Clinical decision-making in critical care

A survey of 230 practising critical care nurses was conducted to examine the frequencies with which the nurses made decisions to perform 10 critical care tasks drawn from cardiac, respiratory and gastrointestinal management. The relationship between the nurses' levels of appointment and the frequencies with which they made their decisions was also studied. Substantial intra-respondent and inter-respondent variations were found in the frequencies with which nurses reported that they made the decisions. Chi-square analysis showed that there was a positive association (p < 0.05) between nurses' appointment levels and the frequency with which decisions were made to perform five of the tasks. Notwithstanding these associations, it is of concern that the professional preparation of some nurses had not been at a level that equipped them to routinely make these decisions. The findings of the study have implications for the development of standards of practice guidelines and critical care education.