DescriptionPurpose: This project aimed to improve staff perceptions of decisional involvement by restructuring the organizational level unit practice council in an urban academic acute care facility in northern New Jersey.
Methodology: The Decisional Involvement Scale was used for data collection and the project was conducted in two phases. In the first phase, the Decisional Involvement Scale was distributed to 681 nurses, including nursing leaders, and an educational module and virtual question and answer sessions were held for the organizational level unit practice council chairs. In the second phase, real-time coaching was provided to the unit practice council chairs and the Decisional Involvement Scale was redistributed to evaluate the impact of this project. This project was completed over an 8-week period.
Results: Results of the Decisional Involvement Scale revealed decisions are primarily made by administration/management with some staff nurse input. The survey participants preferred decision-making that was trending toward decision-making that is equally shared by administration/management and staff nurses. The project also showed decreased decisional involvement gaps between nurse leaders and staff nurses within three subscales of the Decisional Involvement Scale survey. The results of this project suggest that restructuring the unit practice council can help improve staff nurse involvement in decision-making.
Implications for Practice: Magnet organizations incorporate structure and process to improve outcomes. Nurses within a Magnet organization should be involved in shared governance and decision-making, along with mechanism to have decision-making into standards of practice. Assessing levels of decision-making, encouraging involvement in shared governance, and strengthening shared governance structures provides a platform in improving outcomes. This project shows the need for leadership and staff to be aligned. Leaders taking these results and beginning to understand them will be the next step to moving into a more shared decision-making environment.