Nurse Delegation Decision-making: Impact on Nurse Job Satisfaction

Abstract

Since 1985, health care has undergone tremendous changes. Today's patients are more acutely ill and have shorter lengths of stay in the hospital than patients in the past. In addition, the health care industry has shifted from providing primary nursing care to caring for a group of patients. These changes have made it imperative that nurses make sound delegation decisions for safe, efficient care delivery.

The purpose of this experimental study was to ascertain if a structured educational intervention (versus a mimic intervention) was followed by a statistically significant increase in nurse delegation decision making knowledge and nurse job satisfaction. The delegation decision making group reviewed specific information on task identification, problem identification, and how to determine team members' patient assignment. The mimic intervention group received information on changes in care delivery systems and how this would impact the RN role in the hospital. Both educational sessions lasted 90 minutes.

Kast and Rosenzweig's (1985) organizational framework guided this research study. The sample consisted of 92 RNs employed on six different medical-surgical units. Subjects completed the Nursing Assessment Decision Grid at preintervention, immediate postintervention, and 1-month following the intervention. Subjects also completed the Price-Mueller Job Satisfaction Survey and a researcher-developed confidence and intent to use delegation decision survey at preintervention and 1-month postintervention.

Findings supported a statistically significant increase (p $<$.05) in Nursing Assessment Decision Grid scores for the delegation decision making intervention group. Gains were sustained for the 1-month follow-up. Two of the six measures of job satisfaction, specifically autonomy and promotional opportunity, were statistically significant for the delegation decision making intervention group. Further, there was a rise in scores for confidence and intent to use delegation decisions in the delegation decision making intervention group.

Implications for nursing education, nursing service, and nursing research are made. Replication of this research and further intervention studies among hospital nurses are recommended.