1
|
Abstract
PurposeThe purpose of this study is to review research on hospital-based shared governance (SG), focussing on its core elements.Design/methodology/approachA scoping review was conducted by searching the Medline (Ovid), CINAHL (EBSCO), Medic, ABI/INFORM Collection (ProQuest) and SveMed+ databases using SG and related concepts in hospital settings as search terms (May 1998–February 2019). Only original research articles examining SG were included. The reference lists of the selected articles were reviewed. Data were extracted from the selected articles by charting and then subjected to a thematic analysis.FindingsThe review included 13 original research articles that examined SG in hospital settings. The studied organizations had implemented SG in different ways, and many struggled to obtain satisfactory results. SG was executed within individual professions or multiple professions and was typically implemented at both unit- and organization-levels. The thematic analysis revealed six core elements of SG as follows: professionalism, shared decision-making, evidence-based practice, continuous quality improvement, collaboration and empowerment.Practical implicationsAn SG framework for hospital settings was developed based on the core elements of SG, the participants and the organizational levels involved. Hospitals considering SG should prepare for a time-consuming process that requires belief in the core elements of SG. The SG framework can be used as a tool to implement and strengthen SG in organizations.Originality/valueThe review resumes the tradition of systematically reviewing SG literature, which had not been done in the 21st century. General tendencies of the research scene and research gaps are pointed out.
Collapse
|
2
|
Kaddourah B, Al-Tannir M, Kakish S, AlFayyad I. Perception of Shared Governance Among Registered Nurses in Ambulatory Care Center at a Tertiary Care Hospital in Saudi Arabia. Cureus 2020; 12:e8736. [PMID: 32714675 PMCID: PMC7377010 DOI: 10.7759/cureus.8736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Shared governance is considered a model for mounting autonomous decision making in nursing profession and practice. This study aimed to assess how registered nurses in an outpatient department in a tertiary care hospital perceive shared governance. Methods We conducted a cross-sectional study among a convenient sample of registered nurses in an outpatient department. A self-administered, Index of Professional Nursing Governance (IPNG) questionnaire was used to measure the study outcome. A descriptive analysis was used to describe nurses' characteristics and study outcomes. Results A total of 186 nurses completed the questionnaire. Of whom, 151 (92.1%) were female, and 78 (47.3%) were aged between 20 and 30 years. Only 54 (29.3%) and 59 (31.7%) had indicated a shared decision in terms of controls and influence scales, respectively. The majority of the nurses indicated traditional shared across shared governance scales except in the access information scale. Conclusion The findings showed a prevalent traditional nursing management style in the study setting. Supportive strategies and education must be provided for both managers and staff nurses to develop and implement shared governance in their practice.
Collapse
Affiliation(s)
- Bayan Kaddourah
- Nursing Affairs, King Fahad Medical City, Riyadh, SAU.,Ambulatory Care, American University of Beirut Medical Center, Beirut, LBN
| | - Mohamad Al-Tannir
- Epidemiology and Public Health, King Fahad Medical City, Riyadh, SAU
| | - Shadi Kakish
- Nursing Affairs, King Fahad Medical City, Riyadh, SAU
| | | |
Collapse
|
3
|
Affiliation(s)
- Allison Ong
- At Loma Linda University Medical Center, Allison Ong is the director of the Patient Placement and Transfer Center, Patricia Radovich is the director of Nursing Research, and Janet Kroetz is the CNO. Nancy Short is an associate professor at Duke University School of Nursing, Durham N.C., where Allison Ong is also a DNP student
| | | | | | | |
Collapse
|
4
|
Cox Sullivan S, Norris MR, Brown LM, Scott KJ. Nurse manager perspective of staff participation in unit level shared governance. J Nurs Manag 2017; 25:624-631. [DOI: 10.1111/jonm.12500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Lana M. Brown
- Central Arkansas Veterans Healthcare System; Little Rock AR USA
| | - Karen J. Scott
- Central Arkansas Veterans Healthcare System; Little Rock AR USA
| |
Collapse
|
5
|
Kakar AK. Investigating the Prevalence and Performance Correlates of Vertical Versus Shared Leadership in Emergent Software Development Teams. INFORMATION SYSTEMS MANAGEMENT 2017. [DOI: 10.1080/10580530.2017.1288526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Adarsh Kumar Kakar
- Computer Information Systems Department, Alabama State University, Montgomery, Alabama, USA
| |
Collapse
|
6
|
Abstract
This study focuses on the interpretations and experiences of change recipients, those who carry out organizational interventions initiated by others. Based on the ways nurses experienced a shared governance initiative implemented in their hospital, the authors investigated change recipients’ sensemaking about organizational change through their ascribed meanings, emotional responses, and perceptions of its impacts on them. Survey data demonstrated how nurses subjectively assessed their gains and losses from the change initiative. Participation in the initiative increased the experience of gains, as did membership in a unit where change was implemented more fully. Textual analysis of open-ended responses to the survey indicated that gains were linked with interpretations of the change initiative and pleasant feelings and that there was considerable emotional contagion within work units. Such effects are particularly likely in employee empowerment initiatives as experiences are linked to interpretation and mood among change recipients.
Collapse
|
7
|
Kneflin N, O'Quinn L, Geigle G, Mott B, Nebrig D, Munafo J. Direct care nurses on the shared governance journey towards positive patient outcomes. J Clin Nurs 2016; 25:875-82. [PMID: 26833824 DOI: 10.1111/jocn.13114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe shared governance in action through the example of one paediatric institution's decision to institute daily chlorhexidine bathing. BACKGROUND Shared governance processes are discussed extensively in the literature; however, implementation of the processes can be challenging. Recently nurses at one paediatric hospital were involved in a hospital-wide practice change where the theoretical approach of shared governance was actualised. Several questions arose from direct care nurses about unwarranted variations in bathing practices across settings and whether bathing standardisation could address the recent increase in central line-associated bloodstream infections. Shared governance council members identified daily chlorhexidine bathing as a potential intervention to standardise bathing across the hospital and to decrease infection rates. At this time, chlorhexidine bathing had been widely adopted in adult hospitals but was less commonly practiced in paediatric institutions. DESIGN This is a position paper describing the use of shared governance to make a house-wide practice decision and positively impact patient outcomes. METHOD Inquiry Council members conducted a systematic evidence search on best practices around chlorhexidine bathing. This evidence was used in Practice Council discussions to standardise house-wide practice. Once consensus was achieved, council members collaborated with Education Council to ensure understanding, competency, and the adoption and sustainment of the practice change. CONCLUSIONS Patients with central lines are at decreased risk for acquiring a central line-associated blood stream infection due, in part, to the change in nursing practice to include daily chlorhexidine bathing. The shared governance structure was the vehicle through which this practice was vetted and instituted. RELEVANCE TO CLINICAL PRACTICE This paper provides a real-life example of leveraging shared governance structures and the direct care nurse leaders within the councils when an organisation faces critical needs in patient care.
Collapse
Affiliation(s)
- Nicole Kneflin
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lucy O'Quinn
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gina Geigle
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Brenda Mott
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dawn Nebrig
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Munafo
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
8
|
Chamberlain B, Bersick E, Cole D, Craig J, Cummins K, Duffy M, Hascup V, Kaufmann M, McClure D, Skeahan L. Practice models: a concept analysis. Nurs Manag (Harrow) 2013; 44:16-18. [PMID: 24061096 DOI: 10.1097/01.numa.0000434465.90084.eb] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Barbara Chamberlain
- Barbara Chamberlain is the president of BJC Consultants in Williamstown, N.J. Eileen Bersick is the director of Endoscopy Services/DI Nursing at The Valley Hospital in Ridgewood, N.J. Donna Cole is a Magnet® writer at Hunterdon Medical Center in Flemington, N.J. Jayne Craig is a nurse researcher at CentraState Medical Center in Freehold, N.J. Kathleen Cummins is a consultant APN at Somerset Medical Center in Somerville, N.J. Marie Duffy is the chief nurse executive and associate administrator at Inova Mount Vernon Hospital in Alexandria, Va. Valera Hascup is a nurse researcher at Somerset Medical Center in Somerville, N.J., and an assistant professor at Kean University School of Nursing in Union, N.J. MaryAnn Kaufmann is a Simulation Skills and Student Retention specialist at Ocean County College School of Nursing in Toms River, N.J. Diane McClure is a neonatal APN at St. Joseph's Healthcare System in Paterson, N.J. Loraine Skeahan is a nursing instructor at Hunterdon County Polytech Career Academy in Flemington, N.J
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Shared governance is a model of nursing leadership that drives practice. The purpose of this project was to determine whether nursing education, work experience, certification, employment position, setting (inpatient/ambulatory), participation in shared governance, and age were related and predictive of scores on the Index of Professional Nursing Governance (IPNG). The significance was to provide a basis on which to enhance a nursing shared governance model resulting in enhanced patient care. This prospective, cross-sectional study included nurses in any type of nursing role and with any level of educational preparation. An analysis of variance was employed to identify strength of relationships among the categorical or ordinal variables and regression models for the continuous variables. General linear models were used to identify the variables most predictive of IPNG scores. Of the 98 participants, most (96%) were women, 58% were bachelor's prepared, and 80% were staff nurses. The mean IPNG score was 186.5. No significant relationships were found among demographic measures and IPNG scores. A reported role in shared governance, when combined with work setting (inpatient or ambulatory), was predictive of IPNG scores. Nurses who worked in the inpatient setting reported higher mean IPNG scores.
Collapse
|
10
|
Clinical Nurse Specialists Shaping Policies and Procedures Via an Evidence-Based Clinical Practice Council. CLIN NURSE SPEC 2012; 26:74-86. [DOI: 10.1097/nur.0b013e3182467292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Ellenbecker CH, Cushman M. Home healthcare nurse retention and patient outcome model: discussion and model development. J Adv Nurs 2011; 68:1881-93. [DOI: 10.1111/j.1365-2648.2011.05889.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Abstract
Cincinnati Children's Hospital Medical Center has a strong history of embracing staff empowerment and shared decision making. Shared governance for nursing was implemented in 1989; a separate allied health structure was created in 1999. The two operated in parallel with few occasions for interface, and with little collaboration. With the beginning of the medical center's efforts to pursue perfect patient care in 2002, there was a marked increase in the frequency of interprofessional initiatives and collaborations in the organization. By 2005, this increase in collaborative practice precipitated discussions questioning the purpose and efficiency of two separate structures. Over the next two years, planning ensued to merge these structures to better reflect the current interprofessional reality. The enhanced shared governance structure at Cincinnati Children's was launched in 2008. Each discipline now governs its own practice, but as patient care issues overlap, there is a structure in place to resolve patient issues that cross disciplines. The new Patient Care Governance Council includes physician and family representatives.
Collapse
Affiliation(s)
- Cheryl Hoying
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | | |
Collapse
|
13
|
Barden AM, Griffin MTQ, Donahue M, Fitzpatrick JJ. Shared governance and empowerment in registered nurses working in a hospital setting. Nurs Adm Q 2011; 35:212-218. [PMID: 21654480 DOI: 10.1097/naq.0b013e3181ff3845] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Empowerment of registered nurses through professional practice models inclusive of shared governance has been proposed as essential to improve quality patient care, contain costs, and retain nursing staff. The purpose of this study was to determine the relationship between perceptions of governance and empowerment among nurses working in acute care hospital units in which a shared governance model had been in place for 6 to 12 months. The 158 nurses who participated perceived themselves to be moderately empowered and in an early implementation stage of shared governance. There was a statistically significant positive relationship between perceptions of shared governance and empowerment. Recommendations for professional practice and future research are included.
Collapse
Affiliation(s)
- Agnes M Barden
- Patient and Family Centered Care at Long Island Jewish Hospital, 270-05 76th Ave, New Hyde Park, NY, USA.
| | | | | | | |
Collapse
|
14
|
Abstract
Shared governance (SG), a process for empowering nurses in practice settings, has been widely used for decades. However, despite enthusiasm for the concept, the process is not always successful or falters after successful initiation. To assist nursing leaders trying to implement or maintain SG processes, the author summarizes literature on both human and structural factors that contribute to the success or breakdown of SG practice models. Barriers to implementation and strategies to support implementation, as well as enculturation of SG, are discussed.
Collapse
|
15
|
TERVO-HEIKKINEN TARJA, KIVINIEMI VESA, PARTANEN PIRJO, VEHVILÄINEN-JULKUNEN KATRI. Nurse staffing levels and nursing outcomes: a Bayesian analysis of Finnish-registered nurse survey data. J Nurs Manag 2009; 17:986-93. [DOI: 10.1111/j.1365-2834.2009.01020.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
16
|
BOGUE RICHARDJ, JOSEPH MLINDELL, SIELOFF CHRISTINALEIBOLD. Shared governance as vertical alignment of nursing group power and nurse practice council effectiveness. J Nurs Manag 2009; 17:4-14. [DOI: 10.1111/j.1365-2834.2008.00954.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Shane Wood M, Fields D. Exploring the impact of shared leadership on management team member job outcomes. BALTIC JOURNAL OF MANAGEMENT 2007. [DOI: 10.1108/17465260710817474] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
18
|
Cormack C, Hillier LM, Anderson K, Cheeseman A, Clift J, Fisher MJ, Romeo L, Usher H, Wilcox J, Glaves N. Practice Change. J Nurs Adm 2007; 37:279-86. [PMID: 17563520 DOI: 10.1097/01.nna.0000277719.79876.ec] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The authors describe a participative management approach was used to develop and implement a nursing care delivery model for geriatric rehabilitation. This approach led to a sense of shared decision making and established consensus among the majority of staff. An integrated primary and modular nursing model that incorporated a geriatric resource nurse role was developed to maximize accountability and continuity of care. Ongoing evaluation will further clarify the impact of this model on staff and patient outcomes.
Collapse
|
19
|
Mangold KL, Pearson KK, Schmitz JR, Scherb CA, Specht JP, Loes JL. Perceptions and characteristics of registered nurses' involvement in decision making. Nurs Adm Q 2006; 30:266-72. [PMID: 16878012 DOI: 10.1097/00006216-200607000-00011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). SUBJECTS AND METHODS A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. RESULTS AND CONCLUSIONS A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.
Collapse
Affiliation(s)
- Kara L Mangold
- Nursing Graduate Program at Winona State University, Rochester, MN 55904, USA
| | | | | | | | | | | |
Collapse
|
20
|
Davidson PM, Elliott D, Daly J. Clinical leadership in contemporary clinical practice: implications for nursing in Australia. J Nurs Manag 2006; 14:180-7. [PMID: 16600005 DOI: 10.1111/j.1365-2934.2006.00555.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. AIM The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. KEY ISSUES Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. CONCLUSIONS Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.
Collapse
Affiliation(s)
- P M Davidson
- School of Nursing, Family and Community Health, University of Western Sydney and Sydney West Area Health Service, Sydney.
| | | | | |
Collapse
|
21
|
Owen J, Grealish L. Clinical education delivery – A collaborative, shared governance model provides a framework for planning, implementation and evaluation. Collegian 2006; 13:15-21. [PMID: 16789387 DOI: 10.1016/s1322-7696(08)60519-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Following a scheduled review of a university pre-registration Bachelor of Nursing program, a decision was taken to introduce a new model of clinical education delivery. Principles of collaboration, as used by other university nursing programs, were applied to the change management process. As the process of change progressed, a model incorporating collaboration and shared govemance emerged to address the challenge posed by multiple stakeholders from culturally different organisations and the genuine commitment by those stakeholders to share contol in the planning, implementation, and evaluation of the clinical education delivery model. Using a case study approach, this article demonstrates how the principles of collaboration and shared governance were combined to effectively manage change in the delivery of clinical education across several different organisations, aind provides an extended framework for collabortive change management involving multiple stakeholders.
Collapse
Affiliation(s)
- Jenny Owen
- School of Health Sciences [corrected] University of Canberra.
| | | |
Collapse
|
22
|
Currie V, Harvey G, West E, McKenna H, Keeney S. Relationship between quality of care, staffing levels, skill mix and nurse autonomy: literature review. J Adv Nurs 2005; 51:73-82. [PMID: 15941463 DOI: 10.1111/j.1365-2648.2005.03462.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS This paper reports a literature review exploring the relationship between quality of care and selected organizational variables through a consideration of what is meant by perceptions of quality, whose perceptions are accorded prominence, and whether changes in staffing, skill mix and autonomy affect perceptions of quality. BACKGROUND Three basic ideas underpin this literature review: the growing focus on quality improvement in health care, concerns about the quality of care, and the move towards patient involvement and consultation. Of particular interest is the way in which changes in nurse staffing, skill mix and autonomy may affect the delivery of quality patient care. METHODS A search was conducted using the CINAHL, Medline and Embase databases. Key words used were quality of health care; quality of nursing care; nurse; patient; skill mix; nurse-patient ratio; outcomes; adverse health care events and autonomy. The objective was to draw together a diverse collection of literature related to the field of health care quality. Papers were included for their relevance to the field of enquiry. The original search was conducted in 2003 and updated in 2004. FINDINGS Quality of care is a complex, multi-dimensional concept which presents researchers with a challenge when attempting to evaluate it. Traditional nursing assessment tools have fallen out of use, partly because they have failed to provide opportunities to engage with and access the views of patients or nurses. There is also evidence that patient satisfaction as an indicator of quality is compromised on a number of fronts. There is conflicting information on how nurses and patients think about quality. Research looking at the relationship between the selected organizational variables and perceptions of quality also suffers from a number of limitations. We argue that there is a requirement for more patient-centred research exploring perceptions of quality and differences in nurse staffing, skill mix and autonomy.
Collapse
Affiliation(s)
- Veronica Currie
- Research & Development Fellow, Quality Improvement Programme, RCN Institute, Radcliffe Infirmary, Oxford, UK.
| | | | | | | | | |
Collapse
|
23
|
Abstract
New forms of leadership are required if staff are to be effectively engaged and involved in decision-making and promoting clinical effectiveness. One such mechanism is shared governance and shared leadership to ensure practice is both practitioner owned and organizationally supported. Empowering staff is a great challenge requiring effective planning, preparation and commitment. Establishing the process of shared governance requires effective leadership, implementation of a suitable framework, multidisciplinary working and examination of the organization's structure and culture. This paper discusses the challenges of implementation, preparation of staff, and alignment with the organizational agenda. It emphasizes that shared governance is an ongoing and fluid process, requiring continual assessment and re-evaluation in order to be flexible and responsive to an ever-changing environment. The Christie model provides a sustainable framework for moving practice forward and successful implementation has led to greater coordination of practice development and sharing of best practice.
Collapse
Affiliation(s)
- Linda Scott
- Nursing Administration, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK.
| | | |
Collapse
|
24
|
Burnhope C, Edmonstone J. "Feel the fear and do it anyway": the hard business of developing Shared Governance. J Nurs Manag 2003; 11:147-57. [PMID: 12694361 DOI: 10.1046/j.1365-2834.2003.00365.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The article provides an overview of recent lessons from the Shared Governance literature, a description of a 4-year evaluation study and a highlighting of important issues which emerge from this. Early UK Shared Governance implementation relied heavily on North American experience, but there is now a growing body of UK experience. The literature review draws upon evaluation research to date, provides a contextual description of the Shared Governance site and the approach adopted, together with a description of the quantitative and qualitative evaluation design used. The findings indicate that early problems had the most profound impact, that there were continuing chronic difficulties and that a number of important issues have subsequently emerged. The article concludes that there are some significant successes, but that Shared Governance implies cultural change, is subject to "fashion swings" and that there are practical limits to what can be achieved. Implementation means hard work but can produce worthwhile results.
Collapse
|
25
|
Larrabee JH, Janney MA, Ostrow CL, Withrow ML, Hobbs GR, Burant C. Predicting registered nurse job satisfaction and intent to leave. J Nurs Adm 2003; 33:271-83. [PMID: 12792282 DOI: 10.1097/00005110-200305000-00003] [Citation(s) in RCA: 325] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurse job dissatisfaction has been the primary predictor of intent to leave; however, although many predictors of job satisfaction have been identified, little is known about the influence of variable nurse attitudes, such as psychological empowerment and hardiness, on job satisfaction. OBJECTIVE The purpose of this study was to investigate the relative influence of nurse attitudes, context of care, and structure of care on job satisfaction and intent to leave. METHODS A nonexperimental, predictive design evaluated these relationships in a nonrandom sample of 90 registered staff nurses using instruments with known psychometric properties. RESULTS The major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. Predictors of psychological empowerment were hardiness, transformational leadership style, nurse/physician collaboration, and group cohesion. CONCLUSIONS Results supported the influence of nurse attitude on job satisfaction relative to other contributing factors.
Collapse
Affiliation(s)
- June H Larrabee
- School of Nursing, West Virginia University, Morgantown, 26506-9610, USA.
| | | | | | | | | | | |
Collapse
|
26
|
Abstract
Contemporary nursing is an increasingly complex concept encompassing and encapsulating wide variation under the broad rubric of the nursing work place. This paper reports on a study that was designed to contribute to understandings of nursing practice by describing what nurses in Australia are doing everyday in various practice and work settings, the type of skills they need, the challenges they face and the interactions nurses have with other health workers. Drawing on the research which informed the National Review of Nurse Education in Australia in 2001, the paper raises issues critical to the management of contemporary nursing practice. Flexible approaches both to the day-to-day management of nurses and nursing, and educational preparation in partnership with key stakeholders, are a necessity if management of nursing is to keep pace with constant change in health care systems as well as facilitating the attraction and retention of nurses in those systems.
Collapse
Affiliation(s)
- Jacqueline Jones
- Centre for Research into Nursing and Health Care, School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia.
| | | |
Collapse
|
27
|
Abstract
The role of the Nurse Practitioner has been in existence in a variety of contexts and within a broad range of the scope of their practice throughout the world for a number of years. Many nurses work at this advanced level of clinical practice without the acknowledgement f the very important and responsible role that they play within the healthcare setting. Although the United States and United Kingdom have recognised the role of the advanced Nurse Practitioner for a number of years, there still exists confusion and disagreement as to their scope of practice. There is uncertainty and anxiety as to where the role boundaries between nursing and medical and allied health professionals begin and end. The role of the Nurse Practitioner in Australia has not been without its problems in the developmental stage of its creation. New South Wales finally achieved recognition of the role this year after a decade of negotiation. This has culminated in the acceptance for the development of 40 Nurse Practitioner positions across the State. The first of these was accepted in the Far West Area Health Service in May 2001. The Far West Area Health Service created a five-year plan, which addresses the development of nurses preparing for authorisation, the creation of Nurse Practitioner positions in the remote communities, the creation of clinical guidelines to support advanced practice and the evaluation process for both the positions and the nurses. The objective of this approach is to ensure effective implementation of these advanced nursing positions in the remote communities of New South Wales. The Nurse Practitioner role needs to respond to the individual, the family and the community, utilising advanced clinical skills and remaining responsive to the changes in health care within a primary health care framework, which is essential for combating the complex health care issues in remote areas (NSW Health 2000).
Collapse
|
28
|
Heslop L, McIntyre M, Ives G. Undergraduate student nurses' expectations and their self-reported preparedness for the graduate year role. J Adv Nurs 2001; 36:626-34. [PMID: 11737494 DOI: 10.1046/j.1365-2648.2001.02022.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS OF THE STUDY The study identifies third-year nurses' expectations of the graduate nurse role and ascertains how prepared they feel to fulfil this role. BACKGROUND The literature substantiates that the university-workplace transition is marked by differences between students' expectations of the graduate year and the realities of practice they encounter in the workforce setting. Nursing professionals and health service employers continue to debate the expectations required of the new nurse graduate. Yet there is little assessment of graduate nurses' expectations of the workplace. This study describes student nurses' expectations of the graduate year and the extent to which they regard themselves as well- or ill-prepared. DESIGN Third-year student nurses (n=105) from a 3-year Bachelor of Nursing (BN) course at a large Metropolitan University in Australia were surveyed. A group of nursing academics and their senior colleagues in the clinical setting designed a questionnaire in light of common themes derived from literature on the graduate year role. Responses were examined and analysed using descriptive statistics. RESULTS Responses revealed that student nurses tended to favour large public hospitals, and sought a good graduate programme with associated opportunities for guidance and support. Most expected to achieve good working relationships with both professional colleagues and patients. Final year students expressed some apprehension about meeting the performance expectations of the workplace, given their self-perceived lack of clinical experience. CONCLUSION When asked about their initial expectations of the workplace, third year student nurses expressed little apprehension and reported high levels on scales of organizational commitment and professionalism. The research literature suggests that divisions exist between students' expectations of the graduate year and the actual work experience. The expectations of the graduate year described in this study offer a student-centred perspective that contributes to future planning and policy directions of undergraduate curricula, graduate year programmes and nurse retention.
Collapse
Affiliation(s)
- L Heslop
- School of Nursing, Monash University, McNahon's Road, Frankston, Victoria 3199, Australia.
| | | | | |
Collapse
|
29
|
Abstract
As the nursing profession again faces a serious shortage, many are seeking ways to attract and retain talented people in the nursing profession. Creating both empowering and healthy work environments is a way to achieve this goal. Shared leadership is a nursing management model that supports staff nurses in extending their influence about decisions that affect their practice, work environment, professional development, and self-fulfillment. It is a way to strengthen continuous learning and enhance relationships, which are the foundation upon which nurses can develop a new type of relationship with management and with each other.
Collapse
Affiliation(s)
- J Walker
- North Suburban Medical Center, Thornton, Colorado, USA
| |
Collapse
|