Professional empowerment and evidence-based nursing: A mixed-method systematic review

AIMS AND OBJECTIVES

To review, synthesise and integrate primary research on the relationship between professional empowerment and evidence-based practice (EBP) in nursing.

BACKGROUND

Professional empowerment research exposes an association between empowerment and positive work behaviours and attitudes. Empowerment is associated with nurses' productivity, autonomy and resources. However, implementing evidence into practice is not easy due to barriers to EBP, namely organisational and cultural. Research demonstrating the relationship between professional empowerment and EBP will provide direction for future interventions aimed at the development of an effective healthcare sector.

DESIGN

A mixed-methods systematic review, according to the Joanna Briggs Institute approach, with results reported according to PRISMA. The associated checklist for systematic reviews was also used.

METHOD

The electronic databases searched for relevant studies included: Medline, Cumulative Nursing and Allied Health Literature (CINAHL), JBI Database of Systematic Reviews and Implementation Reports, and The Cochrane Library; thesis and dissertation databases; and Web pages of reference organisations and Scientific Events programs. Quality assessments, data extraction and analysis were completed on all included studies, according JBI. Thematic analysis was used to synthesise the data.

RESULTS

We identified 477 studies. After removing duplicates and reviewing title and abstract following the inclusion and exclusion criteria, 26 papers were evaluated for eligibility. The review included 9 articles. The literature was categorised into three themes: (a) organisational and leadership characteristics, (b) individual characteristics, and (c) outcomes/consequences.

CONCLUSION

This review highlights the importance of empowering environments in EBP. A relationship was evident between leadership, organisation, empowerment, individual characteristics and the use and implementation of evidence, resulting in tangible and measurable gains. However, more robust studies are needed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018086414).

Structural and psychological empowerment and organizational commitment among staff nurses in Jordan

AIM

The purpose of this study was to examine the relationships between structural empowerment, psychological empowerment, and organizational commitment in Jordanian staff nurses.

BACKGROUND

Empowering nurses is one of the most effective strategies for increasing efficiency. Therefore, studying the contribution of structural and psychological empowerment to organizational commitment will provide a base for future interventions to improve nurses' working environment.

MATERIALS AND METHODS

This cross-sectional study used snowball sampling to recruit staff nurses working in Jordanian public and private hospitals. The sample consisted of 180 nurses. Data were collected using three valid and reliable self-reporting questionnaires that were distributed in electronic format.

RESULTS

Nurses reported a moderate level of both structural and psychological empowerment, and a high level of organizational commitment. Significant positive relationships were found between structural empowerment and psychological empowerment and organizational commitment (r = .62, p < .001) and (r = .57, p < .001) respectively.

CONCLUSION

Staff nurses reported moderate levels of both structural and psychological empowerment, and have a high level of organizational commitment. Positive relationships between structural empowerment, psychological empowerment, and organizational commitment were found among Jordanian staff nurses.

Psychological empowerment of health professionals

ABSTRACT Objective: To assess whether there are differences in psychological empowerment between different health professionals working in a teaching hospital. Method: A comparative, quantitative, and cross-sectional study carried out with 165 professionals selected at random and who worked in a teaching hospital in the inland of the state of São Paulo. The participants were divided into three groups: 1) nurses, 2) physicians, and 3) other professionals (physiotherapists, psychologists, pharmacists, speech therapists, social workers, and nutritionists). For data collection, a form was used to characterize the sample, as well as the Brazilian version of the Psychological Empowerment Instrument. To compare the scores between the three groups, the Kruskal-Wallis test was used, followed by Dunn' post-test. Results: Nurses, physicians, and other professionals scored 71.4; 69.3, and 71.1 points (p=0.5959), respectively, in the total score of the instrument Conclusion: There are no statistically significant differences in the perception of psychological empowerment of different health professionals. Conclusion: There are no statistically significant differences in the perception of psychological empowerment of different health professionals.

Structural empowerment of nurses in the hospital setting

OBJECTIVE

to measure the level of structural empowerment of nurses working in a university hospital.

METHOD

a descriptive, analytical, and cross-sectional study, carried out with 237 nurses, who developed care and management activities. Data collection took place through a self-administered questionnaire with questions on the personal and professional characterization and the Work Effectiveness Conditions Questionnaire II. Data analysis used descriptive and inferential statistics.

RESULTS

it was identified that nurses have a moderate level of structural empowerment (18.06±SD 0.9). The greatest value was obtained in the Opportunity dimension (4.08±SD 0.8), followed by the Resources (3.17±SD 0.8) and Informal power (3,04±SD 0.9) dimensions; while the scores of Support (2.67±SD 1.0), Formal power (2.59±SD 0.9), and Information (2.51±SD 0.9) were lower.

CONCLUSION

the level of structural empowerment of the nurses was moderate, which means partial access to opportunities, resources, support, and information of the institution.

Perceptions of nurses on access to structural empowerment in a hospital in the Western Cape

Background

Structural empowerment is an ever-evolving concept interpreted and applied in many different ways as it focuses on the structures in a healthcare organisation to allow competent nurses to manage empowering opportunities in a professional manner. At a public hospital in the Western Cape, nurses complained about a lack of access to structural empowerment in a hospital, including structures of power, such as clear information, to partake in important decisions.

Objectives

The purpose of this study was to describe how nurse managers could support nurses in accessing structural empowerment through power resources.

Method

A quantitative design was followed with a survey. The accessible population in this study was different categories of nurses of professional, enrolled and assistant nurses (N = 200), which were on duty at the time of data gathering. The sample was selected by means of probability sampling (n = 110). An existing instrument based on a five-point Likert scale was distributed that took 45 minutes to complete. Descriptive and inferential statistics were calculated, and the chi-square was used to indicate statistical significance differences among the nursing categories on the items (p < 0.05).

Results

The general results indicated that the majority of nurses had challenges to access structural empowerment through power sources (information, support and resources). Significant differences were found between nurse categories for having the necessary supplies for the job (p = 0.043) and rewards for unusual job performance (p = 0.023). Those aspects on which no significant differences were found are of utmost importance, as they indicate the urgency of addressing limitations in power sources for all categories of nurses.

Conclusion

Empowerment can be achieved by enabling access to structural empowerment through power sources (i.e. opportunities, information, resources and support) at different levels for all categories of nurses.

Representaciones sociales de la autonomía profesional de los (as) enfermeros (as) en el quirófano

Introducción: La autonomía profesional en enfermería se presenta como un tema complejo y de poca visibilidad, especialmente en sectores que demandan acciones de gran complejidad como en el quirófano. Objetivo: Analizar las representaciones sociales elaboradas por las enfermeras sobre su autonomía profesional en el quirófano. Materiales y Métodos: Estudio descriptivo y exploratorio de enfoque cualitativo, desarrollado con el apoyo teórico de la Teoría de las Representaciones Sociales. Nueve enfermeros que trabajan en la sala de operaciones de un hospital universitario en el estado de Río de Janeiro participaron en el estudio. La recopilación de datos tuvo lugar entre junio y octubre de 2017 a través de una entrevista semiestructurada. Los datos fueron sometidos a análisis temáticos. Resultados: Del análisis de datos surgieron las siguientes categorías: la autonomía profesional de la enfermera del quirófano: conocimiento, libertad de acción y poder de decisión; los límites para la autonomía profesional de la enfermera en sala de cirugía: relaciones jerárquicas y de poder, y conocimiento. Discusión: La autonomía profesional de las enfermeras en el quirófano es un objeto de representación con diferentes dimensiones, una cognitiva y una práctica, la primera de las cuales se basa esencialmente en el conocimiento técnico-científico, y la segunda en la libertad de acción y el poder de decisión necesario para el pleno ejercicio de autonomía. Conclusiones: La autonomía profesional de las enfermeras es un objeto de representación social, ya que es un cuerpo generador de conocimiento, saberes, reflexión e identidad profesional capaz de despertar actitudes y prácticas. Como citar este artigo: Milosky JP, Silva ACSS, Gomes AMT, Góes FGB, Knupp VMAO, Silva MVG. Representações sociais da autonomia profissional do enfermeiro no centro cirúrgico. Rev Cuid. 2020; 11(1): e849. http://dx.doi.org/10.15649/cuidarte.849

Care-educational technologies: an emerging concept of the praxis of nurses in a hospital context

OBJECTIVE

to know the praxis of nurses in the hospital context and, from this, to define a concept about Care-Educational Technologies.

METHOD

qualitative, exploratory-descriptive research, developed in a university hospital in Rio Grande do Sul State, Brazil, with 21 nurses (non-probabilistic sampling), through non-participant observation and semi-structured interview, conducted from March to December 2015. Records were analyzed through content analysis.

RESULTS

the results showed that in the context of nurses' work, it is possible to deduce care-educational possibilities, based on the person-person, person-tool and/or person-universe relationship. The concept was defined based on the intertwining of caring-training and training-caring for oneself and other people.

FINAL CONSIDERATIONS

the reflections point to the need to develop or strengthen the autonomy of those involved in the health-disease process. This is based on the empowerment of people under their lives' conditions, in their multidimensionality, within human praxis.