Kerzman Hana, Van Dijk Dina, Eizenberg Limor, Khaikin Rut, Phridman Shoshi, Siman-Tov Maya, Goldberg Shoshi
Nursing Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Ben-Gurion University of the Negev, Negev, Israel.
Isr J Health Policy Res. 2015 Sep 1;4:19. doi: 10.1186/s13584-015-0005-z. eCollection 2015.
In recent years, an increasing number of care procedures previously under the physician's authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses' authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics.
A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses' authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work.
Nurses reported positive attitudes toward the expansion of nurses' authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses' satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses' authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses' authority.
In the Israeli reality of a nurse's shortage, we are witnessing professional transitions toward expansion of the scope of nurses' accountability and decision-making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses' authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.
近年来，越来越多以前由医生负责的护理程序已交由注册护士执行。本研究的目的是调查护士对扩大护士权限的态度，以及这些态度与工作满意度方面、专业特征和人口统计学之间的关系。
2010年至2011年期间，在以色列的三个主要医疗中心进行了一项横断面研究。参与者包括在89个科室工作的833名护士。通过自我报告问卷评估对扩大护士权限的态度，以及工作满意度方面，包括对专业自主权的认知、护士与医生的工作关系、工作量和倦怠、对护理质量的认知以及护理人员的工作满意度。
护士对扩大护士权限表示积极态度，对在特定情况下解释诊断测试持适度态度。多元回归分析结果表明，护士对专业自主权和工作关系的满意度是解释他们对扩大护士权限态度的最有影响因素。此外，专业上年轻的护士对护士权限的变化往往更积极。
在以色列护士短缺的现实情况下，我们正在目睹向扩大护士问责范围和决策权的专业转变。当前的研究有助于我们理解护理人员对扩大护士权限的态度。研究结果表明在当前专业背景下重新定义护理实践范围的必要性。
