In the study on which this article is based, nursing homes with the most improvements in resident outcomes had greater registered nurse (RN) participation in decision making than did homes with the least improvements. The results suggest that nursing homes that want to improve quality can use RN participation to make improvements without significantly increasing costs. Complexity theory served as a framework for the study.
Ruth A. Anderson, R.N., Ph.D., is Associate Professor, Duke University Medical Center, School of Nursing, Durham, North Carolina.
Reuben R. McDaniel, Jr., Ed.D., is the Charles and Elizabeth Prothro Regents Chair, The University of Texas at Austin, Management Science & Information Systems, Austin, Texas.
The authors acknowledge the cooperation and assistance of staff at the Texas Health Care Association. The research was supported in part by a Biomedical Research Support Grant and the Luci Baines Johnson Fellowship in Nursing, The University of Texas at Austin School of Nursing.