Entrepreneurship in Nursing: an integrative literature review

Challenging the status quo through nursing entrepreneurship education: A scoping review

BACKGROUND

Entrepreneurship education is commonly incorporated into areas beyond nursing. However, advocating for curricular changes is necessary in a generation that seeks new learning styles and has different preferences and needs. Entrepreneurship has been identified as a valuable subject to be incorporated into nursing education, as it aligns with the foundational principles of Nursing as a science.

AIM

To examine the state of knowledge regarding the entrepreneurship education of undergraduate nursing students.

DESIGN

A scoping review was conducted following JBI and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.

METHODS

The searches were performed on July 19th, 2023, in MEDLINE via PubMed; ISI Web of Science; EBSCOhost CINAHL; Embase; Scopus; BVShost LILACS; and ProQuest. Grey literature was searched on Google Scholar. Records examining the entrepreneurship education of nursing students were included.

RESULTS

The searches resulted in 17 records, 15 of which were from databases and two of which were identified via other methods. Although entrepreneurship education has increased over the years, the incorporation of diverse teaching modalities as a transformative and innovative educational strategy is still not a reality for many undergraduate nursing students worldwide. The findings highlight that entrepreneurship education is incorporated theoretically into mandatory courses with curricular components related to administration and health services management.

CONCLUSIONS

Entrepreneurship education can pivot nursing education and drive change in educational strategy while maintaining the fundamentals of nursing education. With entrepreneurship education, nursing students envision professional identity values, such as leadership, critical thinking, and political development. When understanding their political role, nursing students can exercise leadership to think critically outside the box and challenge the status quo.

Social entrepreneurship and public health nursing knowledge: Opportunities for innovating nursing education in population health

Public health nursing (PHN) competencies are fundamental for addressing population health inequities. Few pathways exist for employing these competencies in the United States (US). Social entrepreneurship in nursing education might provide opportunities for innovating engagement in population health. Partnerships between business and nursing schools have the potential to fulfill this opportunity.

PURPOSE

Explore opportunities for re-invigorating public health nursing through social entrepreneurship education in nursing-business partnerships in U.S. universities.

METHODS

Reviewed programs in nursing/business school partnerships from Carnegie-classified R1 Universities. Identified appropriate coursework.

RESULTS

Of 96 identified nursing schools, eight had business school partnerships, providing 12 programs. Most programs (n = 11) targeted graduate students and addressed core competencies for entrepreneurship. Five business schools had entrepreneurship expertise. Five nursing schools had PHN expertise. Three programs included population health competencies.

DISCUSSION

Despite missed opportunities for advancing social entrepreneurship education among undergraduate and graduate nursing students, existing curricular offerings in the partnerships provide promise. Business/nursing partnerships and PHN knowledge can stimulate the preparation and agency of nurses in addressing population health inequities.

University innovation and start-ups: Barriers and facilitators experienced by nursing faculties - A content analysis study

AIM

University start-ups have gained significant popularity as a means of translating knowledge and research into practical applications. However, there is a lack of understanding regarding the experiences and perspectives of nursing faculties engaged in start-up ventures. The objective of this study was to explore valuable insights into the barriers and facilitators within this context for promoting success, generating entrepreneurial attitudes, as well as enhancing the sustainability of nursing faculty-led start-ups.

DESIGN

We employed a content analysis methodology to capture the real-life experiences of nursing faculties involved in university start-ups. This approach is an effective way to gain a comprehensive understanding of the subject.

METHODS

Data were collected using semi-structured interviews. Graneheim and Lundman's step was used for analysis and to identify recurring patterns and themes within the collected data. Sampling was done purposefully, with convenience and snowball techniques until data saturation. The MAXQDA version 10 software was utilised to easily analyse, code and present data.

RESULTS

The analysis revealed four major themes encompassed: motivational factors, personal attributes, limited entry support and barriers to scaling. These themes shed light on factors, support systems, challenges faced during growth as well as personal characteristics highlighted by the participants. Our study highlighted the factors influencing entrepreneurship in nursing faculties. Addressing the challenges of this study requires enhancing support systems and fostering personal development for entrepreneurial success in healthcare innovation. Policymakers can promote university education to expand the entrepreneurship process using more facilities and make more services accessible.

Construction and validation of an Entrepreneurship Measurement Instrument for nursing students

Objective

To develop a valid and reliable scale to measure entrepreneurship competences of nursing students, by assessing the level of development of diverse entrepreneurship dimensions.

Methods

An Entrepreneurship Measurement Instrument, Catalonia (IME.Cat) was constructed, by adapting two existing instruments, and a psychometric study was performed to address the validity of the content and the construct, and the reliability. The internal consistency and the discrimination capacity of the instrument's items were examined.

Results

The IME.Cat scale showed a high reliability (α=0.89) for the complete set of items. The Cronbach's α value of the individual dimensions were: Problem management=0.78; Creativity=0.76; Personal confidence =0.64; and Risk acceptance =0.46. The corrected homogeneity indices for each of the item in the instrument were high (>0.40). The Confirmatory Factorial Analysis validated the proposed structure of the items according to dimension.

Conclusion

The IME.Cat scale showed solid psychometric values for assessing the entrepreneurship competences of nursing students within its dimensions, which are fundamental for the professional development of nursing.

An online communication skills education program for midwifery students: A quasi-experimental study

BACKGROUND

Communication and entrepreneurship skills, which have a very important place among the 21st century skills, are among the basic skills that a midwife should have.

OBJECTIVE

This study was carried out to investigate the effect of the Communication Skills Education Program on the communication and entrepreneurship skills of the midwifery students.

DESIGN

This study was designed a quasi-experimental study.

SETTINGS

Online.

PARTICIPANTS

First grade Bachelor of Midwifery Science students (n = 117).

METHODS

In this study, the Communication Skills Education Program was given to midwifery students. The Communication Skills Assessment Scale and University Students Entrepreneurship Scale were administered before the education program was implemented (pre-test), when the training program was completed (post-test), and six months after the education program was completed (post-test). Classified data were given in numbers and percentage distribution. Pearson correlation coefficient was used to determine the relationship between the variables. In order to test the significance of the difference between pre-test, post-test and follow-test the repeated measures Analysis of Variance (ANOVA) was performed.

RESULTS

The mean age of the participating students was 19.46 ± 1.74 (min. 18.0, max: 31.0) years. While 8.5 % of the students received training on communication previously, 7.7 % of the students received education on entrepreneurship previously. Statistically significant differences were determined between the scores the students obtained at the pre-test, post-test and follow-up test [F = 224.38, p = .00/F = 325.13, p = .00]. The Bonferroni test performed to find out from which tests the difference stemmed demonstrated that there was a significant difference between the mean scores obtained at all the tests. According to the analysis of the relationship between the mean scores the students obtained from the scales, there was a moderately significant positive correlation only between their pre-test mean scores.

CONCLUSIONS

In conclusion, we determined that the Communication Skills Education Program improved the students' communication and entrepreneurship skills.

Empowering nurses: exploring self-managed organizations in Indian healthcare

BACKGROUND

Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience.

METHOD

This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship.

RESULTS

The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis.

CONCLUSION

In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.

Self-efficacy in nurse entrepreneurs: A concept analysis

BACKGROUND

Nursing entrepreneurship represents an important opportunity for the nursing profession to address population health challenges and improve health care access. Although nurse entrepreneurs can be agents of change, the role of self-efficacy, as a determinant of nurses' success in business, is under-studied conceptually and in research.

PURPOSE

This paper presents an in-depth concept analysis and model of self-efficacy within the context of the nurse entrepreneur role.

METHODS

We used Walker and Avant's concept analysis methodology.

DISCUSSION

A systematic understanding of self-efficacy in nurse entrepreneurs provides insights into how it may influence their judgments and actions. Our analysis sets the stage for research on how self-efficacy in nurse entrepreneurs impacts success in the nursing business.

CONCLUSION

A conceptual model of self-efficacy in nurse entrepreneurs can guide their development through education and networking activities that incorporate experiential components to improve leadership and managerial skills for success in the health care business.

Innovation in Nursing Practice: A Scoping Review

Conceptual clarity on nursing innovation is vital in educating and supporting innovative nurses. This analysis aimed to determine the state of innovation within nursing through a scoping review of the literature. Twenty-four articles were identified, and a constant comparison analysis discovered 3 components essential to the successful innovation: the innate characteristics of the nurse, teams, leader, workplace, and organization; the culture or environmental factors; and then the process components, which include the translation, assessment, outcome, and sustainability of an innovation. This review highlights the need to clarify what does or does not qualify something to be innovative. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A68 .

Nurses’ confidence in starting a new venture, startup or project in the context of nurse-led hackathons: Results of prehackathon survey

Background

A hackathon framework has been successfully applied to solving health care challenges, including COVID-19, without much documented evidence of nurses' baseline or acquired confidence.

Purpose

To understand differences in baseline confidence levels in starting a new venture, startup or project in the context of nurse-led hackathons.

Method

A retrospective secondary analysis of a presurvey of hackathon participants from two NurseHack4Health (NH4H) events held in 2021.

Discussion

Male nurses and international nurses were more confident than the U.S.-based nurses. When comparing the 75% of participants who had not attended a hackathon previously to the 25% of participants who had, there was an increased confidence level among non-nurses and among participants with the previous hackathon, datathon, and ideation experience.

Conclusion

If hackathons can help nurses identify strengths, add new expertise and boost confidence, it may empower nurses to pursue their ideas more effectively, aid professional growth, and provide affirmation of innovator self-identity.

Entrepreneurship and entrepreneurial education in the context of postgraduate nursing

OBJECTIVE

To understand entrepreneurship and entrepreneurial education in the context of postgraduate nursing.

METHOD

Qualitative study based on Grounded Theory. The theoretical sample consisted of 15 master's and doctoral students and seven professors from a postgraduate nursing program at a university in southern Brazil. Individual interviews were conducted between August/2018 and February/2019 in a location defined by the participants, in general the University. The data were collected and analyzed simultaneously by initial and focused coding.

RESULTS

Three categories and 11 subcategories emerged that, interrelated, represented the phenomenon "Glimpsing entrepreneurship and entrepreneurial education in postgraduate nursing".

CONCLUSION

Entrepreneurship and entrepreneurial education, in the context of postgraduate nursing, were understood as incipient and promising processes. In this sense, it is necessary to intensify studies to demonstrate the entrepreneurial possibilities of the area.

Preparedness to self-employed careers: Development, validity, and reliability of an inventory for nursing students

AIMS

To develop and psychometrically validate an inventory based on two scales: awareness regarding factors for determining the prices of freelance activities and knowledge regarding freelance-related norms among nursing undergraduate students in Italy.

BACKGROUND

Although self-employed nursing careers are strategic to enhance employability, no valid scales for assessing nursing students' preparedness to undertake self-employed careers are available.

DESIGN

A multi-method and multi-phase design were employed. Phase one encompassed developmental tasks for generating items and phase two included a cross-sectional data collection for determining the psychometric proprieties of the developed scales and their reliability.

RESULTS

The final inventory encompassed two scales showing adequate validity and reliability after testing it on 882 Italian undergraduate nursing students. The first scale, factors for determining the prices of activities, is based on care complexity and logistic characteristic (two-factor structure). The second scale, knowledge regarding freelance-related characteristics, encompassed two domains: knowledge regarding administrative rules and pensions and retirement issues.

CONCLUSIONS

The developed inventory showed adequate evidence of initial validity and reliability, useful for filling the gap given by the unavailability of valid assessments for educators who pursue measuring the nursing students' preparedness to undertake self-employed careers.

Strengthening DNP Business Acumen: An Educational Intervention

BACKGROUND

As reflected in the literature, business acumen for Doctor of Nursing Practice (DNP) students is lacking. Foundational business concepts and applications in the curriculum necessitate the understanding of core business requirements in health care applicable toward DNP leadership roles.

METHOD

Course pedagogy used evidence-based materials as well as activities that included the development of business innovation proposals, stakeholder presentations, and business plans, as well as practicum hours.

RESULTS

Successful course delivery increased DNP students' knowledge and skills related to business acumen. In addition, students fully grasped the need to sustain and have fully developed scholarly projects that consider the clinical and financial aspects of health care.

CONCLUSION

Development of a business course strengthens the needed skills and acumen toward quality and financial performance critical in the DNP leadership role as well as in contributing toward institutions' growth. [J Nurs Educ. 2021;61(4):201-204.].

Empreendedorismo e educação empreendedora no contexto da pós-graduação em enfermagem

RESUMO Objetivo Compreender o empreendedorismo e a educação empreendedora no contexto da pós-graduação em enfermagem. Método Estudo qualitativo, do tipo Teoria Fundamentada nos Dados. A amostragem teórica foi composta por 15 estudantes de mestrado e doutorado e sete docentes de um programa de pós-graduação em enfermagem de uma Universidade do sul do Brasil. Realizaram-se entrevistas individuais entre agosto/2018 e fevereiro/2019 em local definido pelos participantes, em geral a Universidade. Os dados foram coletados e analisados simultaneamente por codificação inicial e focalizada. Resultados Emergiram três categorias e 11 subcategorias que, interrelacionadas, representaram o fenômeno “Vislumbrando o empreendedorismo e a educação empreendedora na pós-graduação em enfermagem”. Conclusão O empreendedorismo e a educação empreendedora, no contexto da pós-graduação em enfermagem, foram compreendidos como processos incipientes e promissores. Nesse sentido, é preciso que se intensifiquem estudos para demostrar as possibilidades empreendedoras da área.

The Learning Incubator: an innovative teaching and learning technology in nursing

OBJECTIVE

To understand the meaning of the Learning Incubator as a teaching and learning technology in the nursing area.

METHOD

Qualitative research, supported by grounded theory. Data was collected from March to November 2019, through interviews with guiding questions and hypotheses directed at two different groups. The analysis was done by comparative data analysis and included open, axial and integrated coding, as proposed by the method. The theoretical sample included 23 participants, which were nurses, technicians, and nursing students.

RESULTS

The delimitation of the categories converged in the phenomenon (Re)signifying knowledge and practices in the Learning Incubator. Guided by the paradigmatic model, the categories were named according to the three following components: Condition: Recognizing that the being and the professional practice are inextricable; Action/interaction: Revisiting professional practices that are repetitive and mechanic; Consequence: Referring to the reflections and knowledge constructed in the Learning Incubator.

CONCLUSION

The Learning Incubator, as seen by the study participants, is not limited to the Incubator meetings or the themes addressed in it. Beyond a welcoming physical space, the Incubator expands itself and becomes a tool that promotes self-reflection and self-assessment of professional behaviors and attitudes.

Entrepreneurship and nurse entrepreneurs lead the way to the development of nurses' role and professional identity in clinical practice: A qualitative study

AIMS AND OBJECTIVES

To explore the experiences and perspectives of nurses' transition into entrepreneurship in a clinical and cultural nursing setting and the impact of entrepreneurship on the nurses' role and professional identity.

BACKGROUND

Entrepreneurship is a relatively unknown phenomenon in international nursing research, and the prevalence of entrepreneurial nurses is only 0.5-1% of all working nurses globally. Unfortunately, several barriers occur within the healthcare system and existing nursing culture that may affect the potential of bringing entrepreneurship into the nursing profession.

DESIGN

The qualitative study used a phenomenological-hermeneutical approach based on an interpretative phenomenological analysis and COREQ-guided reporting.

METHODS

Nine individual, semi-structured interviews were conducted face to face (n = 6) and by telephone (n = 3) with Danish nurse entrepreneurs between February and March 2019.

RESULTS

The analysis revealed four themes: (a) prejudice towards entrepreneurship; (b) to become an entrepreneur in a nursing culture; (c) rebellion against the traditional role as employee and (d) challenged professional identity and new professional roles.

CONCLUSION

Nurse entrepreneurs are caught between traditional and new ways of viewing nursing identity, norms, values and roles, and they face a conflict of professional values and a stereotyped view of 'real' nursing. Our findings show that entrepreneurship entails a huge learning process that develops nurses' ability to think outside the box in a broader health perspective and challenge the existing nursing culture and role. However, nurse entrepreneurs' ability to engage in entrepreneurship is compromised by professional values, the duty to behave as a good nurse and their own prejudices towards entrepreneurs.

IMPACT

Entrepreneurship and nurse entrepreneurs pose a huge potential development of the nursing role and identity, as they challenge the current view on the nursing profession. This development is important for patients and health professionals, as future health challenges call for new ways of thinking and acting.

Entrepreneurial tendency of Nursing students: a comparison between graduating beginners and undergraduate students

Objective:

to compare the entrepreneurial tendency between beginner and graduating students from undergraduate Nursing courses.

Method:

this is a cross-sectional and quantitative research study. Data was collected from 377 Nursing students from four undergraduate Nursing courses in different Brazilian regions, 162 of them in first year and 215 in last year. Data was collected by means of a social and academic characterization form and the General Entrepreneurial Tendency Test. Data analysis was conducted by means of descriptive and inferential statistics.

Results:

the scores of the beginner students were below the mean in all dimensions of the instrument. The senior year students were above the test mean in the Impulse and determination dimension. A statistically significant difference was identified in relation to the course period and to the entrepreneurial tendency in the following dimensions: Need for achievement (p=0.001) and Impulse and determination (p=0.000).

Conclusion:

the results indicate the importance of investment by universities in the development of an entrepreneurial culture in higher education in Nursing.

The need to integrate in primary healthcare: nurse identity constructions of pharmacists as entrepreneurs

PURPOSE

This study explores nurses' views as to whether they see community pharmacists as "entrepreneurial" and what this might mean for working together in primary care. Pharmacists are expected to fully integrate with their colleagues - particularly nurses - under the New Zealand health policy. Yet, there is scarce literature that examines multidisciplinary teamwork and integration through an entrepreneurial identity lens. This is particularly important since around the world, including New Zealand, community pharmacies are small businesses.

DESIGN/METHODOLOGY/APPROACH

This was an exploratory qualitative study. A total of 18 semi-structured interviews were conducted with nurses from primary care, nursing professional bodies and academics from nursing schools. Interviews were audio recorded and transcribed verbatim. Coding was undertaken through general inductive thematic analysis.

FINDINGS

In total three key themes emerged through analysis: the entrepreneurial profile of the community pharmacist, the lack of entrepreneurship across the profession, and the role identity and value that community pharmacists hold, as viewed by nurses. There appeared to be pockets of entrepreneurship in community pharmacy; nurses did not express a blanket label of entrepreneurship across the whole sector. Nurses also discussed several forms of entrepreneurship including commercial-oriented, clinical and social entrepreneurship. The social entrepreneurship identity of community pharmacists sat most comfortably with nurse participants. Overall, nurses appeared to value community pharmacists but felt that they did not fully understand the roles that this profession took on.

RESEARCH LIMITATIONS/IMPLICATIONS

This paper contributes to the academic literature by identifying three domains of entrepreneurship relevant to community pharmacy as well as multi-level barriers that will need to be jointly tackled by professional bodies and policy-makers. Improving nurses' and other healthcare professionals' knowledge of community pharmacists' role and expertise is also likely to facilitate better inter-professional integration.

ORIGINALITY/VALUE

There is scarce literature that attempts to understand how entrepreneurial identity plays out in health organisation and management. This study adds to the knowledge base of factors influencing integration in healthcare.