ABSTRACT
OBJECTIVES: The objectives of this study were to explore the perceptions of hospital-based staff nurses regarding their involvement in decision making and to gain an understanding of the ways nurses would like to be involved in decision making. BACKGROUND: How nurses want to be involved and the extent to which hospital-based staff nurses are involved in formal and informal structures for decision making remain unknown. METHODS: Stratified cluster random sampling was used to identify hospitals to participate in the study. Staff nurses and chief nursing officers (CNOs) from 10 hospitals in Colorado were invited to participate in this qualitative descriptive study informed by grounded theory. Focus groups with staff nurses and individual interviews with CNOs were also conducted. RESULTS: Safe quality patient care was threaded throughout discussions among the staff nurses and CNOs. CONCLUSIONS: Staff nurses viewed involvement in decision making through the lens of an egalitarian process, whereas administration viewed involvement as soliciting input but making decisions unilaterally.
Subject(s)
Attitude of Health Personnel , Decision Making, Organizational , Nurse Administrators/psychology , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/psychology , Focus Groups , Humans , Models, Nursing , Models, Organizational , Nursing Administration Research , Nursing Evaluation Research , Nursing Methodology Research , Qualitative ResearchABSTRACT
OBJECTIVE: The objective of this study was to determine the relationship between nurse involvement in decisions and nurse-patient outcomes. BACKGROUND: Evidence demonstrates that nurse involvement is associated with satisfaction, but little evidence exists about patient effects. Because of significant resource expenditure, evidence about expected outcomes is needed. METHODS: Outcomes classified as patient satisfaction, nurse satisfaction, infections, and adverse events were compared between units with high and low levels of involvement from 9 hospitals in Colorado. RESULTS: Involving nurses in outcomes evaluation was associated with better patient outcomes. High involvement units had fewer infections and pressure ulcers. CONCLUSIONS: A formal structure was not required to involve nurses in decisions and is related to nurse and patient satisfaction demonstrating a reduction in adverse events.
