Decision-Making Strategies

Which example demonstrates a normative approach to decision-making? 1. A hectic day prompts the nurse manager to call in extra staff to help. 2. Supplies are ordered during the third week of the month to be prepared for the upcoming month. 3. The manager decides to call a team meeting in October to address holiday time-off requests and unit staffing. 4. A group decides to eat at the employee cafeteria for lunch instead of going out because they have a meeting at 1 p.m.

2. Supplies are ordered during the third week of the month to be prepared for the upcoming month. Rationale: This is an example of a normative approach to decision-making. The person is planning a week or more ahead for expected or normal circumstances.

A patient on a telemetry unit experiences cardiopulmonary arrest. Which decision-making style is indicated? 1. Informative 2. Prescriptive 3. Paternalistic 4. Shared decision

3. Paternalistic Rationale: A paternalistic or autocratic decision-making style is required during emergency or crisis situations when there is little or no time to consider the opinions of other staff members and quick decisions must be made.

Place the steps of the decision-making process in order. -Apply an option to the solution. -Evaluate the choices. -Determine whether the decision was effective. -Determine the best decision. -Identify desired outcomes.

-Identify desired outcomes. -Evaluate the choices. -Determine the best decision. -Apply an option to the solution. -Determine whether the decision was effective. Rationale: When a decision must be made, it is important to define the problem and set goals for the outcome. Options should be determined and evaluated, and the pros and cons of each should be weighed. Based on the pros and cons, the options should be ranked, and a decision should be made. Once the decision is implemented, the results should be evaluated to determine whether the decision resulted in an effective resolution of the problem.

The ideal decision-making process has 7 steps

1. Define the objectives. 2. Generate options. 3. Weigh the pros and cons of the options. 4. Rank the options. 5. Make a decision. 6. Implement the decision. 7. Evaluate the result.

Which actions by Jason, the nurse leader, exemplify strategies that facilitate group decision-making? (Select all that apply) 1. Generating a list of guidelines 2. Ensuring a heterogeneous mix of group members 3. Identifying a single impartial party to decide when the group is split 4. Ensuring that ideas discussed are similar to past successful ideas 5. Asking members to identify the pros and cons of ideas and come prepared to discuss them

1. Generating a list of guidelines 2. Ensuring a heterogeneous mix of group members 5. Asking members to identify the pros and cons of ideas and come prepared to discuss them

Two criteria in order for a group decision to be considered effective.

1. It must achieve the predefined goal(s), objective(s), and outcome(s). 2. Those responsible for implementation must accept the decision.

Decision-Making Approaches

1. Normative/Prescriptive Approach 2. Descriptive Approach 3. Satisficing Approach 4. Optimizing Approach

Three models of decision-making styles

1. Paternalistic 2. Informative 3. Shared decision-making

The director of nursing is recruiting departmental nurse managers to lead a group decision-making committee. The director should select managers with which attributes? 1. Risk-taking and innovative personalities 2. Ability to think outside of the box to develop new and exciting ideas 3. Ability to make a final decision if a unanimous decision is not possible 4. Ability to be flexible with the group rules to cater to more group members 5. Understanding of all risks and benefits associated with the decision being made

1. Risk-taking and innovative personalities Rationale: When choosing group members, the nurse leader should include personalities that take risks and innovate. These personalities influence effective decision-making and bring new ideas to the group for discussion. 2. Ability to think outside of the box to develop new and exciting ideas Rationale: Risk-taking and encouragement of risk-taking are competencies that support group decision-making and result in the development of new and innovative ideas. 5. Understanding of all risks and benefits associated with the decision being made Rationale: The nurse leader must have a solid understanding of the risks and benefits of the decision, because he or she must communicate these to all people involved and likely to be affected by the decision.

Which scenarios are examples of environments or situations to be avoided in group decision-making? (Select all that apply) 1. The staff members at a small outpatient facility have mostly dominant or passive personality styles. 2. A hospital unit has a high turnover in management, resulting in a lack of cohesiveness and trust between nurse followers and leaders. 3. A community health clinic has an urgent need to expand services because of a new influenza outbreak in the local community. 4. A long-term project for a comprehensive cancer unit has been approved; the goal is to double the number of patients served in 3 to 6 years. 5. A health care provider's office has a diverse culture of moderately cohesive staff members, and the nurse leader is known as being a risk-taker.

1. The staff members at a small outpatient facility have mostly dominant or passive personality styles. 2. A hospital unit has a high turnover in management, resulting in a lack of cohesiveness and trust between nurse followers and leaders. 3. A community health clinic has an urgent need to expand services because of a new influenza outbreak in the local community.

Which statement by the charge nurse indicates that an informative decision-making style is being utilized? 1. "We will begin morning report at 8:00 AM." 2. "I'd rather not discuss the logistics. Let's just get it done." 3. "Let's talk about that idea you had yesterday. I'd like to look into it further." 4. "The Policy and Procedure Committee has determined that there will be changes in the pharmacy delivery system."

3. "Let's talk about that idea you had yesterday. I'd like to look into it further." Rationale: This statement exemplifies an informative decision-making style. This style is similar to a democratic system, which involves the input of others and a discussion of options and preferences.

Which approach by the nurse demonstrates the use of effective decision-making? 1. Take a trial-and-error approach. 2. Solve the problem based on solutions that have worked in the past. 3. Identify and rank potential solutions to determine the best option. 4. Implement the most obvious solution while researching alternative solutions.

3. Identify and rank potential solutions to determine the best option. Rationale: Effective decision-making involves using a step-by-step process to make more deliberate, thoughtful decisions. It involves organizing relevant information to define alternative solutions, ranking those solutions, and identifying the best option.

Which group decision-making strategy is Jason using to determine proposed changes to the new admission report form? 1. Brainstorming 2. Delphi technique 3. Paternalistic approach 4. Nominal group technique

4. Nominal group technique Rationale: The nominal group technique is a time-consuming but effective method by which members generate and share ideas, and then the group discusses and ranks the ideas.

Case study for the next 2 questions

Jason is a nurse leader in a pediatric unit. A decision must be made about a new admission report form, so Jason puts together a group to determine what information should be excluded from the form. Jason has chosen group members to ensure a varied mix of education, heritage, and specialties. He has reserved a room for the group to meet in weekly, and he has set the time in advance to ensure group availability. He has also developed a list of guidelines that the group will follow, indicating that all members must interact in a positive and constructive way and that any non-unanimous decisions will be settled by a single impartial party. Jason communicates that he wants to ensure that the decisions will be made with approaches similar to those that have been used in the past and have proven successful in the pediatric unit. At the first meeting, Jason indicates that he would like all members to come prepared for the next meeting with a list of ideas for the new admission report form, along with pros and cons, to discuss with the group.

Which situations are affected by internal decision-making factors? a) A nurse always approaches confrontation the same way because of her personal belief system. b) A member of the team is still upset about an argument she had with her spouse this morning. c) Nursing team members only have use of the meeting room for 30 minutes before the next group arrives. d) The nurse manager wants to order new equipment, but there are not enough funds left in the yearly budget. e) The nurse decides to do the same thing she always does to solve a certain problem, because that strategy has worked in the past.

a) A nurse always approaches confrontation the same way because of her personal belief system. b) A member of the team is still upset about an argument she had with her spouse this morning. e) The nurse decides to do the same thing she always does to solve a certain problem, because that strategy has worked in the past.

Which situation exemplifies the use of the Delphi technique? a) Parents sharing views on child care programs offered as an employee benefit and how to improve them b) Employees meeting with the Building Maintenance Department to generate ideas on how to solve the lack of parking spaces c) The marketing team sharing ideas for advertising the new Women's Services Clinic on index cards and picking the best one d) A nurse manager gathering information on best practices for patient satisfaction from the nurses working on every shift on the four Medical-Surgical units in the hospital

d) A nurse manager gathering information on best practices for patient satisfaction from the nurses working on every shift on the four Medical-Surgical units in the hospital Rationale: The Delphi technique, which involves using media to systematically collect ideas from experts through surveys or questionnaires, is a great way to obtain information from a large cohort of people.

A decision must be made on how to spend a unit's surplus budget money, and the nurse manager wants to spend the money on equipment upgrades. A nurse is overheard saying, "The staff should be allowed to decide, as this affects us, but administration will never listen to us over the nurse manager." Which group decision-making strategy should be used in this situation? a) Focus groups b) Delphi technique c) Prescriptive approach d) Nominal group technique

d) Nominal group technique Rationale: The nominal group technique is a decision-making strategy that involves the collection of ideas from the entire group and the ranking of those ideas by the group. This technique is ideal in situations in which there may be members with more dominant personality types to ensure equal participation by all members.

The nurse manager of a psychiatric unit asks a group of staff members to generate ideas for fundraising projects to support homeless patients in the unit. The staff members are asked to write down their best ideas and then pick the best project. Which decision-making technique is being used? a) Focus group b) Brainstorming c) Delphi technique d) Nominal group technique

d) Nominal group technique. Rationale: In the nominal group technique, group members are asked to write down ideas to solve predefined problems.