A critical examination of ethical decision making models

This paper critically examines both the need for, and the use of, ethical decision making models (EDMMs). This paper suggests that EDMMs focus on arriving at the correct decision but ignore the action required to implement it and are therefore incomplete. In most “accounting” circumstances, finding the right decision is not what is required. Rather, a model which provides both a sound decision and, appropriate implementation would be more useful. In trying to establish a new/different EDDM that provides for this it is argued that a biblical model exists which addresses both decision making and action. This paper aims to encourage accounting ethics education to move beyond determining the right decision and focus on taking the right action.

The role of information and communication technology in the urgent decision making process : a work in progress report

This paper reports part of a study that examines how members of a senior management team in a public sector organisation make decisions under urgency. Four regional managers, who are geographically dispersed around New Zealand were interviewed, either face-to-face or via telephone, regarding their experiences of decision making under urgency.

Preliminary results indicate that only three out of a possible seven steps of a conventional decision making process are used during the urgent decision making process. The study also shows that participants do not fully utilise the information and communication technology available during the decision making process. The implications the findings have for practice and research are discussed.

Parental decision-making surrounding complicated births: the impact on parent-infant and infant-marital relationships

This paper reviews current research regarding the impact of birth complications on parental decisionmaking, and the resulting effects on parent-infant and infant-marital relationships. It discusses the importance of informed decision-making on parental satisfaction of the birthing experience, and the benefits of certain strategies, such as kangaroo care, in the facilitation of greater levels of attachment and improved relationships. The paper concludes with suggestions for future research areas to focus on finding better ways to prepare and support parents in these situations, thus improving the quality of relationships between parents and with their child.

Strategic decision-making and emotions

Senior management decisions play a critical role not only in organizational performance but also in the competitiveness of Australia in the international arena. In this conceptual paper, I present a multi-level model of affect in strategic decision-making to understand the impact that emotions have on senior managements' decision-making processes. The aim of the model is to extent on current theory (specifically Affective Events Theory) to minimize the negative impact of emotions on decision-making to produce high quality decisions and, consequently, more effective and competitive organizations. Hypotheses, practical implications and future research opportunities are also discussed.

Toward incorporating human dimensions information into wildlife management decision-making

This paper presents a comparison of values of wildlife held by stakeholder groups and public samples in Victoria, Australia, with a sample of wildlife managers' beliefs about these groups. It also examines the managers' views of the importance of utilizing human dimensions information in their decision-making. In-depth interviews were conducted with wildlife/environmental managers in a sample of state and local government agencies and members of wildlife management stakeholder groups. Questionnaires were used to explore values of wildlife held by stakeholder group members and the Victorian public. There are several instances of interviewed managers misunderstanding the values held by stakeholder groups and subsets of the Victorian public. Such discrepancies can be reduced by incorporating systematically obtained human dimensions information into management decisions. Interviewed wildlife managers appear to appreciate the importance of human dimensions information; however, there was some uncertainty about how it could be applied.

Triage nurses' clinical decision making : an observational study of urgency assessment

Background. Researchers have described both the various decision tasks performed by triage nurses using self-report methods and identified time as a factor influencing the quality of triage decisions. However, little is known about the decision tasks performed by triage nurses when making acuity assessments, or the factors influencing triage duration in the real world.

Aims. The aims of this study were to: describe the data triage nurses collect from patients in order to allocate a triage priority using the Australasian Triage Scale (ATS); describe the duration of nurses' decision making for ATS categories 2–5; and to explore the impact of patient and nurse variables on the duration of the triage nurses' decision making in the clinical setting.

Design. A structured observational study was employed to address the research aims. Observational data was collected in one adult emergency department located in metropolitan Melbourne, Australia. A total of 26 triage nurses consented and were observed performing 404 occasions of triage. Data was collected by a single observer using a 20-item instrument that recorded the performance frequencies of a range of decision tasks and a number of observable patient, nurse and environmental variables. Additionally, the nurse–patient interaction was recorded as time in minutes.

Results. It was found that there was limited use of objective physiological data collected by the nurses' in order to decide patient acuity, and large variability in the duration of triage decisions observed. In addition, analysis of variance indicated strong evidence of a true difference between triage duration and a range of nurse, patient and environmental variables.

Conclusion. These findings have implications for the development of practice standards and triage education. In particular, it is argued that practice standards should include routine measurement of physiological parameters in all but the collapsed or obviously unwell patient, where further delay may impede the delivery oftime-critical intervention. Furthermore, the inclusion of arbitrary time frames for triage assessment in practice standards are not an appropriate method of evaluating triage decision making in the real world.

Patients' decision-making strategies for managing postoperative pain

Despite technological advances, many postoperative patients continue to suffer unrelieved pain. The aim of this study was to identify the strategies used by postoperative patients to bring about pain management decisions. A single-group noncomparative study design was chosen using observations as the means of examining pain activities in 2 surgical units of a metropolitan teaching hospital in Melbourne, Australia. A total of 52 nurses and 312 patients participated in the study, and 316 pain activities were observed. The most common strategy used was patients acting as a passive recipient for pain relief (60%), whereas problem solving (23%) and active negotiation (17%) were less commonly used. Patients in this study were admitted for surgical treatment of a particular condition, and their subsequent pain was specifically related to this acute event. Therefore, the lack of familiarity of the situation and the severity of pain experienced may have encouraged passivity. Patients may have also felt uncertain about how to approach the pain decision, preferring to defer to nurses. Because increased pain levels can be associated with fear, patients could have been unwilling to speak with nurses to discuss their need for pain relief.

Construction of aggregation operators for automated decision making via optimal interpolation and global optimization

This paper examines methods of point wise construction of aggregation operators via optimal interpolation. It is shown that several types of application-specific requirements lead to interpolatory type constraints on the aggregation function. These constraints are translated into global optimization problems, which are the focus of this paper. We present several methods of reduction of the number of variables, and formulate suitable numerical algorithms based on Lipschitz optimization.

Do knowledge and experience have specific roles in triage decision-making?

Accuracy of triage decisions is a major influence on patient outcomes. Triage nurses' knowledge and experience have been cited as influential factors in triage decision-making. The aim of this article is to examine the independent roles of factual knowledge and experience in triage decisions. All of the articles cited in this review were research papers that examined the relationship between triage decisions and knowledge and/or experience of triage nurses. Numerous studies have shown that factual knowledge is an important factor in improving triage decisions. Although a number of studies have examined the role of experience as an independent influence on triage decisions, none have found a significant relationship between experience and triage decision-making. Factual knowledge appears to be more important than years of emergency nursing or triage experience in triage decision accuracy. Many triage education programs are underpinned by the assumption that knowledge acquisition will result in improved triage decisions. A better understanding of the relationships between clinical decisions, knowledge, and experience is pivotal for the rigorous evaluation of education programs.