Effect of Nurses’ Autonomy on the Quality of Patient Care Based on Kramer and Schmalenberg’s Model

This study aims to investigate the effect of nurses’ autonomy on the quality of patient care based on Kramer and Schmalenberg’s model

This is a causal-comparative study. Participants were 101 nurses of Imam Khomeini Hospital in Arak, Iran from the intensive care unit and internal medicine, surgery, pediatrics, gynecology, orthopedics, and emergency departments. The data collection tools were Moghimi and Ramazan’s patent care quality questionnaire and an autonomy assessment questionnaire based on Kramer and Schmalenberg’s autonomy model. The data were analyzed in SPSS software.

This study was approved by the ethics committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1397.66).

The mean autonomy score of nurses was 3.16 ±0.35, indicating a desirable level. Nurses of all departments had limited autonomy. In the internal department, nurses had unsanctioned autonomy, while in the surgical department, they had autonomous nursing care action. The regression models were significant for all departments except for the internal department. With an increase of one unit in limited autonomy in the intensive care unit, autonomous nursing care in the surgical department, and limited autonomy in pediatrics, gynecology, orthopedics, and emergency departments among the nurses, the quality of care can be increased by 0.253, 0.187, 0.522, 0.205, 0.466 and 0.129, respectively.

Nurses’ autonomy can increase the quality of patient care. The nursing managers need to empower nurses and provide an environment for them to apply their knowledge in practicing autonomy.