الفهرس 
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Abstract
Professional nursing governance is a multidimensional concept that encompasses the structure and processes through which professional nurses direct, control and regulate the goal oriented efforts of their professional practice and influence the organizational context in which it occurs through organizational recognition, facilitating structures, the liaison of information, and the alignment of goals. Professional nursing shared governance is the extension of power, control, and authority to the front line staff nurses over their clinical practice.
Aim of the study
This study aims to develop a strategy for improvement of professional nursing governance.
Setting:
The study was conducted in all hospital departments of Medical Research Institute, Alexandria. It included seven departments namely; surgical, medical, anesthesia, oncology, blood diseases, laboratories, and x-ray department with bed capacity of 300 beds.
Subjects:
The study subjects included all medical administrators (N= 10 ) including; director of the hospital and all departments’ heads; all nursing administrators (N= 25) including; director of nursing services (N= 1), assistant director of nursing services (N= 1), nurse supervisor (N= 1), first-line nurse managers (N= 20), infection control / clinical nurse educator (N= 1), quality coordinator nurse (N= 1); and staff nurses (N=185 ) working at all departments in the hospital. Subjects total numbers approximately about (N= 220).
Tools of the study:
Data for this study were collected using the following tools:
Tool (1): Index of Professional Nursing Governance Questionnaire (IPNGQ)
The Index of Professional Nursing Governance (IPNGQ) that was developed by Hess (2011), contains 86 items to assess the degree of professional nursing governance by nursing personnel on a continuum from traditional, to shared, and to self-governance (12).
Tool (2): The Magnet Hospital Forces Interview
The Magnet Hospital Forces Interview tool that was developed and validated by Abd Elkader (2009) based on the relevant literatures (19, 28, 33-35) was used as the standard of assessment to conduct the gap analysis relevant to elements of professional nursing governance in comparison to current structure and processes and identify needs assessment of professional nursing governance for the achievement of nursing excellence by assessing the magnet components and its forces of magnetism at Medical Research Institute Hospital as perceived by medical administrators, nursing administrators and all staff nurses.
In addition to questions related to demographic characteristics of all study subjects will be included that related job/ position, gender, age, educational qualification, working unit/ setting, years of experience and unit experience….etc
Method:
The research tools were translated into Arabic, and tested by ”five” experts from the Faculty of Nursing, Alexandria Main University from the different departments for testing its content validity and translation. Accordingly, the necessary modifications were done based on their comments. A pilot study was carried out on 10% of nursing staff that will not be included in the study subjects (N =25), in order to check and ensure clarity of tools, identify obstacles and problems that may be encountered during data collection. Based on the findings, some questions were modified.
The consent of the subjects to participate in the study was obtained before data collection.
Data collection for this study was conducted by the researcher through self-administered questionnaires and individual interview using the previously mentioned tools to assess the current state of nursing professional governance and to conduct the gap analysis to assess the current structures and processes in the hospital to identify the gap in the structures and processes. Data were collected and strategy developed over a period of seven months started from (8/5/2016 to 30/1/2017).
After completion of data collection, data was analyzed using appropriate statistical analysis and measures. The findings of the analyzed data were utilized to conduct the gap analysis and to develop the improvement strategy of the nursing professional governance for the achievement of nursing excellence at Medical Research Institute Hospital, Alexandria.
The developed strategy was distributed to the hospital Medical and Nursing administrators and jury composed of five experts from Alexandria University to obtain their opinions. The final draft of the professional nursing governance improvement strategy was developed based on the needed modifications.
The following were the main results of the present study:
1. The highest percentage of study subjects (40.5%) were in the age group of less than 30 years old, as they were all nursing staff; and the least percentage of them (5.5%) were in the age group more than 50 years old, represented as 4.8% among nursing staff and 20% among medical administrators.
2. There was more than half of all study subjects including medical administrators and nursing staff (53.6%) were nearly satisfied with their professional practice; represented by 53.3% of nursing staff and 60% of medical administrators, compared with only 2.3% of nursing staff were highly dissatisfied with their professional practice.
3. The mean score of nursing staff assessments’ toward professional nursing governance was (187.59±63.74) which indicated that nurses practice the first level of nursing shared governance (primarily nursing management with some staff input). The highest total mean score of nursing staff assessment of professional nursing governance was
found related to control over professional practice followed by control over personnel. While, the lowest total mean score was related to goal setting and conflict resolution.
4. There was (51%) of nursing staff perceived traditional governance of professional nursing governance. While, (47.1%) of them perceived shared governance, and only (1.9%) of nursing staff perceived self-governance.
5. There was a statistical significant difference between professional nursing governance levels as perceived by nursing staff according to type of unit, educational qualifications of nursing, years of work experience, hospital working experience, and training programs. While there was no statistical significant difference between professional nursing governance levels as perceived by nursing staff and each of gender, age, job title nurse, and satisfaction with their professional performance in the hospital.