Structures and practices enabling staff nurses to control their practice

Area of Science:

• Nursing Practice
• Healthcare Management
• Organizational Behavior

Background:

• Control over nursing practice (CNP) is a key attribute of a productive work environment for staff nurses.
• The Essentials of Magnetism (EOM) instrument measures CNP, with nearly 3,000 nurses participating in this study.
• Understanding the structures that foster CNP is crucial for improving nursing work environments.

Purpose of the Study:

• To identify structures and attributes that promote control over nursing practice (CNP) among staff nurses.
• To explore the components of shared governance structures that enable CNP.
• To provide insights for creating more supportive and empowering nursing work environments.

Main Methods:

• Mixed-methods approach utilizing interviews, participant observations, and the CWEQII empowerment tool.
• Quantitative data from the Essentials of Magnetism (EOM) instrument (n≈3,000 nurses).
• Qualitative data from interviews (n≈446 nurses, managers, physicians, CNOs, COOs) and observations of meetings across 101 high-scoring units in 8 magnet hospitals.

Main Results:

• Viable shared governance structures enabling CNP were identified.
• Specific structural components and attributes that foster nurses' control over practice were elucidated.
• Constant comparative analysis of quantitative and qualitative data revealed key findings.

Conclusions:

• Shared governance structures are essential for promoting control over nursing practice.
• Understanding these structures can guide the development of effective nursing work environments.
• The study provides evidence-based insights for enhancing nurses' professional autonomy and job satisfaction.