Table 2.

Categories Derived from the Conceptual Framework

Nurse Decision-Making Model
Category	Operational Definition*
Nurse decision-making	Using intuitive and/or analytical strategies.
Situation awareness	Assessing the patient and becoming aware of their needs.
Decision	Visit plan (or visit patterns), including the number and frequency of skilled nursing visits.
Decision implementation**	Steps taken by the nurse to follow the initial visit plan.
Reevaluation/Self-reflection	Reevaluating the visit plan during the episode based on unanticipated changes.
Socio-Ecological Lens
Category	Operational Definition*
Patient-level factors	Information-based variables or sources of information used to make decisions such as pre-encounter data and patient assessment data.
Nurse-level factors	Knowing the self, including personal values and professional scope of practice. Prior experiences with similar situations. Knowledge and training necessary to evaluate the situation and weigh potential alternatives.
Agency-level factors	Culture of practice and work environment, including support from managers and colleagues, adequate staffing, agency policies, and degree of collaborative practice.
Policy/Payer-level factors	Home health regulations and payment system.

Notes:

^*The review of the literature led to initial operational definitions for these categories.

^**Decision implementation is not discussed in this manuscript.