Developing a Model for the Participation of Nurse managers in the Health Policy Making Process

Abstract

Abstract Introduction: Nowadays, with the introduction of reforms in health systems, the requirement for nurses and nurse managers for active participation in the health policy making process has increased. The presence of nurse managers in management activities, health policy and other related activities will improve the performance of nurses, adopt appropriate policies and increase the efficiency and effectiveness in providing care to patients in the hospital. Purpose: The purpose of this study is to develop a model for the participation of nurse managers in the health policy making process in Iran. Method and Materials: The present study is a qualitative study that was conducted between 2018 and 2020 in Tabriz University of Medical Sciences (TUOMS), using systematic review, qualitative and Delphi research methods. In the systematic review English and Persian databases to select published articles, were searched with related keywords. Participants in the qualitative phase were hospital nurse managers and experts in the nursing and health policy (n=16) who were selected by purposive sampling. In qualitative phase data were collected by using a semi-structured interview method. Since developing the initial model by the research team, the elements and components of the model were provided to experts in this field through two Delphi rounds to confirm the items and validation to obtain the final model. The method of data analysis in systematic review and qualitative phase was content analysis and in Delphi study was using SPSS-16 software. Finding: The results of data analysis (systematic review, qualitative and Delphi study) identified and confirmed the factors, facilitators and barriers to the participation of nurse managers in the policy making process. Based on the results of systematic review, finally 11 articles were included in the included and excluded criteria. The analysis of semi-structured interviews showed that barriers to participation included 11 sub-themes and facilitators included 8 sub-themes and also, the analysis of qualitative findings led to the identification of advantages, disadvantages, problems and challenges due to the non-participation of nurse managers, knowledge and attittudes on health policy. The participation model of nurse managers includes the elements of facilitators, barriers, factors, advantages, disadvantages, participation results and the policy process cycle, which was validated and finalized using the perspective of experts. Conclusions: Participation of nurse managers in health policy requires the utilization of facilitators and the removal of barriers. To emphasize the value and position of nursing in the health system, it is necessary for nurse managers in all fields to increase their knowledge and awareness of health policy so that they can use the opportunity window to participate in the health policy making process.