Shared Decision-Making in Nursing Homes: Factors Associated With the Empowerment of Direct Care Workers

Objective: The advantages of empowering direct care workers (DCWs) within nursing homes (NHs) are well documented. Our objective is to identify factors that create DCW empowerment as this has not received adequate attention. Method: The data come from a larger study focused on the empowerment of DCWs in NHs. A self-administered instrument was completed by 372 DCWs within 11 NHs in the north Texas region. Cluster analysis and ordinary least squares (OLS) regression were performed. Results: Feedback from nurse management to DCWs was positively associated with shared decision-making (SDM) and ranked highest followed by information exchange, trust in management, and wages linked to performance. Discussion: SDM may be enhanced where nurse management shares relevant information with the DCWs, listens to their ideas, provides explanations when DCW suggestions are not used, and does so in a supportive environment. Organizational characteristics of importance include linking wages to DCW performance and providing an accessible training program.