ABSTRACT
OBJECTIVE: The study aim was to determine if a targeted redesign of shared decision making improved shared governance (SG). BACKGROUND: Nursing SG is collaborative decision making between nurses at every level; it improves quality of care, empowers nurses, and enhances nurse satisfaction. METHODS: Using a quasi-experimental, pretest/posttest design, researchers electronically distributed the Index of Professional Nursing Governance (IPNG) to an inclusive, convenience sample of RNs in a Magnet®-designated 377-bed community medical center. Preintervention scores were used to tailor a redesign of shared decision making, and postintervention data were collected within 1 year to measure outcomes. RESULTS: IPNG overall score and 5 of 6 subscale scores significantly increased after the redesign. CONCLUSIONS: Changes to an SG structure can take 2 to 5 years to be realized. Our findings corroborate that the IPNG is a valuable tool in promoting setting-specific SG.
Subject(s)
Clinical Governance/standards , Cooperative Behavior , Decision Making , Nursing Staff, Hospital/psychology , California , Community Health Services/organization & administration , Cross-Sectional Studies , Humans , Job Satisfaction , Power, Psychological , Quality of Health Care , Reproducibility of ResultsSubject(s)
Nurse-Patient Relations , Obstetric Nursing/standards , Female , Humans , Obstetric Nursing/methods , PregnancyABSTRACT
OBJECTIVE: To examine the effects of a Parish Nurse Intervention Program (PNIP) on maternal health behaviors, glycemic control, and neonatal outcomes among Mexican American women with gestational diabetes. DESIGN: A randomized controlled trial comparing care as usual (CAU) with a supplementary 1-hour education session for diabetes education reinforcement by a Parish Nurse. SETTING: An outpatient treatment clinic for gestational diabetes within a 250-bed tertiary care, non-profit hospital with a Parish Nurse partnership. PARTICIPANTS: One hundred Mexican American women were included in the study with randomization into Parish Nurse Intervention Program (n=49) and care as usual (n=51) groups. MAIN OUTCOME MEASURES: The Health Promoting Lifestyle Profile II (HPLP II) and two measures of glycemic control pre- and post-intervention, as well as newborn size, and days of maternal and neonatal hospitalization. RESULTS: Outcomes indicate significantly improved Health Promoting Lifestyle Profile II scores in the Parish Nurse Intervention Program group post-intervention compared with the Care As Usual group. No significant differences between groups regarding glycemic control, macrosomia, or days of maternal or neonatal hospitalization were found. CONCLUSIONS: A Parish Nurse Intervention Program for pregnant women of Mexican descent with gestational diabetes is effective in leading to improved self-reported health promoting behaviors.
