Excellence through evidence: structures enabling clinical autonomy.
Autonomy is a multidimensional process. Clinical autonomy, the dimension in which patients are the primary beneficiaries, is the focus of this study. Despite high valuation and persistent challenges to nurses to function autonomously, the relationship between autonomous practice and patient outcomes has not been empirically established due, in large measure, to a lack of correspondence between concepts and measurement of autonomy and to a lack of knowledge of enabling structures. The purpose of the research reported here is to identify the structures, practices, elements in the environment, and interventions that nurses, nurse managers, and physicians identify as promoting staff nurse clinical autonomy. Implementation of these interventions would then enable clinical decision making at the frontline and would foster studies to determine whether the expected linkage between clinical autonomy and positive patient outcomes prevails.
Kramer
Marlene
M
Health Science Research Associates, Apache Junction, AZ, USA. mcairzona@juno.com
Maguire
Patricia
P
Schmalenberg
Claudia E
CE
Andrews
Betsy
B
Burke
Rebecca
R
Chmielewski
Linda
L
Donohue
Mary Ann T
MA
Ellsworth
Mary
M
Poduska
Donna
D
Smith
Mary Ellin
ME
Tachibana
Charleen
C
D009718:Nurse Administrators; D009736:Nursing Process; D010379:Peer Group; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D012107:Research Design