Centralization and Decentralization of Decision Making in Relation to the Well-being of Nursing Staff at their Work Setting

Abstract

Background: Nurses have probably always known that their decisions have important implications for patient outcomes. Nurses are increasingly regarded as key decision makers within the healthcare team. Aim of the study: was to assess centralization and decentralization of decision making in relation to the well-being of nursing staff at their work setting. Research design: a descriptive research design was used to achieve the aim of the present study. Setting: The study was conducted at the Health Insurance Hospital Subjects: Convenience sample included all staff nurses who worked at Health Insurance Hospital with total numbers were 222 nurses. Tools of data collection: Tool (I): centralization and decentralization decision-making scale as well as Tool (II): nurses' well-being at work scale. Results: The main findings of the study revealed that (78.8%) of the nursing staff have high decentralized decision making and (23.9%) of them have high centralized decision making. Also (7.8%) of them have moderate level of total well-being Conclusion: This study concluded that there were no statistical significance differences between the nursing staff's personal as well as occupational data and (centralized as well as decentralized decision making. While were no statistical significance differences between nursing staff's personal as well as occupational data and the degree of well-being except attendance a seminar, moreover there was a negative correlation between the nursing staff wellbeing and total centralized as well as decentralized decision making. Recommendations: Increase superior care to staff nurses to ensure that effective and safe care is provided and enhance the work effectiveness as well as nursing staff well being and minimize errors and dissatisfactions Introduction: Global health is undergoing wide changes. These changes embrace developments in technology and in developing new methods for patient care. These advances in technology have led to an increase in the complexity of nurses' decision making particularly in critical care areas where nurses usually care for patients with multiple problems (Fernandes et al., 2023). Decision making can be defined as selecting the most appropriate conceivable way to solve problem and effective decision, it is very important to reach the most accurate information for the solution of the existing problem and use it in the decision making process. Decision making is essential managerial function in any organization. Its success or failure depends to a great extent on the quality of leaders' decisions at various levels. Any decisions related to planning, organizing, staffing, or directing is closely connected to the process of decision-making (Abdelhadi et al., 2020). A centralized organization defined an organization where the decisions are made from the top whereas a decentralized organization is characterized by decision-making lower in the organization. There are advantages and disadvantages with centralized decision-making; the advantages are that it creates uniformity, sends clear signals to the employees and provides a clear path for the organization. On the other hand, the disadvantages are that it can have a negative effect on the nurses' motivation and creativity. The degree of centralization and standardization reduce the flexibility, autonomy and increase control, which may result in a decreased level of self-determination, and also a reduced level of intrinsic motivation among the nurses (Arkan et al., 2022).