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Background: Nurse champions are front-line practitioners who implement innovation and reconstruct policy. Purpose: To understand through a network theory lens the factors that facilitate nurse champions' engagement with radical projects, representing their actions as street-level bureaucrats (SLBs). Materials and methods: A personal-network survey was employed. Ninetyone nurse champions from three tertiary medical centers in Israel participated. Findings: Given high network density, high levels of advice play a bigger role in achieving high radicalness compared with lower levels advice. High network density is also related to higher radicalness when networks have high role diversity. Discussion: Using an SLB framework, the findings suggest that nurse champions best promote adoption of innovation and offer radical changes in their organizations through professional advice given by colleagues in their field network. Healthcare organizations should establish the structure and promote the development of dense and heterogeneous professional networks to realize organizations' goals and nurses' responsibility to their professional employees, patients, and society. [ABSTRACT FROM AUTHOR]

BackgroundNurse champions are front-line practitioners who implement innovation and reconstruct policy.PurposeTo understand through a network theory lens the factors that facilitate nurse champions’ engagement with radical projects, representing their actions as street-level bureaucrats (SLBs).Materials and methodsA personal-network survey was employed. Ninety-one nurse champions from three tertiary medical centers in Israel participated.FindingsGiven high network density, high levels of advice play a bigger role in achieving high radicalness compared with lower levels advice. High network density is also related to higher radicalness when networks have high role diversity.DiscussionUsing an SLB framework, the findings suggest that nurse champions best promote adoption of innovation and offer radical changes in their organizations through professional advice given by colleagues in their field network. Healthcare organizations should establish the structure and promote the development of dense and heterogeneous professional networks to realize organizations’ goals and nurses’ responsibility to their professional employees, patients, and society.

The extant pieces of literature on discretion has mainly focused on its effect on policy implementation and public service delivery, but few studies have looked at its influence on street-level bureaucrats' work behavior, such as taking charge behavior (TCB), which is of great importance for government reforms, especially in developing and transitional countries. Based on the self-determination theory, this study examines whether and how discretion promotes street-level bureaucrats' TCB. Two studies were conducted among street-level bureaucrats in China. First, a survey experiment (n = 355) suggests that discretion positively predicts street-level bureaucrats' TCB. Then, a survey questionnaire study (n = 442) shows that discretion is positively related to TCB through the mediator of public service motivation (PSM). We concluded with implications for theory and practice. [ABSTRACT FROM AUTHOR]

The extant pieces of literature on discretion has mainly focused on its effect on policy implementation and public service delivery, but few studies have looked at its influence on street-level bureaucrats' work behavior, such as taking charge behavior (TCB), which is of great importance for government reforms, especially in developing and transitional countries. Based on the self-determination theory, this study examines whether and how discretion promotes street-level bureaucrats' TCB. Two studies were conducted among street-level bureaucrats in China. First, a survey experiment (n = 355) suggests that discretion positively predicts street-level bureaucrats' TCB. Then, a survey questionnaire study (n = 442) shows that discretion is positively related to TCB through the mediator of public service motivation (PSM). We concluded with implications for theory and practice.