Quality in Decision Making

    Asma Hussein Rammal

Nursing Director at Madina National Hospital in Saudi Arabia

Quality in decision-making is very crucial issue in nursing. Since nurses have the voice to lead, strong leaders should support this leading. In order to have strong leaders they should have the proper knowledge and enough experience in the field. Multiple factors affect the decisions; outside factors and inside factors. The outside factors include the rules and regulations of MOH, Labor law, accredited organizations and the other hospital (competitors). Inside Factors; like policies and procedures of the hospital, the shortage of staff and the support of the higher management. Despite of all these factors the quality of care and patient safety should have the priority when make the decision otherwise; it will affect the health of patient. For instance, when decision was made to transfer patients from ICU to medical ward because their health status was improved a little, but they did not reach the level of being in normal ward. Their health status was deteriorated, and they were sent back to ICU. This type of decision has lots of side effect; 1- It did not take the quality of care in consideration. 2- This decision will affect the reputation of the hospital other than the legal situation that will affect the hospital. Other decision can be taken by higher management to increase the ratio of patient to nurse specially in critical areas other than the ward patient. In this situation, Nursing Director can stop this decision. In order to prevent medical mistakes, work overload on nurses, which in turn will increase the sick leave.

Nursing Directors who considered the leaders for the new nurses should present strong leadership with justified decisions that reflect the quality of care that should have the priority.