Research: Involvement of Registered Nurses in Decision-Making
Jessica McGaha Bertagnolli RN, BSN and Terilyn Dove RN, BSN
2009
Jessica McGaha Bertagnolli RN, BSN and Terilyn Dove RN, BSN
2009
Research Question
What is the actual level of decisional involvement for
nurses at targeted health system in Idaho, and what is the desired level of
decisional involvement for those nurses?
Definition
Decisional Involvement is the pattern of distribution of authority for decisions
and activities
that govern nursing practice policy and the practice environment.*
Purpose
To evaluate the actual (what nurses perceive actually occurs) vs. desired (what nurses believe should occur) level of decisional involvement of nurses at targeted health system hospitals.
Havens & Vasey developed a 21-item instrument –
the
Decisional Involvement Scale
(DIS) –
that compares actual and desired levels of nursing decisional involvement (2003).
Demographic items collected:
Location
Shared Governance Involvement
Shift most often worked
Number of hours currently working
"The nursing processes in place allow me to deliver safe and
quality patient care."
Methods
SAMPLE- Randomized sample of direct patient care Registered Nurses,
including staff nurses, managers, designated charge nurses and clinical
supervisors at the health system hospitals were
invited to participate in an on-line survey.
66% (1, 020) of all direct patient care nurses were contacted by
letter to invite their participation in the survey.
Data collection took place during January 2009.
Of the 1,020 RNs contacted, a total of 265 responded to the Survey
(26% response rate).
Results
Over-all staff responses indicated:
Staff should have more primary decision making responsibility and
administration should have less.
Decisions should be shared more equally between staff and
administration than they currently are.
Significant differences were noted in:
Hours Worked: Those who
work more than 40 hours per week feel that staff should have more decisional
involvement than those who work less
hours.
Shift Worked: Those who work day and evening shift feel
that staff should have more decisional involvement than those who work night
shift.
No significant differences were observed between:
The perceived level of current involvement in decision-making, and
hours/shifts worked or involvement in shared governance. This finding was
consistent across all sites.
Why did we do this study?
Research done on the success of hospitals that have attained
Magnet status has shown that decisional involvement is a common characteristic
(Manojlovich, 2007). A core component of nursing shared governance is the power
of staff to make decisions that effect them, their environment and how they
carry out their work.
Shared governance can be implemented to involve nurses in the
decision making process, but the actual success or extent of practice is more
difficult to measure. Havens and Vasey developed a 21-item instrument that
compares actual and desired levels of nursing decisional involvement (2003
References
Havens, D., Vasey, J. (2003) Measuring staff nurse decisional
involvement: The decisional involvement scale. Journal of Nursing
Administration, 33(6), 331-336.
Manojlovich, M. (2007). Power and empowerment in nursing: Looking
backward to inform the future. On line Journal of Issues in Nursing, 12(1).
Retrieved on 12-13-2007.
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