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Williams KM, Campbell CM, House S, Hodson P, Swiger PA, Orina J, Javed M, Pierce T, Patrician PA. Healthy work environment: A systematic review informing a nursing professional practice model in the US Military Health System. J Adv Nurs 2024; 80:3565-3576. [PMID: 38469941 DOI: 10.1111/jan.16141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
AIM The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our findings would likely benefit other nursing populations and environments as well. DESIGN Systematic literature review. DATA SOURCES We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus. METHODS Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments. RESULTS Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations. CONCLUSIONS This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments. IMPACT This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice. REPORTING METHOD PRISMA 2020 guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
| | | | - Sherita House
- Indiana University School of Nursing, Terre Haute, Indiana, USA
| | - Patricia Hodson
- Joint Base San Antonio, Regional Health Command-Central, Fort Sam Houston, Texas, USA
| | - Pauline A Swiger
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Madigan Army Medical Center, Tacoma, Washington, USA
| | - Judy Orina
- Geneva Foundation, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Mariyam Javed
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Taylor Pierce
- Geneva Foundation, Madigan Army Medical Center, Tacoma, Washington, USA
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Johnson C, Delaney KR, Cirpili A, Marriott S, O'Connor J. American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units. J Am Psychiatr Nurses Assoc 2024; 30:886-895. [PMID: 37698389 DOI: 10.1177/10783903231198247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE An American Psychiatric Nurses Association (APNA) task force reviewed current staffing research to revise and update the 2011 APNA "Staffing inpatient psychiatric units" position paper and provide recommendations to the APNA Board of Directors on how psychiatric mental health (PMH) nurses might champion the staffing needs of inpatient psychiatric units. METHODS Current research on staffing and nursing practice in inpatient psychiatric units was reviewed as well as variables believed to influence staffing and nursing practice, such as consumer needs and workplace culture. Since current nurse staffing principles emphasize nursing value and how that value is connected to outcomes, the literature search included a focus on staffing and related patient outcomes. RESULTS PMH nurses are critical to the safety and quality of care in inpatient psychiatric units. However, there are little existing data on the relationship between staffing levels and even common adverse events such as staff injury and restraint of patients. Furthermore, there is scant research conducted on inpatient psychiatric units that informs optimal staffing models or establishes links between staffing and patient outcomes. CONCLUSIONS Consistent with current evidence, the universal use of a single method or model of determining staffing needs (e.g., nursing hours per, case mix index, or mandatory ratios) is not recommended. PMH nurses should champion systematic evaluation of staffing on their inpatient units against select patient, nurse, and system outcomes. A data repository of PMH nurse-sensitive outcomes is necessary to benchmark unit performance and staffing.
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Affiliation(s)
- Celeste Johnson
- Celeste Johnson, DNP, APRN, PMH CNS, CMJ Behavioral Health Consulting, LLC, Garland, TX, USA
| | - Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, FAAN, Rush University College of Nursing, Chicago, IL, USA
| | - Avni Cirpili
- Avni Cirpili, DNP, RN, Vanderbilt Psychiatric Hospital, Nashville, TN, USA
| | - Suzie Marriott
- Suzie Marriott, MS, RN, PMH-BC, Stony Brook Eastern Long Island Hospital, Port Jefferson Station, NY, USA
| | - Janette O'Connor
- Janette O'Connor, MS, BS, BSN, RN, PMH-BC, New York Presbyterian Hospital, White Plains, NY, USA
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Miller MJ, Korbut N, Amador Garcia L, Agazio JB, Cartwright J. Nurse Attrition: Content Analysis of Free-Text Responses From Two Military Nursing Practice Environment Surveys. Mil Med 2024; 189:784-790. [PMID: 39160829 DOI: 10.1093/milmed/usae275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/21/2024] [Accepted: 05/09/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Staff nurse attrition negatively impacts readiness of the warfighter and the health and wellbeing of all beneficiaries of the Military Health System (MHS). To promote the retention of a robust nursing workforce, a complete understanding of nurses' perceptions regarding their intent to leave is necessary. The purpose of this study was to explore the free-text responses of 1,438 nurses working among military medical treatment facilities for factors influencing their intent to leave, as an indicator of potential turnover, or attrition. MATERIALS AND METHODS This study employed thematic analysis to investigate the qualitative responses from the 2016 and 2018 Military Nursing Practice Environment Surveys. The study was determined to be exempt from Institutional Review Board review through the Womack Army Medical Center's Human Research Protection Program. RESULTS Findings indicate that leadership and management (n = 647), staffing (n = 353), career opportunities (n = 345), staff outcomes (n = 247), culture (n = 153), quality of care (n = 99), patient care barriers (n = 86), non-patient care activities (n = 79), lack of formal professional development (n = 75), and area or care environment (n = 67) were among the top factors influencing staff nurse intent to leave, respectively. CONCLUSIONS Our findings support the evaluation of retention strategies using implementation science for nurses and nurse resource personnel (e.g., nursing assistants, technicians, medics, and corpsman) to ensure a robust nursing work force throughout the MHS. Staff nurses and resource personnel working among military treatment facilities and embedded in units supporting combat and humanitarian missions ensure access to care and health promotion of the warfighter and all MHS beneficiaries.
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Affiliation(s)
- Melissa J Miller
- Center for Nursing Science & Clinical Inquiry, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Nickalous Korbut
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
| | - Lidilia Amador Garcia
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
| | - Janice B Agazio
- Conway School of Nursing, Catholic University of America, Washington, DC 20064, USA
| | - Joel Cartwright
- Department of Behavioral Sciences and Leadership, United States Military Academy, West Point, NY 10996, USA
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Patrician PA, Campbell CM, Javed M, Williams KM, Foots L, Hamilton WM, House S, Swiger PA. Quality and Safety in Nursing: Recommendations From a Systematic Review. J Healthc Qual 2024; 46:203-219. [PMID: 38717788 PMCID: PMC11198958 DOI: 10.1097/jhq.0000000000000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
ABSTRACT As a consistent 24-hour presence in hospitals, nurses play a pivotal role in ensuring the quality and safety (Q&S) of patient care. However, a comprehensive review of evidence-based recommendations to guide nursing interventions that enhance the Q&S of patient care is lacking. Therefore, the purpose of our systematic review was to create evidence-based recommendations for the Q&S component of a nursing professional practice model for military hospitals. To accomplish this, a triservice military nursing team used Covidence software to conduct a systematic review of the literature across five databases. Two hundred forty-nine articles met inclusion criteria. From these articles, we created 94 recommendations for practice and identified eight focus areas from the literature: (1) communication; (2) adverse events; (3) leadership; (4) patient experience; (5) quality improvement; (6) safety culture/committees; (7) staffing/workload/work environment; and (8) technology/electronic health record. These findings provide suggestions for implementing Q&S practices that could be adapted to many healthcare delivery systems.
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Patrician PA, Travis JR, Blackburn C, Carter JL, Hall AG, Meese KA, Miltner RS, Montgomery AP, Stewart J, Ruffin A, Morson DM, Polancich S. Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE): An Evidence-Based Wellness Program. Nurs Adm Q 2024; 48:165-179. [PMID: 38564727 DOI: 10.1097/naq.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.
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Affiliation(s)
- Patricia A Patrician
- Author Affiliations: University of Alabama at Birmingham School of Nursing, Birmingham (Drs Patrician, Miltner, and Polancich, Mr Travis, and Mss Blackburn, Carter, Ruffin, and Morson); Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham (Drs Hall and Meese); Center for Healthcare Management and Leadership, and Office of Wellness, University of Alabama at Birmingham, Birmingham (Dr Meese); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham (Dr Montgomery); and UAB Medical Center, University of Alabama atBirmingham, Birmingham (Dr Stewart)
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Xuan X, Duan X, Feng Z, Zheng Y. Differences in Nurses' Satisfaction and Demand for Spatial Design Among Different Departments of Nursing Units: A Case Study in China. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:129-145. [PMID: 38087872 DOI: 10.1177/19375867231213955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
OBJECTIVES The study aimed to extend original research and identify operational and space-related requirements for specialization from the perspectives of nursing behavior and process. BACKGROUND Studies related to the specialty of different nursing units have been widely conducted in nursing science, while few studies have explored the specialized requirements for the physical environments of nursing units in different departments. METHOD Questionnaire survey data were collected from 125 nurses in 11 clinical departments, and nurse shadowing (approximately 68 hr) was conducted in four clinical departments. RESULTS The questionnaire survey showed that satisfaction with care activity, visibility, and physical environment within the existing nursing unit environment was rated differently among different departments of nursing units. However, nurses in different groups of age, education, work experience, and position indicated no statistically significant difference. Behavioral observations demonstrated that the spatial and temporal distributions of activities, spatial linkages, and communication patterns varied in distinct departments. CONCLUSION This research found that nurses in different departments had different evaluations of satisfaction and environmental characteristics. It also explains the differences in nursing work behaviors and processes found in various departments and sheds light on specialized requirements from the behavior perspective. The findings could help optimize the design of efficient and satisfactory nursing units in different departments.
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Affiliation(s)
- Xiaodong Xuan
- Department of Architecture, College of Architecture & Art, Hefei University of Technology, China
| | - Xiaoxia Duan
- The Second Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Anhui, China
| | - Zihao Feng
- ARTS Group Co., Ltd, Suzhou, Jiangsu, China
| | - Yihe Zheng
- Department of Architecture, College of Architecture & Art, Hefei University of Technology, China
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Miller MJ, Johansen ML, de Cordova PB, Swiger PA, Stucky CH. Impact of the primary care nurse manager on nurse intent to leave and staff perception of patient safety. Nurs Manag (Harrow) 2024; 55:32-42. [PMID: 38170887 DOI: 10.1097/nmg.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Melissa J Miller
- Melissa J. Miller is a nurse scientist and Chief, Center for Nursing Science and Clinical Inquiry, Tripler Army Medical Center in Honolulu, Hawaii. Mary L. Johansen is a clinical professor at Rutgers, The State University of New Jersey in Newark, N.J., and a member of the Nursing Management Editorial Advisory Board. Pamela B. de Cordova is an associate professor at Rutgers, The State University of New Jersey in Newark, N.J. Pauline A. Swiger is a nurse scientist and CNO for the Defense Health Agency in Falls Church, Va. Christopher H. Stucky is a nurse scientist and Chief, Center for Nursing Science and Clinical Inquiry, Landstuhl Regional Medical Center in Landstuhl, Germany
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Campbell CM, Li P, Warshawsky N, Swiger PA, Olds D, Cramer E, Patrician PA. Modernizing Measure of the Nurse Work Environment. West J Nurs Res 2023; 45:932-941. [PMID: 37599466 DOI: 10.1177/01939459231194132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND Research has established a relationship between favorable nurse work environments and better nurse, patient, and organizational outcomes. However, the instrument most frequently used to measure the nurse work environment, the Practice Environment Scale of the Nursing Work Index (PES-NWI), has not had its items significantly re-evaluated since the 1980s. OBJECTIVE We sought to examine the psychometric properties of an updated PES-NWI and create an instrument suitable for further testing and refinement to measure the present-day nurse work environment. Specifically, we sought to establish construct, structural, discriminative, and concurrent validity. For reliability, we desired to establish interrater reliability and internal consistency reliability. METHODS We administered a modified PES-NWI to a national sample of direct-care hospital nurses (n = 818) in the United States. We then assessed the psychometric properties of the instrument. RESULTS While the modified PES-NWI displayed adequate validity and reliability properties, further testing and refinement of the instrument is necessary. CONCLUSIONS With this updated measure of the nurse work environment, researchers and hospital leaders can identify modifiable opportunities for improvement in contemporary hospital nurse work environments which may enhance nurse and patient outcomes.
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Affiliation(s)
| | - Peng Li
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Danielle Olds
- Saint Luke's Hospital, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Emily Cramer
- Health Outcomes and Health Services Research, Children's Mercy Kansas City, Kansas City, MO, USA
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Campbell CM, Swiger PA, Warshawsky N, Li P, Olds D, Cramer E, Patrician PA. Measuring the Work Environment: The Voice of the Staff Nurse. J Nurs Adm 2023; 53:284-291. [PMID: 37098869 DOI: 10.1097/nna.0000000000001284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVE The aims of this study were to obtain direct care hospital nurse input on the relevance of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and to determine whether additional items are needed to measure the contemporary nursing work environment (NWE). BACKGROUND Instruments accurately measuring the NWE are essential due to the NWE's association with nurse, patient, and organizational outcomes. However, the most frequently used instrument for measuring the NWE has not been scrutinized by today's practicing direct care nurses to ensure its current relevancy. METHODS Researchers administered a survey with a modified PES-NWI and open-ended questions to a national sample of direct care hospital nurses. RESULTS Three items from the PES-NWI may be suitable for removal, and additional items may be added to accurately measure the current NWE. CONCLUSION Most PES-NWI items remain relevant for modern nursing practice. However, some revisions could enable greater precision in measuring the current NWE.
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Affiliation(s)
- Caitlin Marley Campbell
- Author Affiliations: Research Assistant (Dr Campbell), Assistant Professor (Dr Li), and Professor and Endowed Chair (Dr Patrician), University of Alabama at Birmingham School of Nursing; Colonel (Dr Swiger), US Army Nurse Corps; Consultant and Principal (Dr Warshawsky), Nurse Scientist, Press Ganey Associates, South Bend, Indiana; Assistant Professor (Dr Olds) University of Kansas School of Nursing, Kansas City; and Associate Professor (Dr Cramer), Health Services and Outcomes Research, Children's Mercy Kansas City, Missouri
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Hodson P, Swiger PA, Campbell CM, Orina JA, Javed M, Hamilton W, Williams K, Foots L, Levenson J, Robins K, Pierce T, McCarthy M, Patrician PA. Findings from the development of a nursing joint professional practice model for the U.S. military. Nurs Outlook 2023; 71:101949. [PMID: 36958117 DOI: 10.1016/j.outlook.2023.101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND By 2022 the Defense Health Agency became responsible for administration of all military treatment facilities (MTFs), which were previously managed by their respective military services. However, three different service-specific nursing professional practice models currently govern nursing practice in MTFs. PURPOSE To describe the literature search, review, and synthesis of evidence which informed the JPPM and provide some of the most actionable findings. METHODS A team of tri-service nurses developed the JPPM by conducting six rigorous systematic reviews to synthesize evidence pertaining to relevant model components. DISCUSSION A total of 51,360 titles and abstracts were initially screened. Data were extracted from 540 included articles. The team then developed standards for five JPPM components: evidence-based practice, safety and quality, leadership development, healthy work environment, and operational readiness. CONCLUSION The JPPM is a meaningful framework that will help create a mutual professional identity and shared vision to promote a unified nursing force in U.S. military settings.
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Affiliation(s)
- Patricia Hodson
- US Army Nurse Corps, Regional Health Command-Central, Joint Base San Antonio, Fort Sam Houston, TX
| | - Pauline A Swiger
- US Army Nurse Corps, Madigan Army Medical Center, Tacoma, WA; Birmingham School of Nursing, University of Alabama, Birmingham, AL
| | | | - Judy Ann Orina
- Geneva Foundation, Madigan Army Medical Center, Tacoma, WA.
| | - Mariyam Javed
- School of Nursing, University of Alabama, Birmingham, AL
| | - Wendy Hamilton
- US Army Nurse Corps, Evans Community Army Hospital, Fort Carson, CO
| | - Kathy Williams
- U.S. Air Force (Retired), 96th Medical Group, Eglin Air Force Base, FL
| | | | | | - Katherine Robins
- Naval Hospital Camp Pendleton, US Navy Nurse Corps, San Diego, CA
| | - Taylor Pierce
- Geneva Foundation, Madigan Army Medical Center, Tacoma, WA
| | - Mary McCarthy
- Madigan Army Medical Center, US Army Nurse Corps, Tacoma, WA
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Gonçalves I, Mendes DA, Caldeira S, Jesus É, Nunes E. The Primary Nursing Care Model and Inpatients' Nursing-Sensitive Outcomes: A Systematic Review and Narrative Synthesis of Quantitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2391. [PMID: 36767759 PMCID: PMC9915435 DOI: 10.3390/ijerph20032391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The delivery of quality, safe, and patient-centered care is foundational for professional practice. The primary nursing model allows nurses to have excellent knowledge about patients and families and to plan and coordinate care from admission to discharge, with better management of health situations. Nurses play a crucial role in improving patients' outcomes, namely those sensitive to nursing care. The knowledge of the relationship between the primary nursing model and the nursing-sensitive outcomes provides new scientific evidence that strengthens the relevance of this nursing care organization model in the inpatients' health outcomes. This systematic review describes the relationship between nurse-sensitive inpatients' outcomes and the primary nursing care model. METHODS A systematic review was conducted with a narrative synthesis, and the following databases were searched: MEDLINE, CINAHL, Web of Science, Nursing & Allied Health Collection, SciELO Collections, and Cochrane. RESULTS A total of 22 full texts were assessed, of which five were included in the study according to the selection criteria. The analysis results indicated that the primary nursing care model was related to nursing-sensitive patient safety outcomes. Patients' experience was also considered a nursing-sensitive outcome, namely in the satisfaction with nursing care. CONCLUSION The negative outcomes are clearly related to the primary nursing care model. There is scarce research that relates primary nursing to positive outcomes, such as patients' functional status and self-care abilities, and more studies are needed.
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Affiliation(s)
- Isabel Gonçalves
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
- Hospital da Luz Lisboa, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - Diana Arvelos Mendes
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, NURSE’IN-UIESI, Estefanilha, 2910-761 Setúbal, Portugal
| | - Sílvia Caldeira
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
| | - Élvio Jesus
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
| | - Elisabete Nunes
- Escola Superior de Enfermagem de Lisboa, Nursing Research, Innovation and Development Centre of Lisbon, 1600-190 Lisbon, Portugal
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Patrician PA, Olds DM, Breckenridge-Sproat S, Taylor-Clark T, Swiger PA, Loan LA. Comparing the Nurse Work Environment, Job Satisfaction, and Intent to Leave Among Military, Magnet®, Magnet-Aspiring, and Non-Magnet Civilian Hospitals. J Nurs Adm 2022; 52:365-370. [PMID: 35608979 PMCID: PMC9154298 DOI: 10.1097/nna.0000000000001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to compare the nurse work environment, job satisfaction, and intent to leave (ITL) among military, Magnet®, Magnet-aspiring, and non-Magnet civilian hospitals. BACKGROUND The professional nurse work environment is an important, modifiable, organizational trait associated with positive nurse and patient outcomes; creating and maintaining a favorable work environment should be imperative for nursing leaders. METHODS Secondary data from the Army Nurse Corps and the National Database of Nursing Quality Indicators included the Practice Environment Scale of the Nursing Work Index (PES-NWI) and single-item measures of job satisfaction and ITL. RESULTS Magnet and military hospitals had identical PES-NWI composite scores; however, statistically significant differences existed among the subscales. Military nurses were the most satisfied among all groups, although this difference was not statistically significant, yet their ITL was highest. CONCLUSIONS Favorable work environments may exist in other organizational forms besides Magnet; however, the specific components must be considered.
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Baernholdt M, Jones TL, Anusiewicz CV, Campbell CM, Montgomery A, Patrician PA. Development and Testing of the Quality Improvement Self-efficacy Inventory. West J Nurs Res 2022; 44:159-168. [PMID: 33745388 PMCID: PMC8450303 DOI: 10.1177/0193945921994158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Quality improvement is paramount for patient safety. Leading change for quality improvement requires nurses with knowledge and skills beyond the clinical management of patients. In this study, staff nurses working in hospitals throughout Alabama were asked via an online survey to rate their quality improvement knowledge and skills using the new 10-item Quality Improvement Self-Efficacy Inventory (QISEI) and their perceptions of the nursing work environment using the Practice Environment Scale of the Nursing Work Index. Nurses (N = 886) rated the basic quality improvement items higher than the more advanced items. Several nurse characteristics and the nursing work environment were associated with nurses' ratings of their quality improvement knowledge and skills. Educators and administrators in health care organizations can use QISEI to gauge their nurses' knowledge and skills and then develop continuous professional development opportunities aimed at improving quality and safety competencies.
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Affiliation(s)
| | - Terry L. Jones
- Virginia Commonwealth University, Richmond, VA, United States
| | - Colleen V. Anusiewicz
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Aoyjai Montgomery
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Patricia A. Patrician
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
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Mrayyan MT, Al-Atiyyat N, Al-Rawashdeh S, Sawalha M, Awwad M. Comparing rates and causes of, and views on reporting of medication errors among nurses working in different-sized hospitals. Nurs Forum 2021; 56:560-570. [PMID: 33884638 DOI: 10.1111/nuf.12581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Medication errors are detrimental to patient safety and the quality of hospital services. PURPOSE The purpose of the study was to compare registered nurses working in the small-, medium-, and large-sized Jordanian hospitals' responses in terms of reported rate and cause of medication errors and their views on medication error reporting. METHODS This was a cross-sectional comparative design, with a total sample of 229 nurses working in different-sized hospitals. RESULTS The rates of reported medication errors were significantly different across hospitals representing 53.5% in small-sized, 41.8% in medium-sized, and 32.8% in large-sized hospitals. No significant differences between hospitals regarding the nurses' reported causes of medication errors. Nurses' views were significantly different in all aspects of their reporting except in their failure to report (drug) error. CONCLUSIONS The hospital's size may associate with nurses' reporting rate and nurses' views on reporting such errors. There is an urgent need for more diligent systematic efforts to prevent, detect, and report medication errors. Collaboration with other health team members, including information technology members, will enhance the outcomes associated with medication administration. The findings of this study warranted further investigations.
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Affiliation(s)
- Majd T Mrayyan
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Nijmeh Al-Atiyyat
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Sami Al-Rawashdeh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Murad Sawalha
- Department of Maternal, Child, and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Al-Ghraiybah T, Sim J, Lago L. The relationship between the nursing practice environment and five nursing-sensitive patient outcomes in acute care hospitals: A systematic review. Nurs Open 2021; 8:2262-2271. [PMID: 33665965 PMCID: PMC8363353 DOI: 10.1002/nop2.828] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/31/2021] [Indexed: 01/12/2023] Open
Abstract
Aim To synthesize the available evidence on the relationship between the nursing practice environment in acute care hospitals and five selected nursing‐sensitive patient outcomes (mortality, medication error, pressure injury, hospital‐acquired infection and patient fall). Design A quantitative systematic review of literature was conducted using the PRISMA reporting guidelines (PROSPERO: CRD42020143104). Methods A systematic review was undertaken up to October 2020 using: CINAHL, MEDLINE and Scopus. The review included studies exploring the relationship between the nursing practice environment in adult acute care settings and one of five selected patient outcomes using administrative data sources. Studies were published in English since 2000. Results Ten studies were included. Seven studies reported that a favourable nursing practice environment reduced the likelihood of mortality in acute care hospitals, but estimates of the effect size varied. Evidence on the association between the nursing practice environment and medication administration error, pressure injury and hospital‐acquired infection was mixed.
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Affiliation(s)
- Tamer Al-Ghraiybah
- School of Nursing & Affiliated Member of Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing & Affiliated Member of Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population, Innovation Campus, University of Wollongong, Wollongong, NSW, Australia
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