Nurses’ perception of Shared Governance

The Third JNC International Nursing Conference 2010 Majeda Afeef, RN, MSN. Wa'ad Al-Fayumi, RN, MSN. Mohammad R. Al-Qudimat, RN,MSN Nurses’ perception of Shared Governance

Background • Aims • Methodology • Design • Tool • Result and discussion • Recommendation • Conclusion Outline

Department of Nursing - KHCC

At the onset of the 21st century, health care organizations are confronting the problem of nursing shortage. • Professional Challenges in Nursing in Jordan: • Heavy workload • Conflicts with other health care professionals • Limited of clinical autonomy • No supportive work environment • Feeling of inadequacy (Almaaitah & Shokeh. (2009).The nursing workforce in Jordan: A policy orientated approach) Background – Nursing challenges

Several factors can push nurses to look for another job including: • Salary • Promotion opportunity • Equality with other professional careers • Having autonomy in decision-making • Having an impact on the quality of care and policy development (Duffield, Aiken, O.Brien-Pallas, and Wise, 2004). Background – Nursing challenges

Main factors affecting the supply of Nursing Workforce in Jordan: • Shortages in female students‘ enrollment in schools of nursing • Shortages in faculty members in the education centers • Insufficient resources and clinical placement for nursing students • Inappropriate staffing practices that lead to understaffing (Almaaitah & Shokeh. (2009).The nursing workforce in Jordan: A policy orientated approach) Background – Nursing in Jordan

Previous study revealed that these working conditions contribute to • Dissatisfaction • Burnout • High rates of turnover • Attrition among male and female nurses in Jordan (Almaaitah & Shokeh. (2009).The nursing workforce in Jordan: A policy orientated approach) Background – Nursing in Jordan

Nurses should be part of the health policy decisions taking into consideration: • Funding • Recruiting • Retaining nurses (Aroskar et al. 2004) Background – Solution

Shared governance is a scheme of accountability that depends on individual autonomy, authority, and control. (Porter-O’Grady, 1992) The earliest foundation for shared governance arose with theorists such as Herzberg and McGregor (1960). Background – Shared Governance SG

Background – SG Magnet Hospital Magnet Model

A Magnet hospital is an environment maintaining empowerment and offering autonomy and ability for concerns/issues to be conveyed legitimately (Brooks, 2004; DeBaca et al., 1993; Porter-O’Grady, 2001). Magnet hospitals have the advantages of providing excellent nursing care and sustaining competent and skilled nurses (Aiken et al., 1997; Bumgarner & Beard, 2003; Havens & Aiken, 1999). Background

To measure nurses perception of governance in the selected Lebanese hospitals and others located in the middle east (in Jordan and Qatar) and the region using the Index of Professional Nursing Governance (IPNG) Purposes

Descriptive cross-sectional design • Tool: • Index of Professional Nursing Governance (IPNG) developed by Hess (1998). • This tool quantifies the perception on a continuum from traditional, to shared, and to self governance. Methodology

Questionnaire involves two sections. • 11 questions and involves collecting socio-demographic characteristics • The second section of IPNG measures six dimensions of governance including • control over nursing personnel • access to information • influence over organizational resources, • participation • control over nursing practice • goals and conflict resolution Methodology - Tool

It is composed of 86 items Each item is coded from 1 to 5 and defined as follows: • nursing management/administration only • primarily nursing management/administration with some staff nurse input • equally shared by nursing management/administration • primarily staff nurses with some nursing management/administration input • staff nurses only. Methodology - Tool

If the total score of IPNG ranges from: • 86 to 172  an environment of primarily management decision making • 173 to 344  shared decision between nurses and management, • 345 and 430  nurses are the primary decision making group (Howell et al., 2001) Methodology -Tool

Procedure: • IRB Approval. • Stamped envelopes containing the Index of Professional Nursing Governance (IPNG) and an oral statement script will be distributed to all units in the hospital. • A brief explanation for each participant was done by one investigator to illustrate the idea of the research and answer any question related to the questionnaire. Methodology

Procedure • The oral statement script contained the purpose of the study and that the survey is anonymous, voluntary. • its completion time needed is about 45 minutes per nurse  one hour compensation • The filled questionnaire was collected in blank separate envelopes. Methodology

Result and Discussion

Table (1): Participants Characteristics N=233

Table 2: IPNG Total and Sub-Scale Means and SharedGovernanceRanges *Within shared governance range

Despite KHCC do not follow the shared governance model as structured model at the time of the study, our nurses perception to the shared governance is within the range of shared governance mentality Shared governance model will be applied with less time frame at our institution Conclusion

Repeat the study after the start of shared governance model of practice Shared governance culture need to be enhanced among hospitals in Jordan and the region Recommendations

American University of Beirut medical center – Beirut, Lebanon Our nurses at King Hussein Cancer Center – Amman, Jordan ACKNOWLEDGMENT

Thank You

Nurses’ perception of Shared Governance