Decision-making processes of nurses in clinical practice and their relationship with work motivation and perceived work effectiveness

Goal: This study aims to analyse the level of nurses' involvement in decision-making processes in clinical practice, and to identify the connections between job position, decision-making opportunities, and selected work characteristics, especially work motivation, subjectively perceived work effectiveness, and attitude towards organisational change. Methods: The study employed a quantitative design and a questionnaire survey. The research instrument was a self-administered questionnaire containing 23 items focused on decision-making competencies, work motivation, and perception of the work environment. The questionnaire was distributed among non-medical healthcare workers in the Czech Republic. 315 fully completed questionnaires were included in the analysis. The data were analysed using the Pearson chi-square test. The effect size was expressed using Cramer's V coefficient. Results: A statistically significant relationship was found between job position and the possibility of participating in decision-making about the operation of the department or clinic (χ2 = 68.995; p < 0.001; V = 0.33). A statistically significant relationship was also identified between the possibility of decision-making and subjectively perceived work efficiency (χ2 = 15.755; p = 0.003; V = 0.16), and between the possibility of decision-making and the way of accepting organisational changes. Conclusion: The results suggest that nurses' involvement in decision-making processes is related to their work perceptions and approach to organisational change. Promoting participative management can improve the work environment in healthcare organisations.