Governance of professional nursing practice in a hospital setting: a mixed methods study

Abstract

Objective: to elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. Method: a mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Results: based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. Conclusion: it is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses.

Métodos Mistos Na Pesquisa Em Enfermagem: Possibilidades De Aplicação À Luz De Creswell

“…9 A recent example of research from Brazilian nursing based on the mixed approach in concomitant triangulation was the study of the governance of the nursing practice in the hospital environment. 14 In this investigation, the collection of quantitative and qualitative data was concomitantly extracted by a validated questionnaire, by means of grounded theory. The authors demonstrated the procedures for collection (concomitant), data analysis and the fusion of both, concluding, based on the final construct of the analyzed data, that care management is the core of the nurses autonomy in a hospital setting; and that this professional uses the development of skills, experience and good professional examples to overcome the daily adversities in their working environment.…”

“…The authors demonstrated the procedures for collection (concomitant), data analysis and the fusion of both, concluding, based on the final construct of the analyzed data, that care management is the core of the nurses autonomy in a hospital setting; and that this professional uses the development of skills, experience and good professional examples to overcome the daily adversities in their working environment. 14 Another study of Dutch origin, reports that concomitant triangulation would be applied to conduct data collection with equal weight attribution. 15 In this research under construction, whose subject focuses on advanced nursing practices with the aim to advance authority over procedures traditionally recognized as being performed by doctors, the authors contribute with a very interesting illustrative delineation about triangulation and report using the data added to them, concomitantly collected with several techniques to infer their conclusions.…”

Nurses’ lived experience serving on unit-based councils: A literature review

“…The Index measures characteristics of nurses' practice environment. [17] The qualitative study showed that "governance in nursing is based on managing nursing care and services. To perform these tasks, nurses seek to get around organizational support constraints and develop management knowledge and skills".…”

“…To perform these tasks, nurses seek to get around organizational support constraints and develop management knowledge and skills". [17] (p. 1029) The results from the Index showed that nurses within SG organizations perceived themselves to have autonomy, control over the environment, and positive relationships with physicians.…”

“…[14] To better support nurses in their autonomous professional nursing practice it is necessary to reorganize the organization's structures and processes. [17] Other organizational implications include supporting nurses in their participation of SG activities by ensuring patient care coverage and compensating them for their commitment. [19] As well, others who explored the lived experience of nurse managers and staff nurses in SG reported that nurse managers themselves believed that mentoring staff was crucial in successful SG implementation, and recognized the importance of letting go of traditional way of management and act as facilitators in the SG process.…”