El-Sayed Ahmed Abdelwahab Ibrahim, Alsenany Samira Ahmed, El-Sayed Boshra Karem Mohamed, Alfaraidy Hala Ahmed Abdullah, Asal Maha Gamal Ramadan
Nursing Department, College of Pharmacy and Applied Medical Sciences, Dar Al Uloom University, Riyadh, Saudi Arabia.
Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Nurs Crit Care. 2025 Jul;30(4):e70118. doi: 10.1111/nicc.70118.
In the context of increasingly digital healthcare systems, clinical judgement among critical care nurses is shaped not only by clinical experience but also by the broader digital environment. Digital culture, digital competence and clinical decision support systems (CDSSs) usability are pivotal factors influencing how nurses make timely, informed clinical decisions. However, the complex interplay among these factors remains underexplored.
To examine the impact of digital culture on critical care nurses' clinical judgement, investigate the moderating role of digital competence and examine how CDSSs usability affects this moderation.
This descriptive cross-sectional study was conducted among 550 critical care nurses working in 28 intensive care units across 10 hospitals located in Cairo and Alexandria in Egypt and Riyadh in Saudi Arabia. Data were collected via four validated instruments and analysed via moderated moderation analysis (PROCESS Models 1 and 3) to test direct and interaction effects among digital culture, digital competence, CDSSs usability and clinical judgement.
Digital culture significantly predicted clinical judgement. This effect was moderated by digital competence, which enhanced the positive association. A significant three-way interaction revealed that the relationship was strongest when both digital competence and CDSSs usability were high. The full model explained 53.9% of the variance in clinical judgement capability.
Digital culture enhances clinical judgement, particularly when supported by high digital competence and usable CDSSs.
Clinical effectiveness in critical care nursing requires strong digital competence, a supportive digital culture and user-friendly CDSSs to enable accurate, timely and informed clinical judgement and decisions.
在数字医疗系统日益普及的背景下，重症监护护士的临床判断不仅受到临床经验的影响，还受到更广泛的数字环境的影响。数字文化、数字能力和临床决策支持系统（CDSS）的可用性是影响护士如何做出及时、明智临床决策的关键因素。然而，这些因素之间复杂的相互作用仍未得到充分探索。
研究数字文化对重症监护护士临床判断的影响，探讨数字能力的调节作用，并研究CDSS可用性如何影响这种调节作用。
这项描述性横断面研究在埃及开罗和亚历山大以及沙特阿拉伯利雅得的10家医院的28个重症监护病房工作的550名重症监护护士中进行。通过四种经过验证的工具收集数据，并通过调节中介分析（PROCESS模型1和3）进行分析，以测试数字文化、数字能力、CDSS可用性和临床判断之间的直接和交互作用。
数字文化显著预测临床判断。这种影响受到数字能力的调节，数字能力增强了这种正相关关系。显著的三向交互作用表明，当数字能力和CDSS可用性都很高时，这种关系最强。完整模型解释了临床判断能力方差的53.9%。
数字文化增强临床判断，特别是在高数字能力和可用的CDSS支持下。
重症监护护理中的临床有效性需要强大的数字能力、支持性的数字文化和用户友好的CDSS，以实现准确、及时和明智的临床判断和决策。
