Determining the relationships between nurses' perceptions of managerial coaching, role ambiguity, and quality and safety competencies

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2023-07-25

Authors

Ferro, Allison L.

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Abstract

Quality and safety remain longstanding challenges in nursing despite decades of efforts aimed at improvement. The Robert Wood Johnson Foundation (RWJF) project led one of these efforts to establish and implement the quality and safety competencies needed to help prepare nursing students for nursing practice (Cronenwett et al., 2007). These competencies are known as the Quality and Safety Education for Nurses (QSEN) competencies. Managerial coaching and role ambiguity are variables that affect quality and safety based on what is known in the literature outside of nursing. The literature suggests managerial coaching can decrease role ambiguity, and may improve quality outcomes. There is a lack of evidence in the nursing literature regarding the relationships between these variables. Donabedian’s Structure Process Outcomes Quality of Care Model was used as a framework to guide the exploration of these variables within an interconnected system. A cross-sectional research design was used to determine the relationships between the variables of managerial coaching, role ambiguity, and QSEN as experienced among nurses who work in the Military Health System (MHS). All nurses who work at Brooke Army Medical Center, San Antonio, Texas, were asked to participate by completing surveys containing valid and reliable study instruments that were used to examine the variables of interest. Study data were examined using descriptive statistics. Of the 382 nurses that responded, they perceived low levels of role ambiguity with military nurses reporting slightly higher role ambiguity than civilian nurses. Most nurses seldom perceived receiving managerial coaching from their first-line supervisors. When examining the QSEN competencies, nurses felt somewhat, or not at all prepared to perform quality-related performance items, and were most prepared to perform patient-centered care. There was a significant negative relationship between managerial coaching and role ambiguity (rs = -.26, p < .001), and a significant negative relationship between role ambiguity and all of the QSEN competencies rs = -.20 to -.36, p < .01). This study provides a foundation of knowledge to inform future education, practice, policy, and research related to the study variables.

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