Participation of nurse managers in the health policy process: a qualitative study of barriers and facilitators

Aim To explore the barriers and facilitators concerning nurse managers' participation in the health policy-making process. Background Despite encouragement for participation in policy-making, nurse managers are seldom involved in this process. Methods A qualitative descriptive research design based on purposive sampling was conducted. Semi-structured one-to-one interviews were conducted with nurse managers and key informants (n = 16). Interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was applied to study reporting. Findings Three levels of barriers were found to nurse managers' participation in health policy-making. The individual level included weakness in characteristics of nurse managers, and the organizational level constituted the inefficient structure. In addition, the environment-related level encompassed external barriers to the organization. Finally, three facilitators with the potential were identified for improving nurse managers' participation in the policy-making process, including improvements in collaboration and communication, governmental and non-governmental organizational activities, and reforms in the health policy-making process. Conclusion Nurse managers need to use the window of opportunity to participate in health policy-making. More importantly, they should be informed about health policy in order to meet the demands of the rapidly changing healthcare environment. Drawing upon their professional organizations and positions, nurse leaders require to network and make a space to stimulate their participation in the policy. Implications for nursing policy and health policy Nurse managers need to develop political skills and utilize strategies to help their participation in health policy-making, leading to better implementation of policies, efficiency, and effectiveness in the health system.