The measurement of professional nursing governance / Robert G. Hess, Jr.

Hess, Robert G.
xii, 179 leaves ; 29 cm.

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Medical subjects:
Dissertations, Academic.
Local subjects:
Penn dissertations -- Nursing. (search)
Nursing -- Penn dissertations. (search)
The purpose of this study was to develop and psychometrically test an instrument, the Index of Professional Nursing Governance (IPNG), for measuring professional nursing governance by hospital-based nurses. A six dimensional model included: (a) professional control over practice, (b) organizational influence of professionals over resources that support practice, (c) organizational recognition of professional control and influence, (d) facilitating structures for participation in decision-making, (e) liaison between professional and administrative groups for access to information, and (f) the alignment of organizational and professional goals and negotiation of conflict.
In Phase One, items extrapolated from multidisciplinary literature of organizations, management and nursing, were judged for content validity by administrative and hospital staff nurse experts. Total average congruency scores for the resulting 88-item instrument was $\ge$.95. In Phase Two, the IPNG was tested for feasibility with 25 nurses.
In Phase Three, the instrument was tested for reliability with 321 nurses from two hospitals. Cronbach's alphas were.95 for the instrument and from.82 to.90 for the six subscales; test-retest reliability was.77 over one month. All items were retained.
In Phase Four, construct validity was examined using 816 nurses from ten hospitals. Principal components factor analysis with varimax rotation produced a six factor solution. Eighty-eight items explained 44% of the variance. Three factors closely resembled original dimensions for Information, Participation, and Goals and Conflict; three new factors, Control over Practice, Supporting Resources, and Nursing Personnel, were slightly different than predicted by the original model. Reliabilities ranged from.87 to.91 for factor derived subscales and.97 for the instrument. Subscale intercorrelations were between.43 and.67. Aggregate scores from shared governance and traditionally governed hospitals showed a significant difference (t = 9.56, p =.005). A correlation of +.60 (n = 578, p =.005) was found between the IPNG and the Hague and Aiken Index of Centralization, representing a moderate correlation between the distribution of governance and staff and the degree of centralization in the organizations.
The final 88-item instrument classifies hospital governance based on the governance distribution between nursing management/administration and staff nurses. The instrument can be used for baseline and evaluative data for the implementation of governance innovation and its outcomes.
Supervisor: Florence S. Downs.
Thesis (Ph.D. in Nursing)-- Graduate School of Arts and Sciences, University of Pennsylvania, 1994.
Includes bibliographical references.
Local notes:
University Microfilms order no.: 94-27545
Downs, Florence S., advisor.
University of Pennsylvania.