Decisional Involvement of Senior Nurse Leaders in Canadian Acute Care Hospitals

Aim: The aim of the present study was to describe the scope and degree of involvement of senior nurse leaders (SNLs) in executive level decisions in acute care organizations across Canada. Background: Significant changes in SNL roles including expansion of decision-making responsibilities have occurred but little is known about the patterns of SNL decision-making. Methods: Data were collected by mailed survey from 63 SNLs and 49 chief executive officers (CEOs) in 66 healthcare organizations in 10 Canadian provinces. Regression analyses were used to examine whether timing, breadth of content expertise and the number of decision activities predicted SNL decision-making influence and quality of decisions. Results: Breadth of content expertise and number of decision activities with which the SNL was involved were significant predictors of decision influence explaining 22% of the variance in influence. Overall, CEOs rated SNL involvement in decision-making higher than the SNL. Conclusions: Senior nurse leaders contribute to organizational processes in healthcare organizations that are important for nurses and patients, through their participation in decision-making at the senior team level. Implications for nursing management: Findings may be useful to current and future SNLs learning to shape the nature and content of information shared with CEOs particularly in the area of professional practice issues