Nursing decision-making in health services: Systematic Review

Objective. This study proposes to perform an analysis of scientific publications about identify the fundamental elements that make up decision making of nurse. Background. Nurses' decision-making assumes a fundamental character on the final quality of care and the comprehensive impact it will have on the health organization, health professionals, individuals and the nursing itself, in general and specialized hospital settings, clinics, nursing homes, primary care in health, rural and urban units, as well as domiciliary services. How has the experience of nurses been in their care practice regarding decision-making on physical, material and human resources for the composition of care? Results. This review was performed according to the methodology of the Joanna Briggs Institute for systematic review of qualitative studies and its protocol is registered in PROSPERO - International prospective register of systematic reviews of the University of York under the number CRD42019127009. The analysis of the 23 selected studies presented a total of 178 findings in which four categories were created, according to the similarity of meanings: systematization of the decision process, determining elements of the decision-making process, participants of the decision making process, and type of power and focus that guides the decision.Discussion. O estudo identificou as contribuições dos enfermeiros para a configuração dos cuidados em ambientes multidimensionais em acções independentes, dependentes e interdependentes na procura de resultados de qualidade para o paciente. A tomada de decisões dos enfermeiros é um passo inevitável e determinante para a obtenção dos resultados esperados. Nenhuma acção é executada sem tomada de decisão, quer seja puramente intuitiva ou totalmente racionalizada.Conclusions. The categories identified in this review constitute essential elements for composition of the nurse decision-making process in the health services that aims for quality in nursing care. Decision-making represents a space for negotiation of the different interests involved in the care process and enables the direction of this process centralized in the patient by using a shared system.