Clinical decision regret among critical care nurses: A qualitative analysis

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. Objectives: 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. Conclusion: While 157 CCNs disclosed a clinical decision they made at work while sleepy, the prevalence may be underestimated and warrants further investigation. (C) 2014 Elsevier Inc. All rights reserved.