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Importance of External Factors in Decision-Making for Nurse Managers

Various external elements, such as health policy, legal requirements, certification, and healthcare finance, have an impact on how nurse managers make decisions. Through an interview, this article examines the viewpoints of a nurse manager to better understand how these outside elements affect decision-making. The results of the interview will be examined and backed by relevant literature.

A Nurse Manager Interview

An interview with seasoned nurse management in a hospital context was undertaken to get insight into the outside variables affecting nurse managers’ decision-making. The nurse manager who was questioned played a significant part in running a nursing unit, supervising employees, and making calculated choices to guarantee the best possible results for patients. The nurse manager’s insights on how external elements like health policy, legal requirements, accreditation, and healthcare finance affect decision-making were very helpful throughout the interview. Their experience provided insight into the difficulties and factors nurse managers must consider while negotiating these outside pressures.

The nurse manager emphasized the importance of health policy in determining how decisions are made. They spoke on the immediate impact of policy and regulatory changes on resource allocation, staffing patterns, and the provision of patient care services. The continual problem in decision-making was underlined as how to adjust to changing rules while assuring compliance. The nurse manager underlined the influence of state laws and accrediting organizations on decision-making regarding regulatory requirements. They discussed their practical experiences implementing quality improvement projects to satisfy legal requirements like those established by the Joint Commission. The nurse manager recognized the need to balance regulatory compliance and the requirement for excellent patient care.

The nurse manager spoke about how financial restrictions and payment models affect decision-making in terms of funding healthcare. They emphasized the need to appropriately allocate a few resources while trying to provide high-quality treatment. The nurse manager gave insight into how money factors into choices about hiring employees, buying equipment, and expanding services. Nurse managers may proactively adjust their decision-making processes, work with stakeholders, and promote evidence-based practices that put patient safety, high-quality care, and organizational sustainability first by being aware of these external factors. The results of the interviews are a helpful tool for learning about the difficulties and factors that nurse managers must take into account. They also emphasize the significance of being knowledgeable and adaptive in the always-changing healthcare environment.

Nurse Manager Perceptions on the Effect of External Factors

The nurse manager discussed their opinions on the influence of outside influences on decision-making throughout the interview, including health policy, legal and regulatory requirements, accreditation, and healthcare funding. Their main conclusions are summarized as follows:

Health Policy’s Effects

  • Making decisions is significantly influenced by health policy.
  • Resource allocation and personnel patterns are directly impacted by changes in rules and laws.
  • Constant obstacles arise while trying to ensure compliance while adjusting to changing rules.
  • Policies have an impact on how patient care is delivered and need adjusting operational procedures.

Regulation requirements’ effects

  • Regulatory agencies and accreditation requirements have a big influence on decision-making.
  • Maintaining quality standards requires adherence to regulatory restrictions.
  • To achieve regulatory criteria, quality improvement activities are put into practice.
  • Regulation compliance and exemplary patient care must be balanced, which is a constant problem.

The effects of accreditation

  • An outside element that affects decision-making is accreditation.
  • It takes aggressive measures to achieve quality benchmarks to adhere to certification criteria.
  • Resource allocation, workflow procedures, and personnel training and development are all impacted by accreditation.
  • For accreditation status to be maintained, multidisciplinary team collaboration is required.

Healthcare Financing’s Effects

  1. Decision-making is highly influenced by issues with healthcare funding.
  2. Resource allocation choices are impacted by budgetary restrictions and payment mechanisms.
  3. For limited resources to be used effectively, financial management is essential to sustaining high standards of care.
  4. Decision-making involves taking into account aspects like income creation and financial sustainability.

The nurse manager’s perspectives highlighted the interconnection of these outside elements and their influence on decision-making in healthcare settings. They emphasized the difficulties in striking a balance between compliance and the need for good patient care. The nurse manager’s observations clarified the challenging decision-making environment and emphasized the need to maintain knowledge, adjust to change, and support evidence-based practices.

Literature-Supported Analysis of the Interview

The Impact of Health Policy on Decision Making

The results of the interview are consistent with previously published research on how health policy affects decision-making in healthcare organizations. Health policies influence the context in which healthcare practitioners function and make choices, according to Kruk et al. (2018). Resource allocation, employment patterns, and service delivery are all directly impacted by changes in rules and regulations. This is supported by the nurse manager’s observations, which emphasize the continual difficulties of adjusting to changing rules while guaranteeing compliance (Tazebew et al., 2023). This demonstrates how important it is for nurse managers to be aware of policy changes and to proactively modify their decision-making procedures to comply with the new standards.

Decision-Making Regulatory Agencies’ Role

The nurse manager’s perspectives on the effects of regulatory requirements are consistent with what has already been written in the field. To guarantee quality and safety, healthcare companies must adhere to the norms and regulations imposed by regulatory bodies like the Joint Commission and state health authorities. Regulatory compliance is essential for retaining certification and fulfilling legal obligations, as stated by Stahlke Wall (2018). The nurse manager’s observations highlight the need for nurse managers to place a high priority on regulatory compliance while aiming for effective and efficient patient care. The agreement between the results of the interviews and the literature emphasizes how much regulatory authorities have an impact on how healthcare companies make decisions.

 Decision Making and Healthcare Financing

The nurse manager’s perspectives of how healthcare funding affects decision-making are consistent with the research in the area. While attempting to provide high-quality treatment, healthcare organizations must manage fiscal restrictions and payment mechanisms. Financial factors have a significant impact on how resources are allocated and how services are delivered (Jia et al., 2021). The nurse manager’s observations highlight the need for effective financial management and balancing the provision of high-quality care and limited resources. The agreement between the interview results and the literature emphasizes how significant healthcare funding is to nurse managers’ decision-making.

Overall, the analysis of the interview data in light of the literature demonstrates the importance of outside variables, such as health policy, legal requirements, and healthcare finance, in affecting nurse managers’ decision-making. The agreement between the observations from the interviews and the current literature emphasizes how crucial it is for nurse managers to stay educated, adapt to changes, and proactively deal with these outside pressures to make wise choices for healthcare organizations.


The nurse management interview shed light on the influence of outside variables on decision-making in healthcare organizations. The investigation of the meeting information, supported by the assortment of writing, stressed how vital well-being strategy, legitimate necessities, and medical care financing affect the attendant decision-making process. The outcomes showed that well-being strategy fundamentally affects how assets are dispensed, how representatives are staffed, and the way in which administrations are given. Nurse managers must negotiate shifting laws and rules, ensure compliance, and modify decision-making techniques. Decisions are greatly influenced by regulatory bodies like the Joint Commission and state health departments. In order to maintain quality standards, compliance with accrediting standards and regulatory requirements is essential. This calls for proactive measures to enhance quality.

Decision-making is highly influenced by issues with healthcare funding. While attempting to provide high-quality care, nurse managers must overcome financial limitations and payment schemes. In order to achieve financial sustainability and give the best possible patient results, efficient financial management and resource allocation are crucial. Overall, the analysis of the interview data shows how these outside variables are related and how they affect nurse supervisors’ ability to make decisions. To be knowledgeable and successful decision-makers, nurse managers must be able to adapt to changes, stay informed, and promote evidence-based practices.

Nurse managers are better equipped to negotiate the intricacies of healthcare decision-making when they know the impact of external influences. Nurse managers may maximize resource allocation, guarantee regulatory compliance, and provide high-quality patient care by proactively addressing these variables. The development of best practices and initiatives for nurse managers will depend on more investigation into how external influences affect decision-making. Nurse managers may influence positive change and enhance outcomes in healthcare organizations by using evidence-based practices.


Jia, L., Meng, Q., Scott, A., Yuan, B., & Zhang, L. (2021). Payment methods for healthcare providers working in outpatient healthcare settings. Cochrane Database of Systematic Reviews.

Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., & Malata, A. (2018). High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health6(11), e1196–e1252.

Stahlke Wall, S. (2018). The impact of regulatory perspectives and practices on professional innovation in nursing. Nursing Inquiry25(1), 10.1111/nin.12212.

Tazebew, C., Mulugeta, T., & Boka, A. (2023). Nurse Managers’ Involvement in Decision-Making and Associated Factors in Selected Government Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study. SAGE Open Nursing9, 237796082311579.


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