Abstract
The global and national shortage of nurses poses a critical challenge to the continuity and quality of healthcare. In Flanders, as in many other regions, the increasing demand for care due to population ageing and rising complexity coincides with high turnover rates among nursing staff. Previous research has shown that nurse autonomy plays a pivotal role in improving care quality, enhancing job satisfaction, and reducing attrition. However, to date, no clear and comprehensive conceptualisation or validated instrument exists to systematically study and strengthen nurse autonomy within the acute hospital context.
This doctoral project aims to deepen the understanding of nurse autonomy and make it measurable in order to support sustainable workforce strategies in acute care hospitals. The project pursues three complementary objectives. First, a conceptual framework will be developed to define the meaning, dimensions, and determinants of nurse autonomy, taking into account both barriers and facilitators at the individual, team, and organisational level. Second, a multidimensional scale will be designed and validated to capture the various aspects of autonomy and to explore its associations with self-leadership, job satisfaction, and nurse retention. Third, a comprehensive organisational analysis will be conducted to generate context-specific insights and to formulate evidence-based recommendations for strategies aimed at strengthening autonomy.
The project is embedded in a collaboration between the University of Antwerp and Ziekenhuizen aan de Stroom (ZAS), one of the largest hospital networks in Europe. This partnership combines academic expertise in nursing leadership, workforce management, and healthcare innovation with a broad clinical practice environment in which research results can be directly implemented. The anticipated outcomes include the development of a scientifically grounded framework and a validated measurement tool, as well as practical recommendations for healthcare organisations and policymakers.
By advancing the conceptual and empirical understanding of nurse autonomy, this research contributes to the professional empowerment of nurses. In doing so, it supports improved job satisfaction, strengthens retention policies, and ultimately enhances the quality, safety, and sustainability of care delivery in acute hospital settings.
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