Magnet Hospital Characteristics - Research Proposal Example

? Magnet Hospital Characteristics Research Proposal Magnet Hospital Characteristics Introduction The value of magnet hospital characteristics in the empowering of the nursing fraternity, reducing the levels of burnout and job dissatisfaction is a subject that receives scant consideration in nursing research. Undoubtedly, many nurses in the United States and across the world find it difficult to progress at their respective places of work due to the structural challenges that impede their efforts (Mangold, et al., 2006; Palmier, 1998). Studies and surveys conducted in various hospitals and nursing institutions have established that the systems are both restrictive and suppressive to the course of empowering the nursing community (Palmier, 1998). The situations are further complicated by the fact that some policy factors expressly put obstacles on the path of empowerment of the nurses. In many institutions, the role of nurses is structured in such a way that they remain subordinate to the doctors (Earie & Denny, 2005). The working relationship between the nurses and the doctors is such that the nurses are refrained from engaging fully even in some of the process in which they have sufficient competence. In essence, the nurses are systematically deprived of the sense of autonomy. Further, they are not allowed access to vital systems and information that might be of use in the execution of their duties. Many hospitals also fail to allow nurses sufficient opportunities for skill development (Earie & Denny, 2005). Neither are they allowed to play active roles in the decision-making processes at the hospitals. Few health facilities allow the nurses the opportunity to serve among the executive levels. The situation is made even more complex by the fact that many healthcare institutions have staffing challenges, which means that the nurses are constantly under pressure because of the enormous work load (Earie & Denny, 2005). The natural consequences of these restrictions and suppressions are burnout and dissatisfaction. Many studies have proposed various ways of improving the working conditions of the nurses (Baston, 2004; Earie & Denny, 2005). However, few of them have explored the capacity of magnet hospital characteristics as an enabling factor of staff empowerment. This study will seek to explore the various ways in which magnet characteristics could be appropriated towards the objectives of empowerment, reduction of burnout and enhancing employee satisfaction within the healthcare facilities. Problem Statement The matter of job dissatisfaction and work related stress continues to engage the concern of stakeholders in the nursing profession. Nurses are continually subjected to adverse working conditions that affect their levels of production and dedication to duty (Earie & Denny, 2005). Despite the consistent improvements of other areas of the healthcare sector, there seems to be insufficient focus on the challenges that afflict the nursing fraternity. The general perception is that the healthcare system, as presently constituted, lays obstacles to the empowerment of nurses. The system is structured in such a way that assigns a subservient role to the nurses despite various research findings that emphasize the centrality of nurses to the success levels of every health care system. Among the many suggestions on the improvement of the nursing industry is the inclusion of magnet hospital characteristics. This study seeks to explore the possible effect of magnet hospital characteristics in solving the challenges of empowerment, work-related stress and burn-out within the nursing industry. Objectives of the Study The general objective of the study is to explore the impact of utilizing magnet hospital characteristics on fostering nursing empowerment, reducing the levels of burnout and job dissatisfaction. Specific Objectives 1. To determine the relationship between magnet hospital characteristics and power relationships within a healthcare institution with specific focus on the nurses and the doctors 2. To explore the association between magnet hospital characteristics and the levels of burnout among the nurses in a healthcare institution 3. To assess the impact of magnet hospital characteristics on the levels of job satisfaction of nurses within a healthcare organization 4. To determine the effect of hospital magnet characteristics on the provision of quality healthcare by nurses in a healthcare institution 5. To assess the impact of magnet hospital association on the levels of patient satisfaction in a healthcare organization Research Questions 1. How do magnet hospital characteristics impact on the power relationships between nurses and doctors in a healthcare institution? 2. What is the association between magnet hospital characteristics and the levels of burnout among the nurses in a healthcare institution? 3. What is the impact of magnet hospital characteristics on the levels of job satisfaction among the nurses within a healthcare organization? 4. How do magnet hospital characteristics affect the quality of services provided by nurses within a healthcare institution? 5. How do magnet hospital characteristics in the nursing profession impact on the levels of patient satisfaction within a healthcare institution? Significance of the Study The significance of this study should be assessed from the perspective of a solution to a prevalent problem in the profession of nursing. This study will assist policy makers, planners and curriculum developers with findings that they might build on to rethink the policy structures that underpin the challenges faced by nurses. The study will also provide broad suggestions that might be useful to the nursing community particularly with regard to the question of empowerment. Furthermore, the study will be of value to future researchers who may want to explore some of the broad and specific findings of the study with the objective of developing appropriate structures for other related research endeavours. The study will provide resourceful insights into the value of magnet hospital characteristics in resolving the challenges of empowerment, stress, burnout, and job dissatisfaction. In general terms, the findings of this study will help in the provision of the general guidelines that might be used in redressing the imbalances of power in today’s healthcare facilities. Literature Review Relevant literature on nursing supports the view that the aspect of autonomy, a balance of power, and positive relationships of nurses, doctors and the management are some of the key tenets of magnet hospital characteristics (Baston, 2004; Erickson, Hamilton, Jones & Ditomassi, 2003). Nurses seek environments of less controls within which they can exercise their roles and practice their skills with a significant level of discretion. Such environments should promote resourceful cooperation between the nurses and the doctors without regard to hierarchies of professional competence. According to surveys on magnet hospital characteristics such environments promote synergies that positively impact on quality services, staff satisfaction, patient confidence and general excellence in all aspects of nursing (Erickson, Hamilton, Jones & Ditomassi, 2003). A cross-sectional survey of a range of literature on magnet hospital characteristics seem to endorse the proposition that they could be utilized for the purposes of nursing empowerment, reducing burnout for the nursing staff and improving the element of job satisfaction (Kluska, Laschinger-Spence & Kerr, 2004). In broad terms magnet hospital characteristics encompasses interdisciplinary collaboration, professional accountability, the philosophy of quality, continuity of care, and safety (Kluska, Laschinger-Spence & Kerr, 2004). Magnet hospital characteristics are also based on the factor of leadership development as a process towards effectiveness. The recognition of nurses as professionals capable of advancing in their career and improving on their skills and roles generally cultivates an enabling environment that fosters positive and supportive associations within the hospital. When properly harnessed the various elements of magnet nursing characteristics can enhance the value of service in a manner that yields various short-term and long-term positive impacts to the profession of nursing. Past and recent researches, expert analyses and case reviews have associated magnet nursing characteristics with reduced mortality rates, fast recovery processes, less readmission cases, and fast and efficient responses to the nursing processes (Mangold, et al., 2006; Palmier, 1998). Further, it has been established that the magnet nursing characteristics help foster the development of positive attitudes of the nursing community and low rates of staff turn-over. The nurses often tend to develop remarkable interest in quality service delivery. Working environments often tend to affect the psychological states of the staff. Nursing environments that promote the flourishing of adverse working relationships between the doctors and nurses will often tend to compromise the quality of service delivery. The competence of doctors will often be affected by the level of support that they receive from the nurses. The balance of power between the two groups should be structured in such a way that promotes horizontal relationships in which the nurses can exercise some form of autonomy in the process of carrying out their duties. The doctors should regard nurses as partners in the promotion of quality service delivery. Antagonistic relationships will often defeat the objectives of quality and excellence. The essence of magnetic hospital characteristics is to promote a sense of continuum and cohesion in the healthcare provision processes for the general good of the patients. Reports and research findings on magnet hospital characteristics have concurred on the fact that the issue of leadership is one of the central pillars of magnet nursing characteristics (Palmier, 1998). The inclusion of nurses at the executive levels of leadership affects the manner in which they apply themselves to the various roles and processes that fall within the province of nursing. According to the opinions of scholars on the effect of power sharing on the nursing profession, nursing institutions and hospitals that cede significant executive power to the nurses are more likely to experience the synergies of magnet hospital characteristics than those that concentrate such power in the doctors and the top-level management (Palmier, 1998; Siu, Laschinger & Vingilis, 2005). The aspect of power sharing must be understood within the overall concept of interdisciplinary cooperation and collaboration. Further studies contend that nursing skill expertise ties in with the requirements of magnet hospital characteristics (Siu, Laschinger & Vingilis, 2005). Necessarily, the element of skill expertise implies training and professional support for the nursing fraternity. Like any other profession nursing requires continual training and improvement of skill to emerge the challenges that relate to new realities that emerge within their field of practice. Refresher programs and further education are some of the ways that could be enlisted towards the objective of achieving magnet hospital characteristics. Surveys have established positive associations between hospitals that feature elaborate skill development programs for the nurses with improved quality of services. Further technological innovations have made it necessary for sustained skill development for the nurses for the purposes of training them on the usage of new gadgets and implements that apply within their field of practice (McCray, 2009). Moreover, technological innovations require that nurses acquire the requisite skills in information communication systems in order to prepare them for the changing mechanics at the work place. Nurses who do not benefit from such training programs may feel disregarded and this may lead to lack of enthusiasm for service. It may also promote ineptitude and error in the process of service delivery. Various studies have proposed that hospitals should adopt structures that support periodic processes of skill development for the nursing fraternity (McCray, 2009; Earie & Denny, 2005). Magnet hospital characteristics feature the use of technological advances as one of the ways that ensure the achievement of the aspect of quality in service delivery (Earie & Denny, 2005). Nurses seek to work in environments of efficiency, which can only be achieved by incorporating the benefits of technology within the nursing processes. In this sense, technology becomes a defining factor in the provision of quality and the promotion of staff morale and satisfaction. Technological advances could involve computerized systems of data management and control of processes. Technological advances release nurses from the strain and stress of manual processes and enhances the element of quality services to the patients. Technology also helps in the decongesting of hospitals thus promoting ample working environment for the nurses. Improving the working conditions of the nurses will always tend to impact positively on the satisfaction of the patients. This may often lead to quicker recoveries and the development of healthy interpersonal relationship between the nursing fraternity and the patients. Surveys have indicated a growing adoption of technological innovations in many hospitals and nursing institutions in the United States and elsewhere in the world. Managing schedules and major programs of the hospitals is less cumbersome and more accurate with the incorporation of the advantages of technology. Adequate staffing has been severally and variously cited as one of the important tenets of magnet hospital characteristics (McCray, 2009). Poor staffing is usually associated with the negative impacts of staff burnout and stress. Generally, the aim of magnet hospital characteristics is the improvement of all the processes, associations and arrangements in the hospital for the benefit of all the stakeholders. Other studies have associated it with the concept of total quality management as understood within the framework of management (Earie & Denny, 2005). Harmonization of the different systems, processes, and individuals within the framework of the core mission of the hospital is the chief objective of magnet hospital characteristics. Researchers on nursing have established that fragmented systems often promote negative competition and conflict between the nursing fraternity and the doctors (Coombs, 2004; Earie & Denny, 2005). Systems that exclude nurses from decision-making processes often foster non-cooperation. Naturally, lack of cooperation between nurses and doctors will impact negatively in quality matters. Poor coordination could result in accidents and other elements of professional malpractice in the nursing community. Generally, nurses will tend to operate in ways that do not promote the general good of the hospitals due to the detached interest that follows. The need for harmonization of systems is consistent with the realization that quality service must involve processes of collaboration and delegation of roles (Earie & Denny, 2005). Reward recognition for the nursing fraternity improves the level of attachment and dedication that the nurses adopt towards the hospital (Anthony, 2004). It reminds them of the importance of their role and the recognition that the hospital community and stakeholders extend towards the same. At the psychological level, the rewards have the effect of driving up the levels of motivation (Anthony, 2004). Recognition also enhances the desire for excellence in service delivery. In the end, the entire nursing fraternity is positively affected by the aspect of recognition in a way that promotes high quality services on the part of the nurses. Experts have proposed certification for excellence as one way that would encourage the dedication of nurses in reaching higher goals of service delivery. Although the available literature sufficiently addresses the impact of magnet hospital characteristics on reducing work related stress and burnout, there seems to be no sufficient information on the details of the precise dimensions in which these variables operate. The problem of nursing empowerment continues to deepen with far-reaching ramifications on the entire healthcare sector. There is need for more research to determine the levels of impact of magnet hospital characteristics on the general aspect of empowerment. Particularly, it might be necessary to explore the dimension of the distribution of power within the nursing institution as a consequence of magnet hospital characteristics in light of the structural challenges involved. This study will seek to explore in deeper details the functioning of specific aspects of magnet hospital characteristics as drivers of employee empowerment. Theoretical Framework The basic tenets of magnet hospital characteristics are consistent with the theory of structural empowerment as developed by Kanter (McCray, 2009; Anthony, 2004). According to this theory, learning opportunities, access to information, development opportunities, and institutional support are the key necessities for empowerment of staff in the work environment. This theory spells out that the necessities of empowerment should work together in order to achieve the optimum levels of empowerment that could impact positively on the organization’s processes and the growth of the employee. The aspect of empowerment, according to this theory must be based on some structures for the sake of sustainability. Appropriating the salient factors of this theory for the particular subject of nursing empowerment might imply the overhauling of policies and rules that support the status quo. By implication, the theory supports the creation of suitable environments that support the flourishing of the individuals’ skills and talents. In return the individuals will feel compelled and obligated to render their best services to the organization. Kanter’s model of structural empowerment obtains its relevance from the fact that it anchors on very specific aspects of empowerment, which squarely relates to the challenges faced by nurses in the healthcare institutions. Methodology of the Study This study will adopt an explorative case study design. In essence it will be qualitative in nature. The choice of the case study approach is relevant because it will explore the various insights and information that relates to the subject matter of magnet hospital characteristics. This way, the study will be able to obtain the most relevant information that could be used to develop quantitative studies on the subject matter. The findings of the case study will be complimented by a survey of a range of related literature on the effect of magnet hospital characteristics on work-related stress, burn-out and empowerment of the nursing fraternity. Preference will be given to the most recent literature in order to align the substance of the study to the prevailing challenges of the industry as understood together with the objectives of the study. The information will be organized according to the specific themes that relate to the specific objectives of the subject. References Anthony, M. (2004). Shared governance models: The theory, practice and evidence. OJIN: The Online Journal of Issues in Nursing, 9, (31). Retrieved February 1, 2008 from: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/ Volume92004/Number1January31/SharedGovernanceModels.aspx Baston, V. (2004). Shared governance in an integrated health care network. AORN, 80(3), 493-496, 498, 501-504, 506, 509-512. Coombs, M. (2004). Power and Conflict Between Doctors and Nurses: Breaking Through the Inner Circle in Clinical Care. London: Routledge. Earie, S. & Denny, E. (2005). Sociology for Nurses. New York: Polity. Erickson, J.I., Hamilton, G.A., Jones, D.E., & Ditomassi, M. (2003). Measuring the impact of collaborative governance: Beyond empowerment. Journal of Nursing Administration, 33(2), 96-104. Kluska, K.M., Laschinger-Spence, H. K., & Kerr, M. S.(2004). Staff nurse empowerment and effort-reward imbalance. Canadian Journal of Nursing Leadership, 17(1), 112-128. Mangold, K.L. et al., (2006). Perceptions and characteristics of Registered Nurses involvement in decision making. Nursing Administration Quarterly, 30 (3), 266-272. McCray, J. (2009). Nursing and Multi-Professional Practice. London: SAGE Publications Ltd. Palmier, D. (1998). How can the bedside nurse take a leadership role to affect change for the future?.Concern, Saskatchewan Registered Nurses Association, 2 (1),16-7. Siu, H.M., Laschinger, H.K.S., & Vingilis, E. (2005). The effect of problem-based learning on nursing students’ perceptions of empowerment. Journal of Nursing Education, 44 (10), 459-469. Read More