Hughes Kerri-Ann, Carryer Jennifer Barbara, White Jill
School of Nursing, College of Health, Massey University, Palmerston North, New Zealand.
Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia.
J Clin Nurs. 2015 Aug;24(15-16):2125-32. doi: 10.1111/jocn.12839. Epub 2015 May 10.
To analyse the reporting structures of nursing leaders of publicly funded hospitals and seek both the views of nurse leaders and Chief Executive Officers/Chief Operating Officers on the structural positioning of nurse leaders in the organisation.
Concern that the continuing restructuring within hospital structures and focus on economic outputs in health services is diminishing the value of nursing leadership.
Qualitative surveys with Nursing leaders and Chief Executive Officers of public hospitals.
Seventeen Directors of Nursing and 10 Chief Executive Officer/Chief Operating Officers' responses were received using two semi-structured questionnaires. Themes were developed from data coded and analysed by hand.
Four broad themes emerged from analysis of the data: (1) variable positional reporting between Director of Nursing and Chief Executive Officers occurred; (2) variable levels of inclusion and influence at the executive decision-making level; (3) ambiguous financial responsibilities and accountabilities held by Director of Nursing; and (4) blurred lines existed between operational and professional reporting lines. Findings unique to the research indicate that the varying levels of visibility and inclusion impact on the structural positioning of nurse leaders which influences authority and empowerment.
Responses from the data analysis indicate that the structural power of nurse leaders defined by the factors of opportunity, power and proportion were hindered by dual accountability reporting lines and a lack of financial control.
The structural positioning of nurse leaders is vital to ensure that they are empowered and able to meet the adaptations required in a changing environment that supports the delivery of effective, quality healthcare.
分析公立医院护理领导者的汇报结构，并征求护理领导者以及首席执行官/首席运营官对于护理领导者在组织中的结构定位的看法。
人们担心医院结构持续重组以及对卫生服务经济产出的关注正在削弱护理领导的价值。
对公立医院护理领导者和首席执行官进行定性调查。
使用两份半结构化问卷收集了17位护理主任和10位首席执行官/首席运营官的回复。通过手工编码和分析数据得出主题。
数据分析产生了四个广泛的主题：（1）护理主任和首席执行官之间的职位汇报存在差异；（2）在行政决策层面的包容和影响力水平各不相同；（3）护理主任的财务职责和责任不明确；（4）运营汇报线和专业汇报线之间界限模糊。该研究独有的发现表明，不同程度的可见度和包容性会影响护理领导者的结构定位，进而影响其权威和赋权。
数据分析的结果表明，由机会、权力和比例因素定义的护理领导者的结构权力受到双重问责汇报线和缺乏财务控制权的阻碍。
护理领导者的结构定位对于确保他们获得授权并能够适应不断变化的环境中所需的调整至关重要，这种环境支持提供有效、高质量的医疗保健。
