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 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.
- 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.