The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review

Goedhart, Nicole S.; Oostveen, Catharina van; Vermeulen, Hester

doi:10.1111/jonm.12455

Cited by 95 publications

(137 citation statements)

References 44 publications

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“…Structural empowerment had to be measured with the scale Conditions for Work Effectiveness Questionnaire (original or revised version) (Laschinger et al, ; Laschinger & Shamian, ). This scale was chosen to remain as homogenous as possible to the concept of structural empowerment and this particular scale has a large amount of research surrounding it (Goedhart et al, ). The study sample should include only nurses.…”

Section: The Reviewmentioning

confidence: 99%

“…Empowerment is defined as a process that identifies which factors lead to disempowering situations and then proceeds to remove them with the aim to improve employees' self-efficacy (Goedhart, Oostveen, & Vermeulen, 2017). Structural empowerment and psychological empowerment are the two aspects of this concept (Kanter, Impact: Structural empowerment in nurses is important to help deliver an effective workplace culture where nurses can be committed and have reduced intention-toleave.…”

Section: Structural Empowermentmentioning

confidence: 99%

“…In terms of job performance, these can be the actions and behaviours of individuals that contribute to organizational goals (Rotundo, 2002;Wong & Laschinger, 2013). It can relate more to personal effectiveness when increased self-efficacy, high motivation, increased organizational commitment, lowered burnout level, increased autonomy, decreased occupational stress, increased job satisfaction, organizational commitment, and authentic leadership are noted; or more broadly, work effectiveness when achievement and successes, respect and cooperation in the organization alongside client satisfaction take place (Cicolini, Comparcini, & Simonetti, 2014;Cowden & Cummings, 2012;Flinkman et al, 2017;Goedhart et al, 2017;Li et al, 2018;Numminen, Repo, & Leino-Kilpi, 2017;Paplanus, Bartley-Daniele, & Mitra, 2014;Rosser et al, 2017;Saber, 2014;Wong & Laschinger, 2013). Two important aspects of performance we focus on in the present review are organizational commitment and job satisfaction.…”

Section: Organizational Performancementioning

confidence: 99%

“…Organizational commitment (mostly affective) has been positively correlated to motivation, organizational citizenship behaviour, job satisfaction, performance and productivity, and intent to stay (Cowden & Cummings, 2012;Goedhart et al, 2017;Laschinger, 1996;Motwani, Klein, & Navitskas, 1999;Saber, 2014), whereas negative correlations have been noted with absences and fluctuation (Kanning & Hill, 2013).…”

Section: Organizational Commitmentmentioning

confidence: 99%

“…Empowerment is defined as a process that identifies which factors lead to disempowering situations and then proceeds to remove them with the aim to improve employees' self‐efficacy (Goedhart, Oostveen, & Vermeulen, ). Structural empowerment and psychological empowerment are the two aspects of this concept (Kanter, ; Laschinger, ; Spreitzer, ).…”

Section: Introductionmentioning

confidence: 99%

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Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta‐analysis

Fragkos

Makrykosta

Frangos³

2020

Journal of Advanced Nursing

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Aims The aim of this systematic review and meta‐analysis is to explore the relationship between structural empowerment and organizational commitment and to examine a theoretical model under which empowerment could potentially affect organizational performance. Design PRISMA guidelines for systematic reviews and meta‐analyses were used and quality assessment of articles was performed. Data sources Electronic database searches were conducted in Google Scholar, PubMed/Medline, CINAHL, Scopus, and EMBASE from January 1950–1 January 2019, which resulted in 204 retrieved studies, published between 1994–2018. Review Methods A random effects model was used to produce a pooled estimate of effect sizes (correlation coefficient, Cronbach's alpha), with analysis of heterogeneity and publication bias. A meta‐analytic structural equation model of the constructs analysed was also performed. Results The final review included 22 studies. The meta‐analytic means of structural empowerment, organizational commitment, job satisfaction, and psychological empowerment alpha reliabilities were 0.87, 0.84, 0.85, and 0.87, respectively. Heterogeneity but no publication bias was present in these outcomes. Structural empowerment was strongly correlated with organizational commitment (r = 0.43). The meta‐analytic correlation coefficients of organizational commitment with psychological empowerment and job satisfaction were 0.53 and 0.47, respectively. Structural empowerment was correlated with job satisfaction and psychological empowerment with correlation coefficients of 0.57 and 0.44, respectively. Finally, job satisfaction was correlated with psychological empowerment with a correlation coefficient of 0.53. A meta‐analytic structural equation model was tested with good fit which predicted performance (commitment and job satisfaction) from empowerment (structural and psychological). Conclusion Structural empowerment is strongly correlated to organizational commitment and with psychological empowerment, they increase organizational performance. Organizations should attempt to make structural empowerment as widespread as possible to create an effective workplace culture. Impact Structural empowerment in nurses is important to help deliver an effective workplace culture where nurses can be committed and have reduced intention‐to‐leave. Structural empowerment was strongly correlated with organizational commitment. Organizational commitment was significantly correlated with psychological empowerment and job satisfaction. Structural empowerment was correlated with job satisfaction and psychological empowerment as well. A meta‐analytic structural equation model with good fit predicted performance. These results will affect nursing researchers and practitioners. Results indicate a need for organizational restructuring that promotes empowerment and formation of theoretical models that connect empowerment to performance.

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Section: The Reviewmentioning

confidence: 99%

Section: Structural Empowermentmentioning

confidence: 99%

Section: Organizational Performancementioning

confidence: 99%

Section: Organizational Commitmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta‐analysis

Fragkos

Makrykosta

Frangos³

2020

Journal of Advanced Nursing

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Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest

et al. 2019

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IMPORTANCE Rapid response teams (RRTs) are foundational to hospital response to deteriorating conditions of patients. However, little is known about differences in RRT organization and function across top-performing and non-top-performing hospitals for in-hospital cardiac arrest (IHCA) care. OBJECTIVE To evaluate differences in design and implementation of RRTs at top-performing and non-top-performing sites for survival of IHCA, which is known to be associated with hospital performance on IHCA incidence. DESIGN, SETTING, AND PARTICIPANTS A qualitative analysis was performed of data from semistructured interviews of 158 hospital staff members (nurses, physicians, administrators, and staff) during site visits to 9 hospitals participating in the Get With The Guidelines-Resuscitation program and consistently ranked in the top, middle, and bottom quartiles for IHCA survival during 2012-2014. Site visits were conducted from April 19, 2016, to July 27, 2017. Data analysis was completed in January 2019. MAIN OUTCOMES AND MEASURES Semistructured in-depth interviews were performed and thematic analysis was conducted on strategies for IHCA prevention, including RRT roles and responsibilities. RESULTS Of the 158 participants, 72 were nurses (45.6%), 27 physicians (17.1%), 27 clinical staff (17.1%), and 32 administrators (20.3%). Between 12 and 30 people at each hospital participated in interviews. Differences in RRTs at top-performing and non-top-performing sites were found in the following 4 domains: team design and composition, RRT engagement in surveillance of at-risk patients, empowerment of bedside nurses to activate the RRT, and collaboration with bedside nurses during and after a rapid response. At top-performing hospitals, RRTs were typically staffed with dedicated team members without competing clinical responsibilities, who provided expertise to bedside nurses in managing patients who were at risk for deterioration, and collaborated with nurses during and after a rapid response. Bedside nurses were empowered to activate RRTs based on their judgment and experience without fear of reprisal from physicians or hospital staff. In contrast, RRT members at non-top-performing hospitals had competing clinical responsibilities and were generally less engaged with bedside nurses. Nurses at non-top-performing hospitals reported concerns about potential consequences from activating the RRT. CONCLUSIONS AND RELEVANCE This qualitative study's findings suggest that top-performing hospitals feature RRTs with dedicated staff without competing clinical responsibilities, that work collaboratively with bedside nurses, and that can be activated without fear of reprisal. These findings provide unique insights into RRTs at hospitals with better IHCA outcomes.

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An Examination of Nurses’ Empowerment and Speaking Up During Postanesthesia Clinical Hand Overs

Redley¹,

Njambi²,

Rawson³

2021

AORN Journal

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Hierarchical relationships can negatively affect nurses’ psychological empowerment and interprofessional hand overs. We explored nurses’ perceptions of their psychological empowerment, teamwork, and work engagement; relationships between these concepts during interprofessional clinical hand overs; and observed interactive communication behaviors during hand overs. We used surveys and observations of interprofessional clinical hand overs to collect data from 39 nurses in a postanesthesia care unit in Australia. Nurses reported high scores for psychological empowerment and work engagement. Relationships between empowerment and teamwork (r = 0.41, P = .01) and empowerment and work engagement (r = 0.65, P < .001) were positive and significant. Relationships between nurses’ observed communication behaviors and perceptions of empowerment, teamwork, and work engagement were nonsignificant. Additional research is needed to better understand how empowerment, teamwork, and work engagement affect nurses’ interactive communication behaviors during interprofessional clinical hand overs in the postanesthesia care unit.

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The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review

Abstract: Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care.

Cited by 95 publications

References 44 publications

Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta‐analysis

Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta‐analysis

Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest

An Examination of Nurses’ Empowerment and Speaking Up During Postanesthesia Clinical Hand Overs

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