DECISIONAL INVOLVEMENT SCALE
Strengthening the staff nurse’s involvement in decision making to improve the culture of the workplace environment is a key factor to improve nurse, patient, and organizational outcomes.
Decisional involvement “is the pattern of distribution of authority for decisions and activities that govern nursing policy and the practice environment” (Havens & Vasey, 2003, p. 332). The DIS, a multi-purpose tool, was designed to measure the degree of staff nurses’ actual and preferred decisional involvement. The DIS is unique and distinct from other tools that measure related concepts such as shared governance, nurse control over practice, and nurse autonomy.
The DIS has been used by many institutions across America and in several foreign countries. The DIS is primarily used by: nursing hospital administrators, nursing researchers, nursing faculty, nursing educators, staff developers, and nursing students.
OVERVIEW
The DIS is a two-part 21-item scale measuring nurse involvement in decisions and activities. One part of the scale measures perceived actual levels of decisional involvement and the second part measures preferred levels of decisional involvement. Thus, the respondents indicate in one part of the scale who they perceive actually has the primary authority (e.g. nurses, management, etc.) for the decision or activity and in the other part who they would prefer to have primary authority.
The two parts of the scale may be used independently or together. The questions relate to six constructs (subscales): unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and cooperation/liaison activities.
Multi-Purpose Measurement:
- Types of decisions made by nurses at the unit level.
- Extent of staff nurses decisional involvement at unit level.
- Perceived actual levels of staff nurses decisional involvement.
- Preferred levels of staff nurse decisional involvement.
- Dissonance between what staff nurses are actually deciding and wish to decide.
- Concordance between staff and management perceptions regarding actual and perceived levels of involvement.
- Areas to target for change.
- Impact of strategies implemented to enhance staff nurse decisional involvement.
DIS Scoring
The DIS uses a 5-point scale. Respondents indicate who they perceive actually (or prefer) are the primary decision-makers according to the scale. For example, administration/management only = 1, primarily administration/management with some staff nurse input = 2, equally shared by administration/management and staff nurses =3, to staff nurses only = 5. Items can be considered individually, by subgroup, or the DIS can be scored as a composite as a score ranging from 21- 105. Others prefer to view the DIS subscales and composite score as a mean using the 1-5 scoring method – showing for the entire DIS and for each subscale the actual and desired mean scores. A high score suggests a high degree of staff nurse involvement and a low score suggests a high degree of administration/managerial involvement. A mid-range score indicates sharing of decisional involvement. When both scores are used (actual and preferred) the degree of decisional dissonance between actual and preferred can be identified.
DEMOGRAPHIC INFORMATION
When using the DIS, please collect a minimum dataset using the questions on the form below. Collecting these data elements in addition to the DIS items will provide more explanatory information and will be beneficial as we establish a large dataset for benchmarking.
RELATED ARTICLES
When using the DIS, please collect a minimum dataset using the questions on the form below. Collecting these data elements in addition to the DIS items will provide more explanatory information and will be beneficial as we establish a large dataset for benchmarking.