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  1. Effken, Judith A. PhD, RN, FAAN, FACMI
  2. Verran, Joyce A. PhD, RN, FAAN
  3. Logue, Melanie D. MS, RN
  4. Hsu, Ya-Chuan PhD, RN


How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically and efficiently, while encouraging consideration of more alternatives to reach targeted goals.