title: Excellence through evidence: structures enabling clinical autonomy.
abstract: 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.
authors.affiliation: Health Science Research Associates, Apache Junction, AZ, USA. mcairzona@juno.com
authors.forename: Marlene
authors.initials: M
authors.lastname: Kramer
authors.forename: Patricia
authors.initials: P
authors.lastname: Maguire
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Schmalenberg
authors.forename: Betsy
authors.initials: B
authors.lastname: Andrews
authors.forename: Rebecca
authors.initials: R
authors.lastname: Burke
authors.forename: Linda
authors.initials: L
authors.lastname: Chmielewski
authors.forename: Mary Ann T
authors.initials: MA
authors.lastname: Donohue
authors.forename: Mary
authors.initials: M
authors.lastname: Ellsworth
authors.forename: Donna
authors.initials: D
authors.lastname: Poduska
authors.forename: Mary Ellin
authors.initials: ME
authors.lastname: Smith
authors.forename: Charleen
authors.initials: C
authors.lastname: Tachibana
mesh_terms: D009718:Nurse Administrators; D009736:Nursing Process; D010379:Peer Group; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D012107:Research Design