ABSTRACT
OBJECTIVE: Researchers examined associations between Index for Professional Nursing Governance (IPNG) types and outcomes. BACKGROUND: Effects of professional nursing governance on nurse-related outcomes by Magnet® status are not well studied. METHODS: Associations were evaluated between average IPNG scores from 2170 RNs, and nurse-sensitive indicators (NSIs) as well as patient and RN satisfaction outcomes (N = 205 study units; 20 hospitals), following Magnet requirements. RESULTS: Magnet hospitals had significantly better IPNG shared governance scores than non-Magnet hospitals (Magnet, 106.7; non-Magnet, 101.3). For Magnet hospitals, units scoring as shared governance outperformed traditional governance for 9 of 19 outcomes (47.4%) (NSI, 2; patient satisfaction, 3; RN satisfaction, 4). Self-governance outperformed shared governance for 8 of 15 outcomes (53.3%) (NSI, 2; patient satisfaction, 6; RN satisfaction, 0). For non-Magnet hospitals, shared governance significantly outperformed traditional governance for 1 of 15 outcomes (6.7%) (patient satisfaction). CONCLUSIONS: Having shared or self-governance is a strategy that can be considered by nurse leaders to improve select nurse-related outcomes.
Subject(s)
Job Satisfaction , Leadership , Nursing Staff, Hospital/organization & administration , Personnel Staffing and Scheduling/organization & administration , Quality Indicators, Health Care , Attitude of Health Personnel , Hospital Administration , Humans , Nursing Staff, Hospital/psychology , Personal Satisfaction , Quality of Health Care , United StatesABSTRACT
OBJECTIVE: Researchers examined associations between Index for Professional Nursing Governance (IPNG) scores and outcomes, by US and international hospitals. BACKGROUND: Nursing governance and effects on nurse-related outcomes are not well studied. METHODS: Associations were evaluated using average IPNG scores from 2170 RNs and nurse-sensitive indicators (NSIs) and patient and RN satisfaction outcomes (n = 205 study units, 20 hospitals, 4 countries). RESULTS: International units had better IPNG shared governance scores (113.5; US = 100.6; P < 0.001), and outcomes outperforming unit benchmarks (6 of 15, 40.0%; US = 2 of 15, 13.3%). Shared governance significantly outperformed traditional governance for 5 of 20 (25.0%) US outcomes (patient satisfaction = 1, RN satisfaction = 4) and for 3 of 11 (27.3%) international (patient satisfaction = 1, RN satisfaction = 2). Internationally, self-governance significantly outperformed traditional governance and shared governance for 5 of 12 (41.7%) outcomes (NSI = 2, patient satisfaction = 3). CONCLUSIONS: Shared governance is a strategy that can be considered by nurse leaders for improving select outcomes.
Subject(s)
Clinical Governance/organization & administration , Nurse Administrators/organization & administration , Nursing Staff, Hospital/organization & administration , Personal Satisfaction , Staff Development/organization & administration , Decision Making, Organizational , Humans , Leadership , Nurse's Role/psychologyABSTRACT
BACKGROUND: One important way to transform food systems for human and planetary health would be to reduce the production and consumption of animals for food. The over-production and over-consumption of meat and dairy products is resource-intensive, energy-dense and creates public health and food equity risks, including the creation of superbugs and antimicrobial resistance, contamination and pollution of land and waterways, and injustice to animals and humans who work in the sector. Yet the continuing and expanding use of animals is entrenched in food systems. One policy response frequently suggested by parties from all sectors (industry, government and civil society) is voluntary or mandatory labelling reforms to educate consumers about the healthiness and sustainability of food products, and thus reduce demand. This paper evaluates the pitfalls and potentials of labelling as an incremental regulatory governance stepping-stone to transformative food system change. METHODS: We use empirical data from a study of the regulatory politics of animal welfare and environmental claims on Australian products together with an ecological regulation conceptual approach to critically evaluate the potential of labelling as a regulatory mechanism. RESULTS: We show that labelling is generally ineffective as a pathway to transformative food system change for three reasons: it does not do enough to redistribute power away from dominant actors to those harmed by the food system; it is vulnerable to greenwashing and reductionism; and it leads to market segmentation rather than collective political action. CONCLUSION: We suggest the need for regulatory governance that is ecological by design. Labelling can only be effective when connected to a broader suite of measures to reduce overall production and consumption of meat. We conclude with some recommendations as to how public health advocates and policy entrepreneurs might strategically use and contest labelling and certification schemes to build support for transformative food system change and to avoid the regressive consequences of labelling.
