Decision-making processes (DMPs) can be altered by several factors that might impact patient outcomes. However, nurses’ views and experiences regarding the multitude of personal and organizational factors that may facilitate or inhibit their decision-making abilities have rarely been studied. Purpose: To explore the personal and organizational factors that influence nurse DMPs in clinical settings at Ministry of Health hospitals (MOH). Method: A qualitative research design was conducted. A purposive sample of 52 nurses was recruited from general and critical wards in two major Ministry of Health hospitals in Hail, Saudi Arabia. A total of eight focus groups (semi-structured interviews) were conducted to elicit participant responses. Results: In this study, the personal differences covered nurses’ experience, physical and psychological status, autonomy, communication skills, values, and cultural awareness. Organizational factors included the availability of resources, organizational support, workload, the availability of educational programs, the availability of monitoring programs, and the consistency and unity of policies, rules, and regulation applications. Conclusions: The major contribution of this study is the comprehensive illustration of influential factors at both the personal level and the organizational level that impact DMPs to achieve desired outcomes for patients and health organizations. This study utilizes a framework that could explain the nature of nurse DMPs.

Background: Nurses in many countries face a high prevalence of psychological pressure while caring for COVID-19 patients. Several determinants of emotional exhaustion leading to occupational burnout risk were documented. However, a recent review examining nurses’ emotional exhaustion during the COVID-19 pandemic is lacking in nursing literature.Purpose: This review aimed to examine the prevalence of nurses’ emotional exhaustion during the COVID-19 pandemic. This review also describes the organizational contributing factors to nurses’ emotional exhaustion.Methods: A systematic review and meta-analysis of the literature following the PRISMA guidelines was conducted in March 2022. Four databases, including PubMed, ProQuest Platform, Wiley, and Google Scholar, were searched from 1 January 2020 to 28 February 2022. The prevalence of nurses’ emotional exhaustion (EE) was pooled using random effect meta‐analyses. The quality appraisal of the studies was done using the Joanna Briggs Institute (JBI) checklist. Data analysis utilized a random effect model to evaluate the pooled effects of the studies due to the high heterogeneity between results.Results: Nine studies were included with a total number of 16,810 subjects surveyed, of whom, 8,150 (48.50%) met the criteria for emotional exhaustion. Based on the standard effect model, the pooled estimate for EE prevalence was 48.9% (95% CI:48.1% to 49.6%). Several organizational factors contributing to nurses’ emotional exhaustion included working in critical care units or isolation wards, longer working hours in COVID-19 quarantine units, night shifts, working with confirmed or suspected co-workers, monthly salary income, and inadequate hospital resources.Conclusion: This review found that nurses were suffering from high to moderate emotional exhaustion levels during the COVID-19 pandemic. Furthermore, several organizational factors influence this emotional exhaustion. These findings highlight the necessity for urgent interventions to decrease psychological impacts on frontline nurses.