Empowerment Of Nurses Research Articles

Effect of head nurse empowerment program on staff nurses' job satisfaction at two educational hospitals in Rasht, Iran.

Background:Job satisfaction of nurses is an important concept in nursing profession because it influences nursing care. Head nurses play a crucial role in the job satisfaction of nurse staffs. The current study, therefore, aimed to investigate the effect of Head Nurse Empowerment Program (HNEP) on job satisfaction of nurses.Materials and Methods:This quasi-experimental study was conducted at two educational hospitals in Rasht, Iran. Of 160 staff nurses who were working in eight medical-surgical wards and two Intensive Care Units, 60 were recruited using simple random sampling method. The samples were randomly assigned to control and experimental groups. The HNEP was applied to promote the management skills among nurses, which included technical, communicational, perceptional, and diagnostic skills. The data were collected using nurses' job satisfaction questionnaire and analyzed using the Mann–Whitney and Wilcoxon Singed Ranks tests. P < 0.05 was set as the significance level.Results:There was a significant difference in the job satisfaction of nurse staff within the experimental group on comparing pre- and post-HNEP phases [78 (65.50) vs. 78 (65.50); P < 0.001]. The job satisfaction also differed between the control and experimental groups [60 (82.25) vs. 128.5 (51.75); P < 0.001]. However, no significant difference [62 (78.75) vs. 60 (82.25); P = 0.129] was found within the control group. The number of satisfied nurse staffs increased in the experimental group from approximately 25% to 76% after HNEP.Conclusions:The HNEP can be used as a promoting tool in the nursing profession. Increasing head nurses' management skills can result in job satisfaction among the staff nurses.

Structural empowerment, job stress and burnout of nurses in China

PurposeTo investigate the status of structural empowerment, job stress and burnout in China, and to explore the relationships among them. MethodsThe questionnaires of CWEQ-II, job stressors and MBI were used to investigate 1002 nurses working at tertiary-level hospitals. ResultsThe average score of CWEQ-II was 2.23±0.59. The score of EE of MBI was 29.75±13.94, PA was 27.40±11.21, both of them showed a high level of exhaustion, DP was 8.07±5.82 and showed a middle level of exhaustion. The findings showed that workload and time pressure were the most frequently encountered job stress among staff nurses, the score was 3.23±0.95; There was a significantly correlation among structural empowerment, job stressors and the level of burnout(p<0.05). Hierarchical regression analysis showed that structural empowerment had significant influence on the every factors of job stressors (p<0.05) and burnout, job stressors had significant influence on the every factors of burnout (p<0.05). Structural equation modeling analyses revealed a good fit to the data based on various fit indices (χ2/df=2.29, GFI=0.945, CFI=0.965, IFI=0.966, RMSEA=0.061). Staff nurses felt that structural empowerment in their workplace resulted in lower levels of job stress which in turn strongly influenced Burnout. ConclusionsThese results provide initial support for an expanded model of structural empowerment, and offer a broader understanding of the empowerment process.

Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.

IntroductionNurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the ‘worry or concern’ sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses’ worry or concern about a patient’s condition.MethodsWe searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: ‘nurses’, ‘worry/concern’ and ‘deterioration’. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014.ResultsThe search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs.ConclusionsThe signs and symptoms we found in the literature reflect the nature of nurses’ worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0950-5) contains supplementary material, which is available to authorized users.

Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

Aim: To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style.Background: Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings.Design: Qualitative phenomenological study.Methods: Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model.Results: Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication.Conclusion: Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit managers are imperative to maintaining an empowering practice environment which can ensure the best care and healthy, engaged staff.

The correlation between structural empowerment and job satisfaction of undergraduate nursing faculty

Objective To investigate the status of undergraduate nursing faculty's structural empowerment and job satisfaction and to analyze the correlation between them. Methods Totally 246 nursing teachers were investigated with Conditions for Work Effectiveness Questionnaire II and Minnesota Satisfaction Questionnaire. The correlation between structural empowerment and job satisfaction were analyzed by Pearson correlation analysis. Results Undergraduate nursing faculty's total score was (3.04±0.57) points, and score of job satisfaction was (2.93±0.59) points, both of which were at moderate level. Structural empowerment was positively correlated with job satisfaction (r=0.450-0.714,P<0.01), the higher structural empowerment level, the higher job satisfaction. Conclusions Undergraduate nursing managers can improve nursing teachers' job satisfaction by strengthening the empowerment to nursing teachers, in order to enhance the teaching quality. Key words: Faculty, Nursing; Structural empowerment; Job satisfaction

Structural empowerment and job satisfaction among nurses coordinators: a pilot study

In literature, the structural empowerment and the job satisfaction have been studied in many different work settings but more need to be done in the setting of Head Nurses. The goal of the study is to evaluate the structural empowerment level of head nurses and if it impacts on the job satisfaction. A cross sectional design study was used. We enrolled 125 head nurses from three different hospitals of Rome. To collect the data we used a questionnaire that included both a part of the collection of sociopersonal data and the two scales (job satisfaction and structural empowerment). We used the SPSS19.0 statistical Software for data analysis to detect significant results. Head Nurse declared to be not enough satisfied at work (mean=3.43) and their structural empowerment level resulted moderate (mean=3.16). The structural empowerment of head nurses impacts their job satisfaction especially concerning opportunities for social and professional interactions, praises, awards, audit and responsibilities. Results underline structural empowerment relevance in head nurses job satisfaction. Healthcare organizations need to address job satisfaction to improve quality of care and more specifically that of head nurses since they directly impact on nurses job satisfaction.

The impact of psychological empowerment and organizational commitment on Chines nurses' job satisfaction.

Abstract Background: Research findings have shown that job satisfaction of Chinese nurses is at a low level. Limited studies have focused on the impact of psychological empowerment and organizational commitment on job satisfaction of Chinese nurses. Aims: The aim of this study is to describe job satisfaction, psychological empowerment and organizational commitment of Chinese nurses and to explore the impact of psychological empowerment and organizational commitment on the nurses' job satisfaction. Methods: A total of 726 nurses were recruited in a convenience sample from 10 tertiary hospitals. Data were collected using four questionnaires including Job Satisfaction Survey, Psychological Empowerment Scale, Organizational Commitment Scale and Demographic Questionnaire. Descriptive analysis, correlation and stepwise multiple regression were used for data analysis. Results: Nurses' job satisfaction, psychological empowerment, and organizational commitment were identified at moderate levels. Nurses' job satisfaction and psychological empowerment were significantly different in terms of age and length of service; nurse job satisfaction varied with respect to marital status. Findings further indicated that nurse job satisfaction was positively correlated with psychological empowerment and organizational commitment. Psychological empowerment, organizational commitment, and marital status were significant predicting factors of nurse job satisfaction. Conclusions: This study provides evidence to help nursing managers and health policy-makers to develop intervention programs aimed at enhancing nurse job satisfaction and retaining nurses.

The impact of head nurse's transformational leadership style on emotional labor and psychological empowerment of nurses

Objective The study aimed to investigate the influence of head nurse's transformational leadership style on emotional labor and psychological empowerment of nurses. Methods Totally 851 staff nurses from four 3A hospitals were investigated with the Transformational Leadership Style Sub Scale of Multifactor Leadership Questionnaire, Psychological Empowerment Scale and Emotional Labor Scale. Results The head nurse's transformational leadership style scored (2.41±0.81). The psychological empowerment of nurses scored (3.27±0.47), its autonomy dimension scored (3.81±0.50), staying at medium level. The emotional labor of nurses scored (3.68±0.61), its deep acting dimension scored (4.67±0.76), which was above medium level. The indirect correlation coefficient between head nurse's transformational leadership style and emotional labor (r=-0.13) was far higher than direct correlation coefficient (r=-0.04). The psychological empowerment was the full mediation variable by which head nurse's transformational leadership style influence emotional labor of nurses. Conclusions Head nurse's transformational leadership style can enhance nurse's self-efficacy, cognition of work significance and work autonomy, so that nurse's deep acting and positive perception of emotional display can be increased, and nurse's emotional exhaustion and job burnout can be decreased to retain nurses. Key words: Leadership; Nurses; Transformational leadership style; Psychological empowerment; Emotional labor

The Michigan Opioid Safety Score (MOSS): A Patient Safety and Nurse Empowerment Tool.

Safely treating postsurgical pain continues to be a challenge, despite more than a decade of focus on its appropriate management. Overuse of opioids and undertreatment of pain continues, as does insufficient monitoring of patients at risk for opioid and pain-related complications. It is clear that relying only on numeric subjective pain scores is inadequate when treating pain. Appropriate bedside evaluation should also include measures of respiration and sedation. Furthermore, assessment of risk should be done with initial pain assessment and continued throughout the pain management course. The recently developed Michigan Opioid Safety Score integrates health risks and objective measures of respiratory rate and sedation, while encouraging the use of multimodal analgesia for all patients.

AN EXPLORATION OF THE PROFESSIONAL SOCIALISATION OF STUDENT NURSES

Desirable levels of knowledge and skills or appropriate values and beliefs of the nursing profession are not manifested in all students who become professional nurses. The aim of the study was to explore the perceptions of professional nurses regarding their role in the professional socialisation of student nurses and the experiences of the students as members of the nursing profession. A qualitative design was applied to collect data from two purposively selected samples, professional nurses and students. Focus-group interviews (two with sample 1 and 5 with sample 2) were conducted. Findings revealed that a lack of exemplary role models, an unfavourable environment and students’ own reasons of career choice influenced the professional socialisation of students. Exemplary role modelling, supportive learning environments, the empowerment of professional nurses and the commitment to professional values of nursing are vital to develop well-socialised professional practitioners.

The impact of psychological empowerment and organisational commitment on Chinese nurses’ job satisfaction

Background: Research findings have shown that job satisfaction of Chinese nurses is at a low level. Limited studies have focused on the impact of psychological empowerment and organisational commitment on job satisfaction of Chinese nurses.Aims: The aim of this study is to describe job satisfaction, psychological empowerment and organisational commitment of Chinese nurses and to explore the impact of psychological empowerment and organisational commitment on the nurses’ job satisfaction.Methods: A total of 726 nurses were recruited in a convenience sample from 10 tertiary hospitals. Data were collected using four questionnaires including Job Satisfaction Survey, Psychological Empowerment Scale, Organisational Commitment Scale and Demographic Questionnaire. Descriptive analysis, correlation and stepwise multiple regression were used for data analysis.Results: Nurses’ job satisfaction, psychological empowerment and organisational commitment were identified at moderate levels. Nurses’ job satisfaction and psychological empowerment were significantly different in terms of age and length of service; nurse job satisfaction varied with respect to marital status. Findings further indicated that nurse job satisfaction was positively correlated with psychological empowerment and organisational commitment. Psychological empowerment, organisational commitment and marital status were significant predicting factors of nurse job satisfaction.Conclusions: This study provides evidence to help nursing managers and health policy-makers to develop intervention programs aimed at enhancing nurse job satisfaction and retaining nurses.

The Factors Influencing Compliance of Multidrug-resistant Organism Infection Control in Intensive Care Units Nurses

Purpose: This study was conducted to identify factors influencing compliance of multidrug-resistant organism infection control in intensive care units (ICU) nurses. Methods: Data were collected from 254 ICU nurses who were working at 6 general and advanced general hospitals in D city and G Province. Results: 77.2% and 84.4% of the subjects correctly answered to questions about Methicillin-Resistant Staphylococcus Aureus (MRSA) and VancomycinResistant Enterococcus (VRE), respectively. The scores of MRSA infection control compliance and VRE infection control compliance were 3.41 and 3.43, respectively. The factors influencing MRSA infection control compliance were empowerment, environmental safety recognition, and education satisfaction, which explained 30% of MRSA infection control compliance. The factors significantly related to VRE infection control compliance were empowerment, hospital types, environmental safety recognition, number of education sessions, and neonatal ICU, which explained 37% of VRE infection control compliance. Conclusion: It is necessary to develop efficient educational programs for infection control including educational contents to improve empowerment and environmental safety recognition of nurses. Furthermore, administrative support for those infection control programs is also necessary.

Reducing Central Line–Associated Bloodstream Infections in Three ICUs at a Tertiary Care Hospital in the United Arab Emirates

Central line-associated bloodstream infection (CLABSI) is associated with significant morbidity and mortality. A quality improvement project was conducted to decrease CLABSI rates by 50% across all ICUs in a tertiary care hospital (Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates). A multifaceted interventional program was implemented in a drive to reduce CLABSI rates. Stage 1 of the intervention entailed implementation of a central line insertion bundle, an insertion checklist, dedicated central line trolleys, education of all staff involved in insertion and maintenance of central lines, and empowerment of nurses. Stage 2 entailed implementation of a maintenance bundle and a CLABSI prevention policy and inclusion of central line assessment in the daily goals. Stage 3 was implemented in the form of CLABSI champions, spot checks on maintenance techniques, and review of every CLABSI. Stage 4 entailed the implementation of a Comprehensive Unit-based Safety Program (CUSP). Stage 5 consisted of a "back to basics" campaign, which included refocusing on basic evidence-based care bundles, introduction of bundle-compliance verification, and educational sessions and awareness programs. Overall CLABSI rates significantly decreased (p < .0001) from a mean of 2.99 (standard deviation [SD], 1.69) in the preimplementation period (January 2008-June 2011) to 1.47 (SD, 1.01) in the postimplementation period (July 2011-August 2014) across all ICUs. Overall, there were significantly more months with CLABSI-free days in the post-implementation than in the preimplementation period. The combination of evidence-based interventions, standardization of procedures, teamwork, and front-line staff involvement in the decision-making process contributed to decreases in CLABSI rates across three ICUs.

Experiences of newly graduated nurses on strategies of gaining self-confidence during their initial work: a qualitative study.

The presence of newly graduated nurses (NGNs) in clinical settings increases the rates of clinical errors and patient injury. In addition, the turnover rate for NGN staffs is significantly higher than the average turnover rate. Therefore, familiarizing NGNs with their workplace and increasing their professional self-confidence increase their empowerment and efficiency. This article elicits the strategies used by NGNs to gain self-confidence during their early career. This qualitative study was conducted using the purposive sampling method and was based on the data saturation principle. Data were collected using in-depth, semistructured interviews from 30 NGNs working at teaching hospitals in four northwest provinces of Iran during 2012 and 2013. Data were collected by means of in-depth semistructured interviews. Qualitative content analysis was used to analyze the data. The interviews elicited eight coping strategies that participants used to form self-confidence during the first 6 months of their career. These strategies included familiarity, knowledge enhancement, clinical skills learning, self-exploration, validation, responsibility, mutual interaction, and personal creativity. In addition,participants used these strategies to reinforce their self-confidence during their first 2 years at work. The results of this research increase the understanding of NGNs, managers, and healthcare professionals regarding the strategies used by NGNs to gain self-confidence. This knowledge may be applied in programs designed to increase the empowerment and efficacy of nurses to improve the quality of patient care and reduce nurse turnover.

A Critical Perspective on Relations between Staff Nurses and their Nurse Manager: Advancing Nurse Empowerment Theory

This study considers empowerment in nurse-manager relations by examining how conflict is handled on both sides and how the critical social perspective has influenced these relations. The authors use inductive analysis of empirical data to explain how (1) nursing work is organized, structured, and circumscribed by centrally determined policies and practices that downplay nurses' professional judgement about patient care; (2) power is held over nurses in their relationship with their manager; and (3) nurses' response to power is to engage in strategies of resistance. The authors illustrate how power influences relations between staff nurses and managers and provide a critical analysis of the strategies of resistance that result in personal, relational, and critical empowerment among staff nurses. Through resistance, staff nurses engage in alternative discourses to counteract the prevailing neoliberal organizational and managerial discourses of efficiency and cost-effectiveness.

Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.

The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care.

Modeling the relations of ethical leadership and clinical governance with psychological empowerment in nurses

Background: Ethical leadership appeared as a new approach in the leadership perspective and provided the ground for promoting individual and organizational efficiency by giving priorities to ethics in organizations. In this regard, the present study was conducted with the aim of modeling the relations of ethical leadership and clinical governance with psychological empowerment among nurses of public hospitals in Kermanshah in 2014. Methods: the research method was descriptive survey. The study sample consisted of all nurses (n=550) working in public hospitals of Kermanshah University of Medical Science for whom 163 nurses were selected using simple random sampling. The tools for data collection were ethical leadership, clinical governance and psychology empowerment questionnaires whose validity and reliability were confirmed. The structural equation modeling was used to analyze the data. Results: The results showed a significant relationship between ethical leadership and clinical governance (P<0.01) and psychological empowerment (P<0.01). Moreover, there was a significant correlation between clinical governance and psychological empowerment (P<0.05). Based on the results of the research, ethical leadership directly and through clinical governance affected the nurses’ psychological empowerment (P<0.05). Conclusion: reliance on ethics and ethical leadership in hospitals, in addition to providing the space and ground for improving the effectiveness of clinical governance approach, can promote the feeling of psychological empowerment in nurses. Accordingly, the ethical issues are required to be taken into consideration in hospitals.

Nurse's psychological empowerment and perceived autonomy in university and teaching hospitals at Menofia Governorate/Egypt

Background : It is believed that, the greater nurses uncertainty is likely to negative attitude toward their organization and the quality of patient care. Staff nurses can be empowered at all levels of the organization, if management allows them the support, encouragement and rewards them. Empowerment is the process by which a leader shares power with others or enable them to act. Autonomy plays an important part in nurses’ job satisfaction and retention. Autonomy is defined as authority and accountability for one's decision and activities. Aim : To study the relationship between psychological empowerment and perceived autonomy of nurses in University and Teaching Hospitals at Menofia Governorate. Design : a descriptive correlational design. Setting : This study was conducted in two selected hospitals namely Menofia University Hospital and Shebine EL-Kom Teaching Hospital. Sample : A convenint sample of 550 nurses was included in the study. Tool : Two tools wereused to collect the data: 1- Psychological Empowerment Instrument. 2- Nurses’ autonomy questionnaire. Results: There was a highly statistical significant correlation between total psychological empowerment and perceived autonomy of nurses. A significant relation was founded between the levels of autonomy and nurses’ work place. While, there was insignificant relation between both of nurses’ psychological empowerment and autonomy according to their age, level of education and years of experiences. Recommendations : Staff development program for nurse managers to integrate staff nurses in decision-making and to deal effectively with new ideas to promote organizational climate and empowerment of nurses.

Critical care and severe sepsis in resource poor settings.

Critical care and severe sepsis in resource poor settings.

Representations of vulnerability and empowerment of nurses in the context of HIV/AIDS

The aim of this study was to analyze the social representations of vulnerability and empowerment of nurses, in the context of their relationships with the work environment, in which they care for people with HIV/AIDS. A qualitative and descriptive study was carried out with 30 nurses in a public hospital that is a reference for HIV/AIDS care. The theoretical framework of the procedural approach from the Social Representations Theory was adopted. The interviews were transcribed and submitted to thematic content analysis using the software Nvivo 9.0. Vulnerability was expressed as embarrassment, dissatisfaction, distress, frustration, insecurity, overload and stress. In turn, empowerment was expressed in the form of positive interpersonal relationships, moral and operational support from the team, adaptations and improvisations, acquisition of scientific knowledge, and professional self-protection.