DECISION-MAKING IN PATIENT CARE BY EXPERIENCED REGISTERED NURSES EDUCATED IN THREE TYPES OF NURSING PROGRAMS.
Contributors: University of Maryland, College Park.
Published: 1991
Number of pages: 276
Subjects: Health Sciences, Nursing.; Education, Adult and Continuing.; Education, Higher.
Description: This descriptive study was designed to investigate phenomena related to decision making in patient care situations by experienced registered nurses educated in three types of nursing programs. Intuitive and rational decision making models were used to provide the theoretical framework of study.

Descriptive and exploratory qualitative research methods used in study included subjects: (1) descriptions of crucial incidents; that are situations in which a nurse's decision making made a difference in a patient's outcome, and (2) responses to a simulated patient situation and related interview questions. Data were analyzed using content analysis strategies.

The sample included 20 associate degree graduates and 11 hospital diploma graduates. Sixteen subjects had, in addition to their initial degree, earned a bachelor of science degree in nursing.

Findings suggest that decision making by experienced registered nurses, while engaged in direct patient care, is an intuitive as well as a rational process. However, most subjects described decision making as a holistic rather than a linear step wise process as suggested in the nursing process.

Findings of the study also indicate that nurses develop expertise in decision making about patient care, to the level of expert, through experience in clinical nursing practice regardless of the type of nursing program attended. These findings support those of earlier research conducted by Benner (1984).

Phenomena related to the decision making process, identified during study, included: (a) type of decision, (b) dimension of patient addressed, (c) factors in the decision making environment, (d) characteristics of the nurse, and (e) phases of decision making process. These phenomena are a basis for further study of decision making, a complex human process essential in the practice of nursing.

As nursing strives to identify its domain of practice and scope of professionalism more research that describes the decision making process as it actually occurs in clinical nursing practice is recommended.
Notes: Source: Dissertation Abstracts International, Volume: 52-09, Section: B, page: 4672.

Thesis (PH.D.)--UNIVERSITY OF MARYLAND COLLEGE PARK, 1991.

School code: 0117.