Structures and practices enabling staff nurses to control their practice

Marlene Kramer, Claudia Schmalenberg, Patricia Maguire, Barbara B. Brewer, Rebecca Burke, Linda Chmielewski, Karen Cox, Janice Kishner, Mary Krugman, Diana Meeks-Sjostrom, Mary Waldo

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures.

Original languageEnglish (US)
Pages (from-to)539-559
Number of pages21
JournalWestern journal of nursing research
Issue number5
StatePublished - Aug 2008


  • Control over nursing practice
  • Empowerment
  • Essentials of magnetism
  • Organizational autonomy
  • Productive work environment
  • Shared governance

ASJC Scopus subject areas

  • General Nursing


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