1 / 20

Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers

Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers. Cindy A. Scherb, PhD, RN Janet P. Specht, PhD, RN, FAAN Jean Loes, MS, RN. Significance of Study.

beryl
Download Presentation

Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers Cindy A. Scherb, PhD, RN Janet P. Specht, PhD, RN, FAAN Jean Loes, MS, RN

  2. Significance of Study • Decisional involvement is the perceived distribution of authority for decisions and activities that govern nursing practice, policy, and the practice environment. (Havens & Vasey, 2003) • Environments with more nurse decisional involvement have better retention. (McClure & Hinshaw, 2002) • The need to provide empirical data to inform nurse administrators about effective organizational features.

  3. Purpose • To explore the nurse ratings of actual and preferred decisional involvement of RNs and describe implications for nurse managers. • Used a subset of data from a larger study that examined the relationships among perceived nurse accountability, decisional involvement, job satisfaction, and nursing-sensitive patient outcomes.

  4. Methodology • Descriptive cross-sectional design • Setting: Midwest rural healthcare network • Serves 14 counties • 250 bed referral center • 9 rural critical access hospitals • 33 primary care clinics • 10 specialty clinics

  5. Methodology (cont) • Sample • All staff nurses, charge nurses, and nurse managers employed by the network • Surveys mailed to 837 RNs in two mailings with a return rate of 39%

  6. Instrument • Decisional Involvement Scale (Havens & Vasey, 2003) • 21 questions measuring actual and preferred levels of decisional involvement • 5-point scale reflecting what group has the authority to make decisions 5 = staff nurses only 4 = primarily staff nurses 3 = equally shared by management & staff nurses 2 = primarily management 1 = administration/management only • Cronbach’s Alpha = .91-.95

  7. Findings • Demographics • N = 320 • Age: Mean = 43.39; SD = 10.58; Range 20 – 73 • Gender: female = 97.8% (N = 312) • Work role: Staff nurses = 91.5%; Nurse managers = 7%; Other = 1.5% • Hours worked per pay period: > 64 hrs = 68.2% • Education: Diploma = 12.9%; Associate = 57.2%; Baccalaureate or higher = 29.8% • Years as a RN: Mean = 17.41; SD = 10.57; Range = .5 - 52 • Years at the organization: Mean = 14.23; SD = 9.68; Range = .5 - 46

  8. Decisional Involvement • Actual Level: Mean = 44.25 (SD = 11.95) • Preferred Level: Mean = 58.29 (SD = 10.84 • Paired sample t-test: p = .000

  9. Descriptive Statistics on Selected DIS Items

  10. Correlations Between DIS Items and Demographic Variables

  11. T-test Results Between Staff Nurses and Nurse Managers

  12. Scheduling Unit Coverage Selection of Unit leader Review of leader’s performance Recommendations for promotion of staff #s & type of support staff Conflict resolution Scheduling Interview & hiring of nurses Recommendation of discipline Review of leader’s performance #’s & type of support staff Areas of Desired Change Staff Nurses Nurse Manager (highest disagreement)

  13. Conclusions • Nursing staff perceived they had low actual involvement in decision making, but they did not want a lot of decision making either. • Years as a RN and the perceived decentralization of the organization were most often correlated with 7 of the DIS items.

  14. Conclusions (cont) • Staff nurses perceived they had significantly less actual involvement in decisions related to 5 areas than did the nurse managers. • In 5 areas (only one similar between the actual & preferred) staff nurses preferred to be involved more than the nurse managers perceived they should be involved.

  15. Implications • The DIS is an excellent tool to critically assess any dissonance that may exist between the perception of decision making involvement between nurse managers and staff nurses. • The DIS can help to prioritize where more effort should be made to increase decision making involvement. The areas that stand out are in looking at the resources for the unit and leadership skills and abilities.

  16. Implications (cont) • The low desired decisional making involvement may be a lack of exposure to the possibilities, rather than a lack of desire for more decisional authority. • The need to address the nurse manager’s style, comfort, and skill with increased decision-making on the part of staff nurses.

  17. Implications (cont) • The implications for younger, less experienced nurses joining a group that is satisfied with their decisional authority may mean that these newer, less experienced nurses will choose not to stay. Are these generational differences?

  18. Limitations • Small sample size and a one site study • Nurses reluctance to complete questionnaires when unit needed to be identified

  19. Research supported by grants from the Winona State University Foundation and the Winona State University Nursing Research Fund.

  20. Contact Information Janet P. Specht, PhD, RN, FAAN Associate Professor College of Nursing The University of Iowa Iowa City, IA janet-specht@uiowa.edu (319) 335-6518 Cindy A. Scherb, PhD, RN Professor Master’s Program in Nursing Winona State University Rochester, MN cscherb@winona.edu (507) 280-5565

More Related