The Institute of Medicine identified that 98,000 deaths occur in hospitals each year due to poor decision-making. The need for better understanding of decision-making in patient care is evident. The purpose of this study is to explore nurses' perceptions of clinical decision-making for a patient who experienced a clinical event. The overarching framework for this research is the Effective Nurse to Nurse Communication framework which uses clinical events, or sudden changes in patient condition, to explore nurse communication between nurses who respond to a clinical event and nurses who receive report from the responding nurse about the clinical event. Naturalistic Decision Making is the framework used to explore the decision-making factors used by experienced decision makers in real world conditions. These frameworks provided the basis for data collection, interview question development, and facilitated data analysis. Twenty nurses in an urban acute care hospital were interviewed at their workplace about a patient who had experienced a sudden change in condition in the previous 24 hours. These interviews were transcribed and analyzed using content analysis. Categories that emerged were: Awareness of Patient Status, Nursing Roles (outside of specific patient care), Goals, Education / Certification / Hospital Training to support decision-making, Experience and Decision-Making, Time Pressure, Teamwork / Support from Staff, Resources, Following Established Routine. Patient Education, and Consideration of Options to Meet Goals. Further analysis indicates that elements of decision-making differ between responding and receiving nurses and based on experience level of the nurse. Strengths, limitations, and suggestions for future research are presented.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/624543 |
| Date | January 2017 |
| Creators | Nibbelink, Christine Williams, Nibbelink, Christine Williams |
| Contributors | Carrington, Jane M., Carrington, Jane M., Brewer, Barbara B., Shea, Kimberly D. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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