Structures and practices enabling staff nurses to control their practice.
This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures.
Kramer
Marlene
M
Health Science Research Associates, Apache Junction, AZ, USA. mcairzona@juno.com
Schmalenberg
Claudia
C
Maguire
Patricia
P
Brewer
Barbara B
BB
Burke
Rebecca
R
Chmielewski
Linda
L
Cox
Karen
K
Kishner
Janice
J
Krugman
Mary
M
Meeks-Sjostrom
Diana
D
Waldo
Mary
M
D000068:Accreditation; D000575:American Nurses' Association; D001291:Attitude of Health Personnel; D001363:Awards and Prizes; D002322:Career Mobility; D003659:Decision Making, Organizational; D017598:Efficiency, Organizational; D006272:Health Facility Environment / Q000458:organization & administration; D006801:Humans; D016294:Models, Nursing; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D009738:Nursing Service, Hospital / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D015279:Organizational Culture; D011209:Power, Psychological; D017009:Professional Autonomy; D011367:Professional Staff Committees / Q000458:organization & administration; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014481:United States; D017132:Workplace / Q000458:organization & administration / Q000523:psychology