title: Strategic threat management: an exploration of nursing strategies in the pediatric intensive care unit.
abstract: Part of the work of a critical care nurse is to manage the threats that arise that could impede efficient and effective job performance. Nurses manage threats by employing various strategies to keep performance high and workload manageable. We investigated strategic threat management by using the Threat-Strategy Interview. Threats frequently involved technology, staff, or organizational components. The threats were managed by a toolbox of multifaceted strategies, the most frequent of which involved staff-, treatment- (patient + technology), examination- (patient + clinician), and patient-oriented strategies. The profile of strategies for a particular threat often leveraged work facets similar to the work facet that characterized the threat. In such cases, the nurse's strategy was directed at eliminating the threat (not working around it). A description at both a domain invariant level - useful for understanding strategic threat management generally - and a description at an operational, specific level - useful for guiding interventions-- are presented. A structural description of the relationship among threats, strategies, and the cues that trigger them is presented in the form of an evidence accumulation framework of strategic threat management.
authors.affiliation: School of Psychology, Georgia Institute of Technology, 654 Cherry Street, Atlanta, GA 30332, USA. Electronic address: frank.durso@gatech.edu.
authors.forename: Francis T
authors.initials: FT
authors.lastname: Durso
authors.affiliation: School of Psychology, Georgia Institute of Technology, 654 Cherry Street, Atlanta, GA 30332, USA.
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Ferguson
authors.affiliation: School of Psychology, Georgia Institute of Technology, 654 Cherry Street, Atlanta, GA 30332, USA.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Kazi
authors.affiliation: Nursing Research and Evidence-Based Practice, Children's Healthcare of Atlanta, GA 30329, USA.
authors.forename: Charlene
authors.initials: C
authors.lastname: Cunningham
authors.affiliation: Nursing Research and Evidence-Based Practice, Children's Healthcare of Atlanta, GA 30329, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Ryan
mesh_terms: D000328:Adult; D001364:Awareness; D002983:Clinical Competence; D032882:Comprehension; D003463:Cues; D003657:Decision Making; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007407:Interviews as Topic / Q000379:methods; D007442:Intubation, Intratracheal; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D009729:Nursing / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012131:Respiratory Insufficiency / Q000628:therapy; D013647:Task Performance and Analysis; D000078329:Workforce; D016526:Workload
keywords: Interviews; Nursing; Strategies