title: Clinical decision regret among critical care nurses: a qualitative analysis.
abstract: BACKGROUND
  Decision regret is a negative cognitive emotion associated with experiences of guilt and situations of interpersonal harm. These negative affective responses may contribute to emotional exhaustion in critical care nurses (CCNs), increased staff turnover rates and high medication error rates. Yet, little is known about clinical decision regret among CCNs or the conditions or situations (e.g., feeling sleepy) that may precipitate its occurrence.
  
  
  OBJECTIVE
  To examine decision regret among CCNs, with an emphasis on clinical decisions made when nurses were most sleepy.
  
  
  METHODS
  A content analytic approach was used to examine the narrative descriptions of clinical decisions by CCNs when sleepy.
  
  
  RESULTS
  Six decision regret themes emerged that represented deviations in practice or performance behaviors that were attributed to fatigued CCNs.
  
  
  CONCLUSIONS
  While 157 CCNs disclosed a clinical decision they made at work while sleepy, the prevalence may be underestimated and warrants further investigation.
authors.affiliation: University of Michigan School of Nursing, 400 North Ingalls, Room 2176, Ann Arbor, MI, USA. Electronic address: cmae@med.umich.edu.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Arslanian-Engoren
authors.affiliation: Health System Sciences, University of Illinois at Chicago College of Nursing, 845 S. Damen (MC 802), Chicago, IL 60612, USA.
authors.forename: Linda D
authors.initials: LD
authors.lastname: Scott
mesh_terms: D000328:Adult; D003422:Critical Care / Q000523:psychology* / Q000592:standards; D003657:Decision Making; D004644:Emotions; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology* / Q000592:standards; D012894:Sleep Stages
keywords: Clinical decision making; Critical care nurses; Decision regret; Fatigue; Sleepiness