The Effects of Time Pressure and Experience on Nurses' Risk Assessment Decisions

Thompson, Carl; Dalgleish, Len; Bucknall, Tracey; Estabrooks, Carole A.; Hutchinson, Alison M.; Fraser, Kevin J.; Vos, Rien de; Binnekade, Jan M.; Barrett, Gez; Saunders, Jane

doi:10.1097/01.nnr.0000313504.37970.f9

Cited by 89 publications

(54 citation statements)

References 30 publications

(20 reference statements)

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“…This study's heavy workload measure includes items associated with nurse perceptions of time pressure, or not enough time to get work done (e.g., arriving early/leaving late, missing breaks, too much work to do). In one simulated study of nurses' decision-making performance, time pressure negatively influenced nurses' capacity to detect the need for intervention, resulting in failure to rescue [37]. Of note is that under conditions without time pressure, nurses with clinical expertise performed better than novice nurses; the positive effects of clinical expertise, however, were negated when time pressure was introduced to clinical simulations [37].…”

Section: Discussionmentioning

confidence: 99%

“…In one simulated study of nurses' decision-making performance, time pressure negatively influenced nurses' capacity to detect the need for intervention, resulting in failure to rescue [37]. Of note is that under conditions without time pressure, nurses with clinical expertise performed better than novice nurses; the positive effects of clinical expertise, however, were negated when time pressure was introduced to clinical simulations [37]. The European Nurses' Early Exit study surveyed over 61,000 nurses [38].…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

MacPhee

Dahinten

Havaei

2017

Administrative Sciences

148

129

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This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses' workload demands at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands; (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction; (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes; (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

MacPhee

Dahinten

Havaei

2017

Administrative Sciences

148

129

View full text Add to dashboard Cite

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“…The findings of this study revealed that experience is one of the main factors that determine the nurses' ability to take decisions. Clinical experience where found to positively strengthen nursing care [13] [20]. Through experience, the critical care nurses become more aware of their role in decision-making process.…”

Section: Discussionmentioning

confidence: 99%

“…The difficult and complicated health situation in critical care areas highlight the complexity and the importance of nurses decision making [14]. Patients in critical care units are seriously ill and frequently unstable and their health changed rapidly [14] [19] [20]. These changes require the nurses to make decisions in a limited period of time [4].…”

Section: Discussionmentioning

confidence: 99%

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Maharmeh¹,

Alasad²,

Salami³

et al. 2016

Health

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The purposes of this study were to describe the decision making process and decision activities of critical care nurses in natural clinical settings. An exploratory descriptive approach utilizing both interview and observation methods, was used for data collection. The study involved twenty four critical care nurses from three hospitals in Jordan. Participant observation was performed to understand the routine clinical decisions made by Intensive Care nurses. About 150 hours of observations were spent in the involved Intensive Care Units. Nurses were interviewed to elicit information about how they made decisions about patient's care. The study revealed that the most common model nurses tend to use was intuitive model in order to observe the cues relating to the patient's situation. Data revealed that the decision making process is continuous and that experience is one of the main factors that determine nurses' ability to take decisions. Five themes were generated from the data: on-going process, autonomy, experience/power, joint/ethical decisions, and advocacy. Critical care nurses were seen to be sensitive to the patient's verbal and non-verbal cues; they were able to respond to these evidences to ensure that the patient's condition did not deteriorate. Critical care nurses are likely to be more confident and effective when dealing with patient's changing situations with more experience.

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“…From traders in the stock market to consumers in a store, many real-world decisions are made under time pressure (e.g., Bourgeois & Eisenhardt, 1988;Dhar & Nowls, 1999;Roth & Ockenfels, 2002;Thompson et al, 2008). This time pressure can alter many facets of decision-making, potentially making people more impulsive, defensive, or stressed, and occasionally more risk seeking (Ariely & Zakay, 2001;Dror, Busemeyer, & Basola, 1999;Gladstein & Reilly, 1985;Kelly & Karau, 1999;Nursimulu & Bossaerts, 2014;Zakay & Wooler, 1984).…”

Section: Introductionmentioning

confidence: 99%

Rapid makes risky: Time pressure increases risk seeking in decisions from experience

Madan

Spetch

Ludvig

2015

Journal of Cognitive Psychology

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Time pressure is a common constraint on many real-world decisions, such as those made by traders placing orders in the stock market, bidders in an auction, or gamblers at a casino. Many of these situations also involve elements of risk or uncertainty. Previous research has mostly found that time pressure leads to more risky choices. These previous studies, however, have examined decisions made from probabilities that were explicitly described, rather than learned through experienced outcomes. Here we tested how time pressure influences decisions from experience, while manipulating outcome value. Participants under greater time pressure chose risky options more often, independent of outcome value. Our results suggest that, as with decisions from description, time pressure moderately increases risk seeking in decisions from experience.

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The Effects of Time Pressure and Experience on Nurses' Risk Assessment Decisions

Cited by 89 publications

References 30 publications

The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Rapid makes risky: Time pressure increases risk seeking in decisions from experience

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