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Nurse Managers' Decisions: Fast and Favoring Remediation

Effken, Judith A. PhD, RN, FAAN, FACMI; Verran, Joyce A. PhD, RN, FAAN; Logue, Melanie D. MS, RN; Hsu, Ya-Chuan PhD, RN

Journal of Nursing Administration: April 2010 - Volume 40 - Issue 4 - p 188-195
doi: 10.1097/NNA.0b013e3181d40f7c

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically and efficiently, while encouraging consideration of more alternatives to reach targeted goals.

Authors' Affiliations: Professor (Dr Effken), Emeritus Professor (Dr Verran), Doctoral Student (Ms Logue), The University of Arizona College of Nursing, Tucson; Assistant Professor (Dr Hsu), Chang Jung Christian University, Tainan, Taiwan.

Corresponding author: Dr Effken, The University of Arizona College of Nursing, PO Box 210203, Tucson, AZ 85721-0203 (

Funding: This research is funded by a grant from the National Library of Medicine (National Institutes of Health) 1R01LM009516-01A1. Disclosure: Portions of this article were presented at the 2009 AMIA Fall Symposium, San Francisco, California, November 17, 2009.

© 2010 Lippincott Williams & Wilkins, Inc.