Comparing Nurses' Perceptions of Governance Related to Hospitals' Journeys to Excellence Status in the Middle East

By Mouro, Gladys; Tashjian, Hera et al. | Nursing Economics, July/August 2013 | Go to article overview

Comparing Nurses' Perceptions of Governance Related to Hospitals' Journeys to Excellence Status in the Middle East


Mouro, Gladys, Tashjian, Hera, Bachir, Rana, Al-Ruzzeih, Majeda, Hess, Robert, Nursing Economics


EXECTIVE SUMMARY

* The interest in the Magnet Journey extends to the Middle East.

* The results of this study revealed nurses in hospitals that are on the Journey to Magnet perceive that decision making is shared between nursing management/administration and staff nurses.

* Nurses in these hospitals positively attribute their involvement and engagement in every aspect of the nursing profession.

* This scheme of shared governance promotes professional accountability and enhances individual autonomy, authority, and control.

* The growth of health care in the Middle East region with rising expectations for patient care outcomes will challenge the nursing profession in the future.

* Shared governance will certainly help nurses take ownership in making decisions for patient care and as a result achieve better patient outcomes.

EARTH CARE ORGANIZATION in Lebanon and Jordan face a serious nursing shortage. Experienced and qualified nurses are leaving their careers and student enrollment in schools of nursing is decreasing. At a nursing conference organized by the Lebanese Nursing Order in 2008, the official body for the nursing profession in Lebanon, the president of the order reported only 7,054 were registered as nurses and 87% were working. Moreover, there was one RN for every 567 people, and the ratio of nurse to hospital beds was 1 to 4.5 compared to Europe where it is 1 to 2.5 beds and the United States where the ratio is 1 to 2. Based on records of established recruitment firms in Lebanon between 2000 and 2006, the primary reasons for leaving nursing jobs were finan- cial and professional career devel- opment (El-Jardali, Merhi, Jamal, Dumit, & Mouro, 2009). In Jordan, the situation was even bleaker where there are three nurses per thousand population (7,840 regis- tered nurses; 64% working) (Kronful, 2009). This shortage is likely to persist as nurses report heavy workload, limited autono- my, a nonsupportive environment in the workplace, lack of appreci- ation, and meager salaries (Al- Maaitah & Shokeh, 2009; Badr, Rizk, & Farha, 2010).

To address this challenge, a group of nurse researchers in the United States took a unique ap- proach to understanding the shor- tage. The groundbreaking research described in 1983 in the book Magnet Hospitals Revisited: At- traction and Retention of Pro- fessional Nurses (McClure & Hinshaw, 2010) identified themes that later became the Forces of Magnet® designation. Currently more than 370 domestic and inter- national hospitals and health care organizations have been recog- nized as Magnet® hospitals. These organizations have a long history of nurses' satisfaction in the work- place linked to increased autono- my in practice, structural empow- erment, participation in decision making, and positive working environment (Drenkard, 2010).

Unfortunately, organizations with hierarchical structures and little staff engagement in decision making are the predominant facil- ities in the Middle East. As of 2009, only one facility in Lebanon, the first in the Middle East and the third in the world outside the United States, has received the Magnet designation. Only two hospitals, one located in Saudi Arabia and another in Jordan, are currently embarking on the Journey to Magnet Excellence(TM). This designation, developed by the American Nurses Creden- tialing Center, implies the institu- tion has met exceptional global standards for professional nursing care and essentially recognizes structures, processes, and out- comes of health care organizations (Drenkard, Wolf, & Morgan, 2011).

The purpose of this study is to assess whether by creating a shared governance environment in Middle Eastern hospitals, the perception of nurses will be en- hanced and the nursing shortage in the Middle East decreased.

Literature Review

The Magnet Recognition Pro- gram formally recognizes a hospi- tal environment that provides the best quality nursing care. …

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