THE RELATIONSHIP OF DECENTRALIZED ORGANIZATIONAL STRUCTURE TO PERCEIVED ASPECTS OF PROFESSIONAL NURSING PRACTICE ENVIRONMENT.

Description

Despite evidence that organizational outcomes are negatively affected when professionals have limited decision making and their practice is constrained, little is known about the relationship of decentralized decision making (DDM) structures to the professional practice environment (PPE). In this study, the relationship of DDM to clinical nurses' perceived aspects of a PPE was examined. DDM consisted of the hierarchy of authority for work decisions and participation in strategic and unit group decisions. The PPE aspects of interest to administrators in complex organizations who are charged with organizational effectiveness include: control over practice, professional development, innovation activity, and peer relationships. Using a correlational design, data were collected from a random sample of 320 clinical nurses employed in a university teaching hospital. Instruments used included the Index of Centralization and the Professional Practice Environment Scale. Multivariate procedures were used to test hypotheses and to construct models. Authority for work decisions was positively related to the four aspects of PPE. Participation in decision making was positively related to all aspects except control over practice. Several individual and situational characteristics were found to moderate the relationship between DDM and PPE. Work pressure was statistically controlled. Model building showed that unit decision making was the most important variable in the relationships with professional development and innovativeness. Results contribute to organizational and nursing administration theory and are a useful guide for administrators to enhance PPE as a way to help manage constant change.

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