Critical care nurses' use of decision-making strategies

Author: Aitken L.M.

Source: Journal of Clinical Nursing, Volume 12, Number 4, July 2003 , pp. 476-483(8)

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Abstract:

Summary

• Effective decision-making has the potential to facilitate improvements in health care. This paper reports several aspects of a study which used ‘thinking aloud’ within a concept attainment framework to examine the decision-making processes of expert critical care nurses in relation to haemodynamic monitoring.

• The purpose of this study was to examine whether hypotheses were used in the decision-making process and, if so, were hypotheses deactivated when no longer relevant. In addition, the strategies that were used during the decision-making process were examined.

• Eight expert critical care nurses consented to participate in the study after ethics clearance was obtained from both the University and Hospital ethics committees.

• The majority of expert critical care nurse participants in this study demonstrated extensive use of hypotheses to explain the relationship between attributes and concepts.

• There was no evidence of specific deactivation of hypotheses when they were no longer relevant.

• Participants demonstrated use of a range of decision-making strategies, with a Focus Gambling Strategy being the most common. The reason for using different decision-making strategies was not clear and may represent variation between decision-makers or between scenarios for each individual decision-maker.

• Recommendations are made to help improve critical care nurses' decision-making.

Keywords: critical care nursing; decision-making; decision-making methods; think aloud

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2702.2003.00763.x

Affiliations: 1: Project Director, Critical Care Nursing Professorial Unit, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia

Publication date: 2003-07-01