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Involving Nurses in Decisions: Improving Both Nurse and Patient Outcomes

Houser, Janet PhD, RN; ErkenBrack, Lysa MSN, RN; Handberry, Lydia BSN, RN; Ricker, Fran MSN, RN; Stroup, Linda MSN, RN

JONA: The Journal of Nursing Administration: July/August 2012 - Volume 42 - Issue 7/8 - p 375–382
doi: 10.1097/NNA.0b013e3182619325

Objective: The objective of this study was to determine the relationship between nurse involvement in decisions and nurse-patient outcomes.

Background: Evidence demonstrates that nurse involvement is associated with satisfaction, but little evidence exists about patient effects. Because of significant resource expenditure, evidence about expected outcomes is needed.

Methods: Outcomes classified as patient satisfaction, nurse satisfaction, infections, and adverse events were compared between units with high and low levels of involvement from 9 hospitals in Colorado.

Results: Involving nurses in outcomes evaluation was associated with better patient outcomes. High involvement units had fewer infections and pressure ulcers.

Conclusions: A formal structure was not required to involve nurses in decisions and is related to nurse and patient satisfaction demonstrating a reduction in adverse events.

Supplemental Digital Content is available in the text.

Author Affiliations: Academic Dean (Dr Houser), Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado; Member of the 08-188 Research Planning Committee (Ms ErkenBrack); Staff Nurse (Ms Handberry), Progressive Care Unit, Swedish Medical Center, Englewood, Colorado; Executive Director-Policy Director (Ms Ricker), Colorado Nurses Association, Denver; Associate Chair (Ms Stroup), Department of Nursing, Metropolitan State College of Denver, Colorado.

Funding was provided for this study by Colorado Senate Bill 08-188, The Colorado Trust, and Sigma Theta Tau, Alpha Kappa chapter.

The authors declare no conflicts of interest.

Correspondence: Dr Houser, Rueckert-Hartman College for Health Professions, Regis University, Mail Code G-6, 3333 Regis Blvd, Denver, CO, 80221 (

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© 2012 Lippincott Williams & Wilkins, Inc.