# The Effect of Emergency Department Nurses’ Core Self‐Evaluations on Their Perceptions of Clinical Decision‐Making: A Cross‐Sectional Study

## TL;DR

This study finds that emergency department nurses with higher self-evaluations tend to have better perceptions of their clinical decision-making abilities.

## Contribution

The study establishes a novel link between core self-evaluations and clinical decision-making perceptions in ED nurses.

## Key findings

- ED nurses with higher core self-evaluations reported better clinical decision-making perceptions.
- Head nurse position and dissatisfaction with the work environment significantly influenced decision-making perceptions.
- The study suggests targeted training and support can improve clinical decision-making in ED nurses.

## Abstract

Nurses in emergency departments (EDs) typically face time and resource constraints when they make clinical decisions. Furthermore, core self‐evaluations, a fundamental, deep‐seated personality trait, represent a key factor influencing work motivation, job performance, and other behavioral outcomes. However, the relationship remains unclear between ED nurses’ core self‐evaluations and their perceptions of clinical decision‐making.

This study aims to explore the impact of ED nurses’ core self‐evaluations on their perceptions of clinical decision‐making.

A cross‐sectional survey design was used.

This cross‐sectional study surveyed 578 registered ED nurses from 30 public hospitals in Beijing, China. Data were collected via online and on‐site questionnaires, including sociodemographic characteristics, the Core Self‐Evaluations Scale, and the Clinical Decision‐Making in Nursing Scale. Statistical analyses included independent samples t tests, analysis of variance (ANOVA) with Welch’s correction for heterogeneity of variance, Pearson correlation analysis, and multiple linear regression analysis.

The ED nurses reported moderate levels of core self‐evaluations (39.16 ± 6.38) and relatively high perceptions of clinical decision‐making (150.12 ± 18.32). The statistically significant positive correlation was found between core self‐evaluations and perceptions of clinical decision‐making (r = 0.567, p < 0.001). Multiple linear regression indicated that head nurse/nurse manager position (β = 0.079, p = 0.049), perceived uncertainty (β = −0.085, p = 0.032), and dissatisfaction (β = −0.074, p = 0.019) with the ED working environment were significantly associated with clinical decision‐making perceptions.

This study demonstrated that enhancing the core self‐evaluations of ED nurses may improve clinical decision‐making quality. Nursing managers should establish targeted incentive systems, provide relevant resource support, and encourage critical thinking and self‐reflection during training. These measures can strengthen ED nurses’ self‐efficacy and value recognition, ultimately advancing decision‐making competence and care quality.