Making decisions: nursing practices in critical care

Area of Science:

• Nursing Science
• Clinical Decision-Making
• Healthcare Management

Background:

• Critical care nursing involves complex decision-making processes.
• Understanding these decisions is crucial for improving patient care and outcomes.
• Factors influencing decision complexity require further investigation.

Purpose of the Study:

• To identify the types and complexity of decisions made by critical care nurses.
• To explore factors influencing the complexity of these clinical decisions.

Main Methods:

• A two-phase study combining clinical decision recording and semi-structured focus groups.
• 12 critical care nurses documented decisions over two hours.
• Thematic analysis of transcribed interviews identified influencing factors.

Main Results:

• Five decision types identified: assessment, intervention, organization, communication, and education.
• Three key factors influencing complexity: communication, patient-related factors, and decision properties.
• Communication decisions were reported as most difficult, while nurse familiarity with the patient reduced complexity.

Conclusions:

• Clinical decision-making in critical care is multifaceted.
• Familiarity with patients significantly impacts decision complexity.
• Findings have implications for critical care nursing practice and patient outcomes.