title: Intraorganizational influence in the health care setting: a study of strategies preferred by head nurses and infection control practitioners.
abstract: BACKGROUND
  The purpose of this study was to examine influencing strategy preferences among head nurses (HNs) in the operating room, HNs in critical care and ICPs.
  
  
  METHODS
  A 21-item questionnaire on influencing strategy was used to identify 8 dimensions of influence: assertiveness, sanctions, ingratiation, rationality, bargaining, upward appeal, manipulation, and coalitions. The questionnaires were randomly distributed by regional coordinators in nine geographic regions throughout the United States to an operating room HN, a critical care HN, and an ICP at each of 12 hospitals (six with < 250 beds, six with > 250 beds). Two hundred ninety-seven respondents (92%) participated in the study.
  
  
  RESULTS
  Although both HNs and ICPs rated rationality (logic, information, and appeal to intelligence) highest as the preferred approach to influence behavior, ICPs rated this dimension significantly higher than both operating room HNs and critical care HNs (p < 0.001). The least preferred strategy among all three groups was sanction (threatening job security). Critical care HNs rated manipulation (threatening to stop working with the other person) significantly higher than did both operating room HNs (p = 0.04) and ICPs (p = 0.01). Age was found to be a factor in the preference for sanctions as an influencing strategy, regardless of specialty: respondents younger than 40 years preferred sanctions less as a means to change behavior than did those older than 40 years (p < 0.01).
  
  
  CONCLUSIONS
  These findings have implications for effective intraorganizational influence in health care settings.
authors.affiliation: Center for Research and Scholarship, Georgetown University School of Nursing, Washington, DC 20007.
authors.forename: B
authors.initials: B
authors.lastname: Goldrick
authors.forename: J
authors.initials: J
authors.lastname: Leclair
authors.forename: E
authors.initials: E
authors.lastname: Larson
mesh_terms: D001242:Assertiveness; D006801:Humans; D016357:Infection Control Practitioners; D007362:Intensive Care Units; D007400:Interprofessional Relations; D009745:Nursing, Supervisory; D009873:Operating Rooms; D011897:Random Allocation; D011795:Surveys and Questionnaires