Task Complexity and Nursing Expertise as Factors In Decision Making

Corcoran, Sheila

doi:10.1097/00006199-198603000-00013

Cited by 84 publications

(107 citation statements)

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“…The common explanation for such an inverted U shape draws upon the encapsulation hypothesis (Rikers et al 2000), stating that, compared to novices, 'intermediates have acquired an extensive body of knowledge, but have not yet reorganised this knowledge in a functional manner to perform various tasks' (Patel and Ramoni 1997, p. 93). As our study's results do not replicate this effect, they stand in line with several earlier studies conducted in the nursing sector that searched for systematic differences in nurses' performance or knowledge, but failed to detect any or found unusual patterns (Corcoran 1986;Hamers et al 1997;Tanner et al 1987).…”

Section: Relevance Of the Different Facets Of Negative Knowledgesupporting

confidence: 71%

Negative expertise: comparing differently tenured elder care nurses' negative knowledge

et al. 2010

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Negative expertise is conceptualised as the professional's ability to avoid errors during practice due to certain cognitive agencies. In this study, negative knowledge (i.e. knowledge about what is wrong in a certain context and situation) is conceptualised as one such agency. This study compares and investigates the negative knowledge of elder care nurses at three different levels of professional experience. Thereby, various forms of negative knowledge-declarative, procedural, self-reflective and vicarious-are investigated. Moreover, the specificity of negative knowledge is compared across different levels of professional experience. Verbal data was collected from a prompting task study of 37 elder care nurses. These were prompted 20 diagnoses of varying typicality for the professional field. The nurses were asked what was critical to pay attention to and what ought to be avoided in case of these diagnoses. The study's results reveal a significant superiority of highly tenured elder care nurses in vicarious negative knowledge, as well as in highly specified negative knowledge. Procedural and procedural negative knowledge (PNK)-which are the most important facets in quantitative termsshow an approximately parallel developmental pattern among the different groups. For declarative knowledge, a U-shaped intermediate effect was discovered. It is concluded that PNK has the most immediate error-preventive function. With regards to future research, the great specificity of highly tenured elder care nurses' negative knowledge discovered in this study is discussed here as one possible explanation as to why they are able to intentionally avoid errors (i.e. their negative expertise).Résumé L'expertise négative est conceptualisée en tant que la capacité professionnelle à éviter les erreurs lors de la pratique dues à certains agents cognitifs. Dans cette étude, les connaissances négatives (c.-à-d. les connaissances relatives à ce qui est erroné dans un contexte ou une situation donné) sont conceptualisées en tant qu'agent de ce type. Cette étude compare et étudie les connaissances négatives des infirmières prodiguant des soins aux personnes âgées à trois stades d'expérience professionnelle différents. Nous étudions donc plusieurs formes de connaissances négatives, à savoir les connaissances déclaratives, procédurales, auto-réflectives et vicariantes. De plus, la spécificité des connaissances négatives est comparée en fonction des différents niveaux d'expérience. Des données verbales ont été collectées à partir d'une étude de tâches proposées à 37 infirmières soignant des personnes âgées. On leur a proposé 20 diagnostics de typicalité variable dans leur domaine professionnel. Il a été demandé aux infirmières ce qu'il était crucial de surveiller avec attention et ce qui devait être évité dans le cas de ces diagnostics. Les résultats de cette étude révèlent une supériorité importante des infirmières soignant des personnes âgées les plus gradées en matière de connaissances négatives vicariantes ainsi qu'en ce qui concerne les con...

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Section: Relevance Of the Different Facets Of Negative Knowledgesupporting

confidence: 71%

Negative expertise: comparing differently tenured elder care nurses' negative knowledge

et al. 2010

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“…The experienced nurse makes clinical decisions based on cues she or he identifies in the situation. These cues are learnt from previous knowledge and experience [9]. The experience comes from recognizing patient's health situations and then developing action strategies to manage these situations [22].…”

Section: Discussionmentioning

confidence: 99%

“…Although the professional role of nurses has extended and become more responsible, these added responsibilities serving for wider decision making [5]. Corcoran [9] argues that the more complex the task, the more complex the decision making and the higher the likelihood that an incorrect decision will be made. This is supported by Tanner et al [10] who stated that decisions are more difficult when tasks are more complex; however the process of decision making becomes easier and manageable when the nurses become more experienced [8].…”

Section: Introductionmentioning

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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“…8 Survey participation takes nurses away from the professional responsibility of caring for multiple patients, simultaneouslya work complexity unique to nurses in hospitals. 9,10 This uniqueness arises from the client-practitioner relationship that is the essence of all professions. 11 In nursing, this relationship is characterized by responsibility for multiple, compromised, clients of different cultures with different needs and diagnoses, requiring constant surveillance, often located in multiple rooms.…”

mentioning

confidence: 99%

“…16 This makes it more difficult for nurses not only to work as a team in managing the multiple patient simultaneity work complexity but also to participate in surveys. 9,13,15 …”

mentioning

confidence: 99%

Incentives and Procedures Effective in Increasing Survey Participation of Professional Nurses in Hospitals

Kramer

Schmalenberg

Keller-Unger

2009

Nursing Administration Quarterly

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Positive patient and nurse outcomes depend upon improved clinical nurse work environments. Improvements can be confirmed through environmental surveys that have sufficient participation to yield accurate data. Professional clinical nurses in hospitals face a unique work complexity that inhibits survey participation. What procedures/incentives are effective in increasing survey participation? Are procedures/incentives effective with non-nurses applicable to nurses? These questions were answered through a focused literature review, a case-study analysis of procedures and incentives used by M.D. Anderson Cancer Center that resulted in a 93% response rate on an environmental Web-based survey, operational data from environmental surveys administered to staff nurses in 286 hospitals nationally and internationally, and an e-mail survey of nurse leaders/managers in 7 strategically selected hospital units. Incentives effective with nurse populations differed from those of non-nurse populations in several areas. Benchmarking and gap analysis-assessment, comparison to internal or external referents, introduction of needed improvements, and reassessment-are best leadership/management practices and are essential elements of the research and quality improvement efforts characteristic of Magnet hospitals. As the use of surveys for quality improvement and workforce management increases, nurse leaders need to know what procedures and incentives encourage response rates large enough to produce valid, representative data.

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Task Complexity and Nursing Expertise as Factors In Decision Making

Cited by 84 publications

References 0 publications

Negative expertise: comparing differently tenured elder care nurses' negative knowledge

Negative expertise: comparing differently tenured elder care nurses' negative knowledge

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

Incentives and Procedures Effective in Increasing Survey Participation of Professional Nurses in Hospitals

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