Measuring nurse managers' boundary spanning: development and psychometric evaluation.

AIM: To test the psychometric properties of a boundary spanning measure by nurse managers. BACKGROUND: The health-care environment requires hospital units to coordinate efforts autonomously across their boundaries and to manage relationships with other professionals, units and departments. Boundary spanning has become increasingly important for first-line nurse managers as unit gatekeepers; however, the available measures are limited. METHOD: The 30-item instrument was developed from a literature review. Survey participants were 4918 nurses at 231 hospital units. Statistical analyses of construct validity and internal consistency were performed. Furthermore, the correlation between nurses' scores on the Nurse Managers Boundary Spanning Scale and nurses' evaluations of their managers were examined. RESULTS: Three factors and 26 items were derived from factor analyses: connecting and mediating, informing and feedback utilisation, and resource acquisition. Cronbach's subscales' alpha coefficients were above 0.9. Correlation analysis indicated that the Nurse Managers Boundary Spanning Scale score correlated with nurses' positive perceptions of their managers. CONCLUSION: This study demonstrates tentative support for the validity and reliability of the Nurse Managers Boundary Spanning Scale. Although further study is needed, the Nurse Managers Boundary Spanning Scale shows possibilities as a new measurement of nursing leadership. IMPLICATIONS: This study underscores measures to build on nurse managers' roles by building on the limited research available.

Four factor research awareness scale for nurses in Japanese: instrument development study.

AIM: Research awareness is an important consideration necessary for providing superior nursing care. However, a gap exists between research and clinical practice. A major obstacle to integrating research into clinical practice is the absence of research awareness among nurses. Studies on research awareness have focused primarily on three factors: attitude, competence, and encouragement for conducting research. The Research Awareness Scale for Nurses (RASN) in Japanese incorporates a critical, yet generally overlooked fourth factor of flexible structure for research. The aim of this study was to develop a nursing research awareness scale that could be used to determine the reasons for the lack of interest in research among nurses and to help nursing administrators take steps to integrate research into clinical practice. METHODS: The RASN was developed and tested in three stages. An item pool for the scale was generated from a published work review and focus group interviews. The scale was then tested in a pilot study, and finally in a main study. Reliability and validity were examined by exploratory and confirmatory factor analysis, Cronbach's alpha, one-way anova and correlation analysis. RESULTS: The RASN exhibited good validity in the four factor structure ("attitude", "competence", "encouragement", and "flexible structure"). Cronbach's alpha exhibited good internal consistency. The RASN was significantly and positively correlated with research-related education and activities. CONCLUSION: The RASN had good internal consistency, content validity, discriminant validity, and construct validity. These findings demonstrate that the RASN is a useful instrument for evaluating approaches toward the integration of research into clinical practice.

Physicians' perceptions of physician-nurse collaboration in Japan: effects of collaborative experience.

Studies of physician-nurse relationships have focused mainly on nurses' perceptions. Few studies have explored physicians' perceptions and related factors. This study had two aims: to describe physicians' perceptions of physician-nurse collaboration in Japan by focusing on attitudes toward collaboration and collaborative practice and to examine the effect of physicians' experiences related to collaboration on their perceptions of collaboration. A cross-sectional survey was conducted. Of the 520 physicians from four hospitals, 248 completed the survey. The survey included the Jefferson Scale of attitudes toward physician-nurse collaboration, the collaborative practice scales, learning experiences related to collaboration with nurses and experiences of joint activities with nurses. Multiple regression analysis revealed that learning experiences in undergraduate and out-of-hospital education and experiences of joint committee work were significantly associated with higher collaborative practice scores. Although participants' attitude scores had a strong association with practice scores, there were no variables significantly associated with the attitude score. This study supported the importance of education in undergraduate courses and suggested that it should be ongoing after qualification. Joint activities other than daily practice, such as continuous quality improvement, might also be effective. Factors that improve physicians' attitudes toward collaboration should be further explored.

Expected roles and utilization of specialist nurses in Japan: the nurse administrators' perspective.

AIM: This study explored (1) expected roles for specialist nurses in Japan and (2) nurse administrators' experience-based management strategies for effective implementation of these roles. Background In Japan, specialist nurses have begun to be recognized as valuable human resources. However, managerial issues in utilizing specialist nurses, including unclear roles and lack of reports on effective management strategies, remain. METHOD: Three focus-group discussions were conducted. Nine nurse administrators participated. Data were analysed using qualitative content analysis techniques. RESULTS: The expected roles for specialist nurses were: (1) facilitating general nurses' learning; (2) monitoring and improving the patient care standard; and (3) developing new roles for nursing. Two management strategies were: (1) enhancing specialist nurses' influence, and (2) enhancing specialist nurses' motivation. CONCLUSIONS: Specialist nurses are important human resources able to assume responsibility for process improvement in nursing care. Effective ways to enhance specialist nurses' influence and motivation include developing their management and communication skills, and coordinating their workload and relationships with other health care professionals. IMPLICATIONS FOR NURSING MANAGEMENT: Process improvement indicators may be useful for evaluating specialist nurses' work. Nurse administrators can contribute to effective implementation of specialist nurses' roles not only by clarifying their roles but also by empowering them to keep up with changing organizational needs.

Development of nurses with specialties: the nurse administrators' perspective.

AIM: This study clarified how Japanese nurse administrators consider the current status and future prospects of development and utilization of nurses with specialties. BACKGROUND: The demand for specialized nurses is not satisfied throughout the country. METHODS: Nine nurse administrators participated in three focus-group discussions. Data were analyzed using qualitative content analysis technique. RESULTS: On development of specialized nurses, four categories were abstracted: offering opportunities for career development; establishing an environment of life-term continuous learning; providing well-balanced support for the needs of organizations and individual nurses; and support for career development as a specialist. CONCLUSIONS: To develop specialized nurses effectively it is important to focus more attention on qualitative aspects of nurses' professional experience in in-service education and to support appropriate personnel for strategic human resource development. IMPLICATIONS FOR NURSING MANAGEMENT: Facilitating frequent contacts between specialized and general nurses should be highly valued as making an environment where nurses can face career goals daily leads to steady preservation of human resources. It is necessary for nurse administrators to keep human resources quantitatively and to clarify the developmental process after nurses obtain special roles to plan for continuous education.