↓ Skip to main content

Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned

Overview of attention for article published in BMC Health Services Research, April 2015
Altmetric Badge

Mentioned by

twitter
1 X user

Citations

dimensions_citation
5 Dimensions

Readers on

mendeley
61 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned
Published in
BMC Health Services Research, April 2015
DOI 10.1186/s12913-015-0827-y
Pubmed ID
Authors

Kaye M Knight, Amanda Kenny, Ruth Endacott

Abstract

Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the complexities of the environment. Protective mechanisms provided indicators of clinical leadership and governance effectiveness, which may assist rural nurse leaders to strengthen quality and safe care by unlocking the potential of intuitive behaviours. Kanter's theory of structural power provides a way of conceptualising these protective mechanisms, illustrating how rural nurse leaders enact power.

X Demographics

X Demographics

The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 61 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 10%
Student > Ph. D. Student 3 5%
Student > Doctoral Student 3 5%
Student > Bachelor 2 3%
Professor 2 3%
Other 7 11%
Unknown 38 62%
Readers by discipline Count As %
Nursing and Health Professions 10 16%
Medicine and Dentistry 4 7%
Agricultural and Biological Sciences 2 3%
Social Sciences 2 3%
Business, Management and Accounting 1 2%
Other 4 7%
Unknown 38 62%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2015.
All research outputs
#18,405,972
of 22,799,071 outputs
Outputs from BMC Health Services Research
#6,469
of 7,629 outputs
Outputs of similar age
#193,644
of 264,946 outputs
Outputs of similar age from BMC Health Services Research
#70
of 87 outputs
Altmetric has tracked 22,799,071 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,629 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,946 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 87 others from the same source and published within six weeks on either side of this one. This one is in the 2nd percentile – i.e., 2% of its contemporaries scored the same or lower than it.