Does this patient need a narcotic injection? A descriptive analysis of decision making

Thirty six nurses divided into three groups were asked in a series of three questionnaires to evaluate patients' needs for post-operative narcotic pain relief. Using a decision-analytic procedure, which combined a version of the Delphi technique and the multi-attribute utility approach, the six most salient criteria in order of priority were identified. These criteria were then tested in the clinical situation using a series of scenarios. A difference between how nurses purportedly evaluated patients' needs for narcotic pain relief and what they actually did in hypothetical clinical situations was found. The theoretical implications of these results are discussed.