025-03-30

Background: Clinical decision-making is a fundamental aspect of nursing practice, involving data collection, analysis, and the application of evidence-based knowledge to ensure optimal patient outcomes. It is a complex and dynamic process that requires nurses to integrate clinical expertise, intuition, and critical thinking in fast-paced healthcare settings. Effective decision-making enhances patient safety, improves care quality, and supports positive health outcomes in diverse clinical environments.
Aim: The purpose of this study is to analyze the concept of clinical decision-making in nursing by determining its defining attributes, antecedents, and consequences. Moreover, clarifying its significance in nursing practice, education, and patient care.
Design: This study employs the Walker & Avant concept analysis model to examine the concept of clinical decision-making in nursing.
Review Methods: The analysis followed the step-by-step concept analysis approach outlined by Walker & Avant, which involves selecting a concept, determining its defining attributes, identifying antecedents and consequences, and examining model, borderline, and contrary cases.
Results: Key attributes of clinical decision-making in nursing, including intuition, critical thinking, clinical judgment, evidence-based knowledge, experience, and clinical reasoning. Model, borderline, and contrary cases illustrate the varying degrees to which these attributes influence patient care outcomes. Effective clinical decision-making enhances patient safety, optimizes treatment outcomes, and improves communication, emphasizing its critical role in nursing practice.
Conclusion: Effective clinical decision-making is essential for ensuring patient safety, optimizing treatment outcomes, and enhancing healthcare efficiency. By integrating critical thinking, evidence-based knowledge, and clinical experience, nurses can make informed decisions that improve patient care and reduce healthcare costs. Strengthening clinical judgment through education and experience is crucial for advancing nursing practice and achieving better patient outcomes.

Effect of Rotational Shifts Schedule on the Well-being of Public & Private Nurses of Sindh: Pakistan

Abdul Sami Nursing — 2025-03-30

Research objective: To assess the effect of rational shift schedules on the well-being of public and private nurses in different hospitals in Sindh.
Study Design: It was a descriptive Cross-Sectional Study.
Place and duration of Study: The research was carried out at five different Public and Private hospitals; public hospital included (R.B.U.T) Civil Hospital Shikarpur, Ganga Bai Women (HGBW) Hospital Shikarpur, Civil Hospital Jacobabad and Private Hospital included Dr. Zeenat Isani Institute of Medical Sciences (ZIMS) Shikarpur, Jacobabad Institute of Medical Sciences (JIMS) Jacobabad. Moreover, this study started from 25th January 2025- to 25th February 2025.
Material and Methods: The targeted population included all the hospital nurses who are working in different wards of the hospitals including Intensive Care Unit (ICU), Emergency Room (ER), Female Surgical Ward (FSW), Male Surgical Ward (MSW), Female Medical Ward (FMW), Male Medical Ward (MMW), Pediatrics Ward (PW), Neonate Intensive Care Unit (NICU), Nutritional Ward (NW), and Gynecology (GW). A convenient sampling method was used for data collection. The total sample size was 108, which was obtained through open EPI.
Results: The table (01) shows that the male frequency is n=29 (26.8%), and the female frequency is n=31 (28.7%). This table also revealed that the female frequency is slightly higher than the male frequency. Moreover (table 02) shows that the male frequency is 32 (29.6%), whereas the female frequency is n=16 (14.81%). This table also revealed that the male frequency is higher than the female frequency. (Table: 03) shows that the age limit from 20-30 years, where the frequency was (n= 47) and Percentage (43.5%); moreover, the age limit from 30-40 years, where the frequency was (n=53) and Percentage (49%), this table also revealed that the frequency of age limit from (40-50) n=8 where Percentage is (7.4%).
Conclusion: This study revealed that any institution that wants to serve patients around the clock must have shift workers. Shift work is necessary for nurses to provide continuous, high-quality care, yet it has specific negative implications on patient safety and nurses’ health. Adverse impacts can be social, psychological, spiritual, or bodily. Shift workers have complained of headaches, exhaustion or fatigue, and Stomach problems. Shift employment has been positively linked to mental health issues like stress and anxiety.

A Comprehensive Investigation of the Key Elements that Foster and Hinder Active Aging Level in Community Dwelling Older Adults of Pakistan: An Analytical Study

Rashida Bibi — 2025-03-30

Study Aim: This study aimed to investigate active aging status, and key elements that foster or hinderence of active aging among older adults in Pakistan.
Study Design: A cross-sectional study was conducted from June 2022 to November 2022 in the six districts of Khyber Pakhtunkhwa, Pakistan. The sample size was 230 older adults, aged 60 and above, calculated using Ravesoft software. Residents who could understand the local language (Urdu) and were independent in Activities of Daily Living (ADL) were included.
Results: Participants' ages ranged from 66 to 70 years. A significant number (79.6%) lived in a joint family system. Participants reported a medium level of active aging at 79% and a moderate level of well-being at 64%. Additionally, 32% rated their current health status poor, while 43% experienced mild to moderate levels of depression. A significant negative association was found between non-communicable diseases, ethnicity, gender, age, marital status, education, source of income, and active aging level (P < 0.005). The regression analysis explains the fostering association between demographic variables such as economic status, education level, male gender, and subjective well-being with self-reliance (R2 = 0.05), learning and integration into society (R2 = 0.72), healthy lifestyle (R2 = 0.77), spiritual wisdom (R2 = 0.81), social contribution (R2 = 0.82), economic security (R2 = 0.88), and strengthening family ties (R2 = 0.87).
Conclusion: Pakistani older adults have a moderate level of active aging. access to healthcare, social, and financial support can contribute to enhancing the active aging status.

Relationship Between Communication Skills and Emotional Intelligence Among Nurses of CMH Rawalakot: A Cross-Sectional Study Design

Rubab Tariq — 2025-03-30

Emotional intelligence (EI) is also known as emotional quotient (EQ) is the ability to perceive, interpret, demonstrate, control, evaluate, and use emotions in productive and positive ways when interacting with others. The purpose of this research was to determine the relationship between nurses' communication skills and emotional intelligence (EI). A Descriptive Cross-Sectional Design was used to conduct this study at CMH hospital Rawalakot, AJK.50 staff nurses were selected by using non-probability convenient sampling. To assess the emotional intelligence and communication skills, a semi-structured questionnaire was used; a pre-test of the questionnaire was conducted to evaluate its external validity. Out of 50 Nurses, 78% participants were female and 22% male, 64% were single and 36% married. The 84% of the nurses belong to 24 to 31 years young-adult aged group as compare to 6% between 32-35 years age and 10% 20-23 years group. The findings of this study were 84% nurses are agreed of self-motivation, 86% knows the patient’s emotions from their behavior, and 96% agreed their communicating message ways to patient is simple and clear. Sixty-eight (68%) are very sensitive towards others feelings and emotions. The research determines a strong, significant correlation between nurses' communication skills and EI and its related dimensions.