Redesigning health care environments has occurred in response to cost and quality pressures.
Efforts to redesign the nursing practice environment have focused on the structure and process of nursing care delivery.
When redesign efforts address the structure of nursing practice systems to facilitate one important process, nurses'participation in decision making, better patient and organizational outcomes are expected.
The purpose of this study was to determine if two dimensions of structure : administrative (decentralization) and professional authority (expertise) influence the process of participation in decision making for two kinds of decisions (care-giving and condition-of-work) that nurses make.
The stratified sample consisted of 300 registered nurses working on medical-surgical units.
Administrative and professional authority accounted for a small but significant amount of variation in participation in decision making.
Because the extent of explained variation was small, the findings may challenge the prevailing assumption that greater authority for decision making results in the exercise of that authority.
Redesign of the practice environment therefore must incorporate multiple factors in achieving greater participation in decision making.
Mots-clés Pascal : France, Europe, Homme, Personnel sanitaire, Infirmier, Milieu hospitalier, Pratique professionnelle, Soin, Prise décision, Participation, Hiérarchie, Autorité, Administration publique, Décentralisation, Reconception
Mots-clés Pascal anglais : France, Europe, Human, Health staff, Nurse, Hospital environment, Professional practice, Care, Decision making, Participation, Hierarchy, Authority, Civil service, Decentralization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0509554
Code Inist : 002B30A05. Création : 22/03/2000.