Valoración del entorno de práctica profesional por enfermeras españolas que participan en foros de Internet

Association of Nursing Practice Environment on reported adverse events in private management hospitals: A cross-sectional study

AIMS AND OBJECTIVES

To examine the relationships between nurses' perceptions of their practice environment, other working conditions and reported adverse events in two private management hospitals.

BACKGROUND

Patient safety is influenced by knowledge, available resources and the context in which nursing care is provided. In this sense, it has been found that certain work environments (e.g., workload, nurse turnover level, patient-to-nurse ratio, nurse staffing, nurse manager ability) influence patient outcomes. The association between nursing practice environment and reported adverse events has not been explored in private management hospitals.

DESIGN

A cross-sectional study. The STROBE was selected as the checklist in this study.

METHODS

A total of 219 nurses were included in the study. This study was conducted from June 2018-June 2019 in Spain. Data were collected through questionnaires focusing on work conditions, reported adverse events (falls, medication errors, catheter-related sepsis and pressure ulcer) and Practice Environment Scale of the Nursing Work Index. Binary logistic regression analysis was performed to determine the factors influencing the occurrence of errors.

RESULTS

Nurses reported poor perception of the professional environment, and 62.1% reported having made at least one error in the previous year. Manager support and leadership and nurse-physician relations were the most favourable aspects of work environment. Medical-surgical units, rotating in the same shift and favourable work environment, were associated with more reporting of adverse events.

CONCLUSION

The factors of nursing practice (hospital area workload, staff rotating and perception of work environment) associated with reporting adverse events can be worked upon from the organisation and provided an opportunity for safety culture improvement and safer healthcare services.

RELEVANCE TO CLINICAL PRACTICE

Improving the nurse work environment may reduce adverse patient events in private management hospitals.

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.

Essential elements of professional nursing environments in Primary Care and their influence on the quality of care

OBJECTIVES

Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality.

METHOD

We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%).

RESULTS

One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021).

CONCLUSIONS

Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions.

[Evaluation of the nurse working environment in health and social care intermediate care units in Catalonia]

INTRODUCTION

A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment.

METHODS

An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected.

RESULTS

From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment.

CONCLUSIONS

In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment.