Assessment of cognitive bias in decision-making and leadership styles among critical care nurses: a mixed methods study.
OBJECTIVE
To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery.


BACKGROUND
The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan.


METHODS
Two-phase mixed methods sequential explanatory design and grounded theory.


METHODS
critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20).


METHODS
Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis.


RESULTS
Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance.


CONCLUSIONS
There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making.
School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Soon
http://orcid.org/0000-0001-8005-468X
S
Lean Keng
AlBashir Hospital, Jordan.
Hani Nawaf Ibrahim
HN
AlQudah
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003071:Cognition / Q000502:physiology; D064648:Critical Care Nursing / Q000379:methods* / Q000592:standards; D004522:Educational Status; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology; D055815:Young Adult
care delivery; cognitive bias; critical care nurses; decision-making; leadership styles; nursing