Direct care nurses on the shared governance journey towards positive patient outcomes

Exploring the governance practices of nurse managers in the Greater Accra Region of Ghana

AIM

The study aim was to examine governance practices of nurse managers at the unit level in the Greater Accra Region of Ghana.

BACKGROUND

Health care managers are encouraging authorities of hospitals to appoint knowledgeable and experienced nurse managers to better coordinate and carry out the delivery of health care services. Nurse managers' governance practices have been identified as essential in ensuring quality health care delivery. This study investigated nurse managers' governance practices at the unit level.

METHODS

The study employed a quantitative cross-sectional design to gather data from 522 nurses in 19 selected hospitals in the Greater Accra Region of Ghana. Data were analysed using descriptive statistics and linear regression analyses.

RESULTS

The study findings showed that nurse managers exhibited a moderate level of governance practices. Qualification, training in management, experience as a nurse and experience as nurse manager together had no significant influence on governance practice (R²  = .012, p = .180). The only experience as a nurse manager was a significant predictor in the model (B = 0.037, p = .023).

CONCLUSION

Nurse managers' roles and responsibilities continue to evolve within the complex health care system. It is important to empower nurse managers to enhance their governance practices through a well-structured programme such as coaching and mentorship to improve efficiency and effectiveness at the unit level.

IMPLICATION FOR NURSING MANAGEMENT

Governance practices of nurse managers to create a favourable environment is essential to ensure efficiency, quality and unit outcomes. Experience as a nurse manager predicted governance practices, this implies that nurse managers should be assisted to enable them to gain experiences in governance practices.

Sustaining the Development of Clinical Nurses Within a Magnet Organization

Development of clinical nurses in Magnet-designated organizations is enhanced through a commitment to shared governance principles, a relevant and visible professional practice model, and engagement of clinical nurses in shared decision making. Cultivating practice innovations and reward and recognition programs further assist to sustain this development and leads to growth of future leaders.

Beliefs and implementation of evidence-based practice among nurses and allied healthcare providers in the Valais hospital, Switzerland

RATIONALE

Evidence-based practice (EBP) is upheld as a means for patients to receive the most efficient care in a given context. Despite the available evidence and positive beliefs about it, implementing EBP as standard daily practice still faces many obstacles.

AIMS AND OBJECTIVES

This study investigated the beliefs about and implementation of EBP among nurses and allied healthcare providers (AHP) in 9 acute care hospitals in the canton of Valais, Switzerland.

MATERIALS AND METHODS

A cross-sectional descriptive survey was conducted. The target population was composed of 1899 nurses and 126 AHPs. Beliefs about and implementation of EBP were measured using EBP-Beliefs and EBP-Implementation scales of Melnyk et al.

RESULTS

The initial sample consisted in 491 participants (overall response rate 24.2%): 421 nurses (22.4% response rate) and 78 AHPs (61.9% response rate). The final sample, composed only of those who declared previous exposure to EBP, included 391 participants (329 nurses and 62 AHPs). Overall, participants had positive attitudes towards EBP and were willing to increase their knowledge to guide practice. However, they acknowledged poor implementation of EBP in daily practice. A significantly higher level of EBP implementation was declared by those formally trained in it (P = 0.006) and by those occupying more senior professional functions (P = 0.004). EBP-Belief scores predicted 13% of the variance in the EBP-Implementation scores (R²  = 0.13).

DISCUSSION

EBP is poorly implemented despite positive beliefs about it. Continuing education and support on EBP would help to ensure that patients receive the best available care based on high-quality evidence, patient needs, clinical expertise, and a fair distribution of healthcare resources.

CONCLUSION

This study's results will be used to guide institutional strategy to increase the use of EBP in daily practice.