The work on correspondence and coherence stages of decision-making reflects the importance of both inference and justification to decision-making providing a more complete representation of the decision-making process. For the decision-making process, correspondence represents an inference stage and coherence provided the justification stage ( Hammond, 1996). Coherence and correspondence were viewed as complimentary ( Hammond, 1996). With correspondence, the accuracy of a decision was emphasized without regard for the rationale behind the decision and the experience level of the decision-maker was important to this process ( Hammond, 1996). Traditionally, physician decision-making was evaluated using coherence ( Hammond, 1996). Using coherence, the decision-making process, rather than the end result, was evaluated ( Hammond, 1996). Coherence explored the rationale behind a decision using a mathematical approach based on logic ( Hammond, 1996). The combination of satisficing and perception emphasizes the importance of human elements to the decision-making process.Įarly medical decision-making theories focused on the approaches of coherence and correspondence ( Hammond, 1996). The decision-maker’s perception is described as influenced by their environments, goals, and values ( Simon, 1959). This early work also describes the importance of perception as an influence on decision-making ( Simon, 1959). In this research, fulfillment of the motivating force was referred to as satisficing to indicate that a satisfactory rather than ideal result is acceptable ( Simon, 1959). The decision-making process ends with fulfillment of the motivating force ( Simon, 1959).
A review of the literature was conducted with the goal of summarizing the factors and processes identified in research on nurse patient care decisions in the medical-surgical setting.Įarly decision-making research in economics included a consideration of the influence of motivating forces ( Johansen & O’Brien, 2015 Simon, 1959). An understanding of nurse decision-making in the medical-surgical environment is essential for enhancing patient outcomes. In addition, nurse decision-making can vary significantly based on nurse practice setting ( Tummers, van Merode, & Landeweerd, 2002). The complexity of decision-making for nurses continues to increase with increases in patient acuity and technological advances ( Simmons, Lanuza, Fonteyn, Hicks, & Holm, 2003). Nursing research further explored elements important to nurse decision-making that include experience and intuition, context of the decision-making situation, knowing the patient, interpretation, and reflection ( Johansen & O’Brien, 2015 Tanner, 2006). Research on decision-making has emerged from a variety of fields including economics, nursing, and medicine ( Johansen & O’Brien, 2015). Improved understanding of decision-making research in this environment may help to guide future efforts to support nursing practice. Nurse decision-making in acute care is highly demanding. For instance, critical care nurses can make decisions every 30 seconds ( Bucknall, 2000). Research identifies other factors associated with decision-making challenges for acute care nurses.
This process is further complicated by the fact that nurses may care for five or more patients in an acute care environment ( Tanner, 2006). Nurses must consider numerous, potentially competing factors when making decisions to meet patient and family needs ( Tanner, 2006). Decision-making in acute care nursing practice is a complex process. Decision-making is essential to nursing practice ( Lauri & Salantera, 1998). The Institute of Medicine has identified that up to 98,000 patients die each year as a result of poor decision-making in healthcare ( Kohn, 1999).