title: Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.
abstract: OBJECTIVE
  To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings.
  
  
  BACKGROUND
  Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making.
  
  
  METHODS
  Descriptive cross-sectional design.
  
  
  METHODS
  Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis.
  
  
  RESULTS
  Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit.
  
  
  CONCLUSIONS
  Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks.
  
  
  CONCLUSIONS
  The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings.
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.
authors.forename: Eriikka
authors.initials: E
authors.lastname: Siirala
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.
authors.forename: Laura-Maria
authors.initials: LM
authors.lastname: Peltonen
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Hospital District of Southwest Finland, Turku, Finland.
authors.forename: Heljä
authors.initials: H
authors.lastname: Lundgrén-Laine
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Hospital District of Southwest Finland, Turku, Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Salanterä
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.|Group Administration, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Junttila
mesh_terms: D003430:Cross-Sectional Studies; D003657:Decision Making; D005387:Finland; D006801:Humans; D009718:Nurse Administrators / Q000523:psychology*; D019990:Perioperative Care / Q000451:nursing / Q000592:standards*; D017009:Professional Autonomy; D036301:Qualitative Research; D057188:Workflow
keywords: daily unit operation; decision-making; nurse manager; peri-operative settings; think-aloud method