Role Based Leadership: Transforming the Practice Culture Through Role Clarity and Structural Support for Autonomy

2.50
Hdl Handle:
http://hdl.handle.net/10755/243494
Category:
Abstract
Type:
Presentation
Title:
Role Based Leadership: Transforming the Practice Culture Through Role Clarity and Structural Support for Autonomy
Author(s):
Loos, Nancy; O'Rourke, Maria W.
Author Details:
Loos, Nancy, RN, MSN, PHN, NE-BC, Nancy.Loos@CHW.EDU; O'Rourke, Maria W., DNSc, RN, FAAN, FAAHC;
Abstract:
Purpose

This study examined the relationship between autonomy and organizational structure within a magnet context through self-reports of  adult-critical care RNs. Role clarity at management and clinical levels is essential to ensuring full RN role capacity realized at all organizational levels. Structural and process support for decision-making autonomy within a healthy work environment is considered crucial to RN professional role enactment and empowerment, work satisfaction, and evidence-based practice.  A defined model of the professional role clarified autonomous professional practice while the patient care model provided structural and system support for autonomous decision-making. 

Method

This quantitative, cross-sectional survey design was completed with a convenience sample of direct-care RNs in adult ICU in a large suburban trauma center (N ~ 92). Of 92 nurses, 69 completed the survey (75%); 58 (63%) completed a role development program and professional role orientation survey, the Professional Role Development Guide(63%). Participation included voluntary, one-time, anonymous completion of the 58-item Essentials of Magnetism II (EOMII). Two optional 10-point single item scales—Organizational Job Satisfaction (OJS) and a Nurse-assessed Quality of Patient Care (QC) were included.

Results

75% (N=69) return rate across two shifts. More than 60% of PRDG role behaviors were in the Competent to Proficient expertise level. Autonomy score was positively related to OJS (r=0.46) and QC (r=.58) (p<0001).  Mean OJS score:  5.38 and average QC score was 6.0 on a 10 point scale. Total EOMII scores were positively related to total OJS (r=0.507) and QC outcome indicators (r=.601; p<.01; n=64).

Conclusions 

A professional role orientation within nursing management serves as the driving force for ensuring structural support and system clarity for autonomous clinical decision-making in order to positively impact quality of care and nurses’ job satisfaction. Role clarity regarding RN unique sphere of practice and their decision-making authority is essential to an autonomous practice culture.

Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleRole Based Leadership: Transforming the Practice Culture Through Role Clarity and Structural Support for Autonomyen_GB
dc.contributor.authorLoos, Nancyen_GB
dc.contributor.authorO'Rourke, Maria W.en_GB
dc.author.detailsLoos, Nancy, RN, MSN, PHN, NE-BC, Nancy.Loos@CHW.EDU; O'Rourke, Maria W., DNSc, RN, FAAN, FAAHC;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/243494-
dc.description.abstract<b>Purpose </b> <div></div><p>This study examined the relationship between autonomy and organizational structure within a magnet context through self-reports of  adult-critical care RNs. Role clarity at management and clinical levels is essential to ensuring full RN role capacity realized at all organizational levels. Structural and process support for decision-making autonomy within a healthy work environment is considered crucial to RN professional role enactment and empowerment, work satisfaction, and evidence-based practice.  A defined model of the professional role clarified autonomous professional practice while the patient care model provided structural and system support for autonomous decision-making.<b> </b><p><b>Method</b><p>This quantitative, cross-sectional survey design was completed with a convenience sample of direct-care RNs in adult ICU in a large suburban trauma center (N ~ 92). Of 92 nurses, 69 completed the survey (75%); 58 (63%) completed a role development program and professional role orientation survey, the Professional Role Development Guide(63%). Participation included voluntary, one-time, anonymous completion of the 58-item <i>Essentials of Magnetism II</i> (EOMII). Two optional 10-point single item scales—Organizational Job Satisfaction (OJS) and a Nurse-assessed Quality of Patient Care (QC) were included.<b> </b><p><b>Results</b><p>75% (N=69) return rate across two shifts. More than 60% of PRDG role behaviors were in the Competent to Proficient expertise level. Autonomy score was positively related to OJS (r=0.46) and QC (r=.58) (p<0001).  Mean OJS score:  5.38 and average QC score was 6.0 on a 10 point scale. Total EOMII scores were positively related to total OJS (r=0.507) and QC outcome indicators (r=.601; p<.01; n=64). <p><b>Conclusions  </b><p>A professional role orientation within nursing management serves as the driving force for ensuring structural support and system clarity for autonomous clinical decision-making in order to positively impact quality of care and nurses’ job satisfaction. Role clarity regarding RN unique sphere of practice and their decision-making authority is essential to an autonomous practice culture.en_GB
dc.date.available2012-09-12T09:23:03Z-
dc.date.issued2012-09-12-
dc.date.accessioned2012-09-12T09:23:03Z-
dc.conference.date2012en_GB
dc.conference.name23rd International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationBrisbane, Australiaen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.