A new interlink decision making index for making multi-criteria decisions

In this paper a mechanism that is the brain child of the authors, has been proposed to overcome the potential manipulation of results as a direct consequence of the applied weightings. It is known as the Interlink Decision Making Index

Piercing the decision-making sphere : happiness as the key to real shareholder participation

The purpose of this article is to explain why recent corporate governance reforms and initiatives proclaiming to enhance shareholder participation and elevate shareholder rights, do not go far enough. Indeed, it is suggested that corporate governance polices and reform programs, which have emerged across the world in response to a number of high-profile corporate collapses, act to re-emphasise the limited, 'passive' role which individual shareholders have traditionally experienced in public companies. Although increasing the amount information provided to shareholders about corporate decisions and strategies, and providing shareholders with a greater opportunity to participate in annual general meetings, do go some way in 'empowering' shareholders, it is argued that shareholders essentially remain passive observers, rather than becoming active participants. To become active participants, or corporate governance 'insiders " it is argued that corporate law needs to be directed at piercing the 'decision-making sphere' for individual shareholders in public companies. This involves accommodating an active role for shareholders in the actual decision-making processes of the corporation, rather than simply being informed of decisions that are made and being entitled to veto decisions at the annual general meeting. The second part of the article looks specifically at how the 'oppression' or 'unfair prejudice' remedy, the most commonly used shareholder remedy, is capable - if reformulated so that the pursuit of happiness, rather than vague notions of 'fairness' and 'justice' is the central objective of the remedy - of being used to influence a change of culture within public companies directed at facilitating an active participatory role for shareholders.

Haemodynamic instability after cardiac surgery: nurses` perceptions of clinical decision-making

Background. Cardiac surgical patients are distinguished by their potential for instability in the early postoperative period, highly invasive haemodynamic monitoring technologies and unique clinical presentations as a result of undergoing cardiopulmonary bypass. Little is known about nurses’ perceptions of assuming responsibility for such patients. An nderstanding of nurses’ perceptions may identify areas of practice that can be improved and assist in determining the adequacy of current decision supports.

Aim. The aim of this study was to describe critical care nurses’ perceptions of assuming responsibility for the nursing management of cardiac patients in the initial two-hour postoperative period. Design. An exploratory descriptive study based on naturalistic decision-making.

Methods. Thirty-eight nurses were interviewed immediately following a two-hour observation of their clinical practice. Content analysis and a systematic thematic analysis process called ‘Framework’ were used to analyse the interview transcripts.

Results. Nurses described their perceptions of managing patients in terms of how they felt about making decisions for complex cardiac surgical patients and in terms of how clinical processes unique to the admission phase impacted their decision-making. Nurses felt either daunted or stimulated and challenged when making decisions. Nurses identified handover from anaesthetists, settling in procedures and forms of
collegial assistance as important processes that impacted their decision-making.

Conclusion. Nurses’ previous experiences with similar patients influenced how they felt about making decisions during the initial two-hour postoperative period, but did not alter their views about processes important for patient safety during this time. Relevance to clinical practice. Feelings expressed by nurses in this study highlight the need for clinical supervision and appropriate allocation of resources during the immediate recovery period after cardiac surgery. Nurses identified ways to improve clinical processes that impacted their decision-making during the immediate recovery of cardiac surgical patients.

The influence of patient complexity and nurses` experience on haemodynamic decision-making following cardiac surgery

Critical care nurses’ haemodynamic decision-making in the immediate postoperative cardiac surgical context is complex. To optimise patient outcomes, nurses of varying levels of experience are required to make complex decisions rapidly and accurately. In a dynamic clinical context such as critical care, the quality of such decision-making is likely to vary considerably. The aim of this study was to describe variability of nurses’ haemodynamic decision-making in the 2-hour period after cardiac surgery as a function of interplay between decision complexity, nurses’ levels of experience, and the support provided. A descriptive study based on naturalistic decision-making was used. Data were collected using continuous non-participant observation of clinical practice for a 2-hour period and follow-up interview. Purposive sampling was used to recruit 38 nurses for inclusion in the study. The quality of nurses’ decision-making was influenced by interplay between the complexity of patients’ haemodynamic presentations, nurses’ levels of cardiac surgical intensive care experience, and the form of decision support provided by nursing colleagues. Two factors specifically influenced decision-making quality: nurses’ utilisation of evidence for practice and the experience levels of both nurses and their colleagues. The findings have implications for staff resourcing decisions and postoperative patient management, and may be used to inform nurses’ professional development and education.

The clinical landscape of critical care: nurses' decision-making

Background. Many studies have tended to explore individual characteristics that impact on nurses' decision-making, despite significant acknowledgement that context is a major determinant in decision-making. The few studies that have examined environmental influences have tended not to study real decisions in the dynamic and complex clinical environment.

Aims. To investigate environmental influences on nurses' real decisions in the critical care setting.

Method. Naturalistic observations and semi-structured interviews were conducted with 18 critical care nurses in private, public and rural hospitals. Observations and interviews were recorded, transcribed verbatim and coded for themes using content analysis.

Results. All clinical decisions were strongly influenced by the context in which the decision was made. Three main environmental influences were identified: the patient situation, resource availability and interpersonal relationships. Time and risk guided all clinical decisions. Nurses established the state of the situation, the time constraints on decisions and the level of risk involved for both patient and nurse.

Conclusions. Decision-making is a manifestation of the landscape and although an increased understanding of the landscape is required, more important is the need to measure the impact of contextual variables on nurses' decision-making in order to improve health care outcomes.

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.