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Nurse Decision Making in Acute Care.

Christine W Nibbelink1, Jane M Carrington

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Summary

Acute care nurses use complex factors for clinical decision-making during patient events. Understanding these factors can improve electronic health record decision support for better patient outcomes.

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Area of Science:

  • Nursing Science
  • Healthcare Decision Making

Background:

  • Effective nurse decision-making is crucial for optimal patient outcomes in acute care settings.
  • Clinical events, such as changes in patient condition, necessitate timely and informed nursing decisions.

Purpose of the Study:

  • To explore acute care registered nurses' (RNs) perceptions of clinical decision-making processes when managing patients experiencing clinical events.
  • To identify factors influencing nurses' decision-making in acute care.

Main Methods:

  • Qualitative content analysis of interviews with 20 acute care RNs.
  • Utilized the naturalistic decision-making framework to guide the exploration of contextual factors.

Main Results:

  • Key emergent categories influencing decision-making included: awareness of patient status, experience, established routines, time pressure, teamwork, goals, education, resources, patient education, and nursing roles.
  • Nurses integrate a diverse range of complex factors into their decision-making processes.
  • Identified specific contextual elements critical to acute care nursing decisions.

Conclusions:

  • Acute care nurses' decision-making is multifaceted, incorporating numerous influencing factors.
  • Findings provide valuable insights for enhancing decision support tools within the electronic health record.
  • Improved decision support has the potential to positively impact patient care and outcomes.