Articles

Abstract

Key organizations and new legislation are promoting staff nurse involvement in decisions about nursing practice and patient care as a long-term strategy to improve the culture of the work environment.The authors discuss the Decisional Involvement Scale (DIS), a multipurpose measure that can be used as a diagnostic tool, an organizational development strategy, and an evaluative instrument. In addition, support to substantiate the DIS as a valid and reliable measure is summarized.

Donna Sullivan Havens and Joseph Vasey

Journal of Nursing Administration • Vol.33, No.6 • June 2003

The Staff Nurse Decisional Involvement Scale: Report of Psychometric Assessments

Abstract

Background: For decades, enhancing staff nurse decisional involvement in matters of nursing practice and patient care has been identified as a long-term strategy to improve the quality of the nursing work environment and the safety and quality of patient care.

Objective: To describe psychometric assessments of the Decisional Involvement Scale (DIS), a diagnostic and evaluative measure of nurse decisional involvement.

Methods: A series of assessments were conducted to evaluate the psychometric performance of the scale. Content validity was assessed by experts in the field. Descriptive statistics were used to examine the use and performance of the scale. The contrasted groups approach was used to assess construct validity. Item analysis was used to explore evidence of the internal consistency of items and subscales across multiple samples. Structural modeling was used to conduct a confirmatory factor analysis using data from two independent samples of staff registered nurses (RNs; n = 849 and 650).

Results: Acceptable content validity indexes (CVIs) were independently generated by three content experts. Construct validity was supported, as hypothesized; nurses working on professional practice units scored significantly higher for all items when compared to nurses working on units without professional practice models in place. Internal consistency (coefficient alpha) was high and nearly identical for the total measure and all subscales across the two independent nurse samples. Six subscales were identified using factor analysis, and these were confirmed by structural modeling.

Conclusion: Psychometric findings support that the DIS is a valid and reliable measure of staff nurse decisional involvement.

Donna Sullivan Havens and Joseph Vasey

Nursing Research, November/December 2005, Vol 54, No 6

Abstract

Enhancing involvement in organizational decisions is one strategy to improve the work environment of registered nurses and to increase their recruitment and retention. Little is known about the type of decision making and the level of involvement nurses desire. This was a descriptive study exploring staff nurse and nurse manager ratings of actual and preferred decisional involvement and differences between staff nurses and nurse managers. A sample of 320 RNs from a Midwestern health care network was surveyed using the Decisional Involvement Scale. Nurse managers and staff nurses had statistically significant differences in their perceptions of who was involved in actual decision making in the areas of unit governance and leadership and collaboration or liaison activities. There were statistically significant differences in preferred decisional involvement between staff nurses and nurse managers in the overall DIS scale and the subscales of unit governance and leadership and quality of support staff practice.

Cindy A. Scherb, Janet K. P. Specht, Jean L Loes, and David Reed

Western Journal of Nursing Research, August 17, 2010.

Registered Nurses’ Involvement in Decision Making

Abstract

Purpose: This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs).

Subjects and Methods: A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit gover- nance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN’s actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured.

Results and Conclusions: A statistically significant difference was found between RNs’ actual and preferred decisional involvement, with RNs preferring more decisional involvement than they ac- tually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.

Kara L. Mangold, MS, RN; Kristina K. Pearson, MS, RN, OCN; Julie R. Schmitz, MS, RN; Cindy A. Scherb, PhD, RN; Janet P. Specht, PhD, RN, FAAN; Jean L. Loes, MS, RN

Nursing Administration Quarterly,Vol. 30, No. 3, pp. 266-272.