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Vleminckx S, Van Bogaert P, De Meulenaere K, Willem L, Haegdorens F. Factors influencing the formation of balanced care teams: the organisation, performance, and perception of nursing care teams and the link with patient outcomes: a systematic scoping review. BMC Health Serv Res 2024; 24:1129. [PMID: 39334182 PMCID: PMC11429156 DOI: 10.1186/s12913-024-11625-5] [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: 07/04/2023] [Accepted: 09/20/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The composition of care teams is crucial for delivering patient-centered healthcare, yet assembling a well-balanced team remains a challenge. This difficulty stems from the intricate dynamics of team capacity, culture, context, and the demands of the job. The current literature offers limited guidance for decision-makers on how to effectively navigate these dynamics to compose a balanced care team. METHODS We conducted a systematic scoping review of literature spanning from 2009 to 2022. The aim was to identify factors that significantly influence the work environment, team performance, nursing outcomes, and patient outcomes within healthcare settings. Our review focused on extracting and synthesizing evidence to uncover these influencing factors. RESULTS Our analysis identified 35 factors that play a significant role in shaping the work environment and influencing team performance, nursing outcomes, and patient outcomes. These factors were categorized into nine key domains: workload, leadership, team composition, stress and demands, professional relationships, safety, logistics and ergonomics, autonomy and responsibility, and transparency and task clearness. CONCLUSIONS To improve patient care and nursing job satisfaction, policymakers and decision-makers can consider these influencing factors in the design and management of care teams. The findings advocate for strategic adjustments in these domains to enhance a team's balance. Furthermore, our review underscores the need for further research to fill the identified gaps in knowledge, offering a directive for future studies into optimal care team composition. This systematic approach to team composition can significantly impact patient outcomes and nurse satisfaction, providing a roadmap for creating more effective and harmonious teams.
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Affiliation(s)
- Senne Vleminckx
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium.
| | - Peter Van Bogaert
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Kim De Meulenaere
- Faculty of Business and Economics - Management Department, University of Antwerp, Antwerp, Belgium
| | - Lander Willem
- Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), University of Antwerp, Antwerp, Belgium
| | - Filip Haegdorens
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
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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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Tadie A, Muche M, Liknaw T, Edmealem A. Nurses' attitude towards patient advocacy and its associated factor in East Gojjam Zone Public hospitals, Northwest Ethiopia, 2023. BMC Nurs 2024; 23:561. [PMID: 39138438 PMCID: PMC11323593 DOI: 10.1186/s12912-024-02206-2] [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: 11/23/2023] [Accepted: 07/26/2024] [Indexed: 08/15/2024] Open
Abstract
INTRODUCTION One of the most important but underappreciated roles of nurses is patient advocacy. To advocate for patients effectively, the nurses should have a favorable attitude towards patient advocacy. Despite this fact, the nurses' attitude towards patient advocacy was not known in Ethiopia. Thus, this study aimed to assess nurses' attitude towards patient advocacy and its associated factors in East Gojjam Zone Public Hospitals, Northwest in 2023. METHODS Institutional-based cross-sectional study design was conducted among 385 nurses in East Gojjam Zone Public Hospitals from March 1 to April 30, 2023. Nurses were selected using simple random sampling techniques from 11 public hospitals. The data were collected in a self-administered way. Binary logistic regression was used for data analysis. All independent variables having a P value of < 0.25 in the bivariable logistic regression were fitted into a multivariable logistic regression. The AOR at a 95% confidence interval was used to identify the strength of the association, and a p value of 0.05 was used to declare it statistically significant at the final model. RESULT A total of 385 nurses participated in the study, for a 91% response rate. Among these, 49.9% of nurses had an unfavorable attitude. Being working in a primary hospital [AOR = 2.3; 95% CI: (1.4-3.8)], poor cooperation of nurses [AOR = 1.7; 95% CI: (1.1-2.8)], being unsatisfied with the job [AOR = 1.7; 95% CI: (1.1-2.7)], and poor perceived supervision of work [AOR = 6.2; 95% CI: (3.7-9.8)] were factors associated with nurses' attitudes towards patient advocacy. CONCLUSION The number of nurses who had an unfavorable attitude towards patient advocacy was high. Working in a primary hospital, poor cooperation with others, being dissatisfied with the job, and having an unfavorable perception towards the supervision of work were the factors associated with the unfavorable attitude of nurses towards patient advocacy. It is recommended that all hospitals better support the nurses to increase their job satisfaction and have good supervision of the nurses' activities.
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Affiliation(s)
- Abay Tadie
- Advanced Nurse Practitioner, Bichena Primary Hospital, Bichena, Ethiopia
| | - Mikiyas Muche
- Department of Nursing, Debre Markos University, P.O. Box: 269, Debre Markos, Ethiopia
| | - Tiliksew Liknaw
- Department of Nursing, Debre Markos University, P.O. Box: 269, Debre Markos, Ethiopia
| | - Afework Edmealem
- Department of Nursing, Debre Markos University, P.O. Box: 269, Debre Markos, Ethiopia.
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Lake ET, Gil J, Moronski L, McHugh MD, Aiken LH, Lasater KB. Validation of a short form of the practice environment scale of the nursing work index: The PES-5. Res Nurs Health 2024; 47:450-459. [PMID: 38669131 PMCID: PMC11236491 DOI: 10.1002/nur.22388] [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: 08/24/2023] [Revised: 03/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5. We conducted a cross-sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item-to-subscale R2 from the original PES-NWI publication. Five psychometric properties of the PES-5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES-5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28-item and 5-item versions was 0.94. The Cronbach's alpha reliability of the PES-5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES-5 mean value across responses to a single-item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES-5. The classification accuracy of the PES-5 was high, with 88% of hospitals classified identically by both versions. The PES-5 shows promise for measurement of nurses' work environments while maximizing response rate by reducing participant burden.
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Affiliation(s)
- Eileen T Lake
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Jennifer Gil
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Lynne Moronski
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Matthew D McHugh
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Linda H Aiken
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Karen B Lasater
- Department of Biobehavioral Health Sciences, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Ribeiro OMPL, de Lima Trindade L, da Rocha CG, Teles PJFC, Mendes M, Ribeiro MP, de Abreu Pereira SC, da Conceição Alves Faria A, da Silva JMAV, de Sousa CN. Scale for the environments evaluation of professional nursing practice-shortened version: Psychometric evaluation. Int J Nurs Pract 2024:e13291. [PMID: 39051426 DOI: 10.1111/ijn.13291] [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: 08/04/2023] [Revised: 12/07/2023] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
AIM The aim of this study is to test the validity and reliability of the shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). METHODS This methodological, cross-sectional study was conducted between September and December 2022. The original version of the SEE-Nursing Practice was administered in questionnaire format across 17 hospitals. Exploratory and confirmatory factor analyses were conducted to identify relevant items for the new shortened version of the scale and evaluate its construct validity. RESULTS The study involved 1713 registered nurses from various regions of Portugal. From the exploratory factor analysis, the SEE-Nursing Practice was condensed to 59 items and 3 subscales. In the structure subscale, 14 items were removed, and the remaining 29 items distributed over four factors; in the process subscale, 18 items were removed, and the remaining 19 items organized into three factors; in the outcome subscale, 2 items were removed, and the remaining 11 items distributed over two factors. The Cronbach's alpha for the three subscales exceeded 0.90, indicating high reliability. Confirmatory factor analyses provided support for the validity of the 59-item model. CONCLUSION The shortened version of the SEE-Nursing Practice shows adequate validity and reliability, reducing the burden associated with its longer version.
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Affiliation(s)
| | | | | | | | - Mariana Mendes
- CNPQ Scholarship, Federal University of Santa Catarina, Santa Catarina, Brazil
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Campbell CM, Warshawsky N, Swiger PA, Li P, Olds D, Patrician PA. Evolution of an Instrument: Measuring the Nursing Work Environment: A Scoping Review. J Nurs Meas 2024; 32:47-57. [PMID: 37348888 DOI: 10.1891/jnm-2022-0028] [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: 06/24/2023]
Abstract
Background and Purpose: The Nursing Work Index (NWI) was developed in the 1980s to measure the nursing work environment (NWE). Instruments descended from the NWI continue to measure the NWE today. The purpose of this review was to identify instruments derived from the NWI, examine how they have been used and revised, and evaluate their ability to capture elements of the current work environment. Methods: A scoping literature review. Results: Forty articles were included. Instruments developed from the NWI have been translated into numerous languages and administered to hundreds of thousands of nurses globally. Conclusions: The study of the NWE remains extensive throughout the world. Future research should examine the factorial structure of instrument adaptions and ensure that items are relevant to contemporary nursing practice.
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Affiliation(s)
| | | | | | - Peng Li
- University of Alabama, Birmingham, AL, USA
| | - Danielle Olds
- University of Missouri - Kansas City, School of Medicine & Saint Luke's Hospital, Kansas City, MO, USA
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Paterson C, Davis D, Roberts C, Bail K, Wallis E, Northam HL, Frost J, Jojo N, McGrory C, Dombkins A, Kavanagh PS. Sense of coherence moderates job demand-resources and impact on burnout among nurses and midwives in the context of the COVID-19 pandemic: A cross-sectional survey. J Adv Nurs 2024. [PMID: 38426656 DOI: 10.1111/jan.16125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/04/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
AIM This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. DESIGN Cross-sectional quantitative survey. DATA SOURCES The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. RESULTS 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. CONCLUSION It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution in this study, as the focus was on nurses and midwives.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| | - D Davis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Bail
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Frost
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Western Sydney University, Penrith South, New South Wales, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - C McGrory
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - A Dombkins
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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Vitale E, Chang YC. Validation and Measurement of Psychometric Properties of the "Nursing Work Environment Questionnaire" (NWE-q) in Italian Nurses. Risk Manag Healthc Policy 2024; 17:233-247. [PMID: 38282785 PMCID: PMC10821726 DOI: 10.2147/rmhp.s448083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024] Open
Abstract
Background Evidence suggests that an optimal workplace is a physical, chemical, biological, organizational, social, and cultural condition in which each element contributes to the employer's condition. Purpose To develop a nursing work environment questionnaire (NWE-Q). Patients and Methods Convergent validity was measured using Pearson's correlation test. Internal consistency for each dimension of the Nursing Work Environment questionnaire (NWE-q) was performed thanks to the Cronbach's alpha coefficient. Construct validity and factor structure of the data were also assessed. Reliability was evaluated by measuring internal consistency. Interclass correlation coefficient and convergent validity were also assessed. Group validity was evaluated according to the sociodemographic characteristics collected using an independent t-test. Results 376 nurses participated in this study. Both Kaiser-Meyer-Olkin measures of sampling adequacy were, and the Bartlett test of sphericity showed very strong evidence. Owing to oblique rotation, three main sub-dimensions were defined with good internal consistency for all items of the NWE-q (27 items), and each sub-dimension was registered. Very strong interclass correlations were assessed for the NWE-q total scores and for each sub-dimension, with the exception of the system dimensions, in which the interclass correlation showed a weak relationship. Strong positive evidence was found between the NWE-q for both the total and each sub-dimension correlated with the items of both the individual and organizational validated nursing performance questionnaires. Strong evidence was observed for both the organizational and system subdimensions according to shift and gender. Conclusion The NWE-q was promptly completed in the online mode, and its scoring characteristics seemed to be more accessible and simpler to adopt.
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Affiliation(s)
- Elsa Vitale
- Department of Mental Health, Local Health Authority of Bari, Bari, Italy
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
- Nursing Department, China Medical University Hospital, Taichung, Taiwan
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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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Wang Q, Chen T, Lang X, Feng D, Liu Y, Zhang K, Huang J, Liu S, Sheng X, Huang S. When and how does the practice environment most benefit the job outcomes of newly graduated nurses? J Adv Nurs 2024; 80:339-349. [PMID: 37449572 DOI: 10.1111/jan.15783] [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: 01/03/2023] [Revised: 06/02/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Providing a favourable practice environment has been regarded as an essential to improve the job outcomes of newly graduated nurses (NGNs). However, little is known about how and when NGNs can best utilize their practice environment to produce optimal job outcomes. AIM The aim of this study, which is based on the Conservation of Resources Theory and the Social Cognitive Model of Career Self-Management, is to investigate whether NGNs who have a higher level of personal growth initiative are more likely to benefit from their practice environment and achieve better job outcomes by increasing their occupational self-efficacy. DESIGN A cross-sectional study. METHODS From 1 September 2022, to 30 September 2022, 279 NGNs from five Chinese state-owned hospitals were recruited for this study. The participants completed measures of practice environment, personal growth initiative, occupational self-efficacy, job stress, job satisfaction, turnover intention and quality of care. A descriptive analysis and a moderated mediation model were computed. Reporting adhered to the STROBE statement. RESULTS The influence of the practice environment on job outcomes was significantly mediated by occupational self-efficacy, with personal growth initiative acting as a moderator of this mediation effect. CONCLUSIONS NGNs who exhibited a higher degree of personal growth initiative were more likely to derive benefits from their practice environment and attain positive job outcomes by enhancing their occupational self-efficacy. To boost NGNs' occupational self-efficacy and achieve optimal job outcomes, hospital administrators may not only provide a supportive practice environment for them but also conduct interventions that promote their personal growth initiative. NO PATIENT OR PUBLIC CONTRIBUTION This study was designed to examine the psychosocial factors associated with NGNs' job outcomes. The study was not conducted using suggestions from the patient groups or the public. IMPACTS Our findings indicate that favourable practise contexts may not always benefit the nursing job outcome if NGNs do not exhibit a high level of personal growth initiative and produce increased occupational self-efficacy. Therefore, hospital administrators should consider implementing an intervention to improve the personal growth initiative of NGNs so that they can take full advantage of the practice environment and gain resources at work to create optimal job outcomes.
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Affiliation(s)
- Quan Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Chen
- The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Xiaorong Lang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Danni Feng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuchen Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kexin Zhang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingjing Huang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiya Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoxuan Sheng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sufang Huang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Pantha S, Jones M, Gray R. Stakeholders' Perceptions of How Nurse-Doctor Communication Impacts Patient Care: A Concept Mapping Study. NURSING REPORTS 2023; 13:1607-1623. [PMID: 37987412 PMCID: PMC10661264 DOI: 10.3390/nursrep13040133] [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: 08/12/2023] [Revised: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions on how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. A total of 20 patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size, suggesting that each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) on 09.07.2020 (osf.io/9np8v/) prior to recruiting the first participant.
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Affiliation(s)
- Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Noorie, SA 5608, Australia;
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
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13
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Lucas P, Jesus É, Almeida S, Araújo B. Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care. BMC Nurs 2023; 22:413. [PMID: 37915013 PMCID: PMC10621276 DOI: 10.1186/s12912-023-01571-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/20/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. METHODS We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. RESULTS Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety. CONCLUSIONS The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units.
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Affiliation(s)
- Pedro Lucas
- Center for Interdisciplinary Research in Health, Instituto Ciências da Saúde, Universidade Católica Portuguesa, Rua de Diogo Botelho, Porto, 1327, 4169-005, Portugal.
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, Lisbon, 1600-096, Portugal.
| | - Élvio Jesus
- Center for Interdisciplinary Research in Health, Instituto Ciências da Saúde, Universidade Católica Portuguesa, Rua de Diogo Botelho, Porto, 1327, 4169-005, Portugal
| | - Sofia Almeida
- Center for Interdisciplinary Research in Health, Instituto Ciências da Saúde, Universidade Católica Portuguesa, Rua de Diogo Botelho, Porto, 1327, 4169-005, Portugal
| | - Beatriz Araújo
- Center for Interdisciplinary Research in Health, Instituto Ciências da Saúde, Universidade Católica Portuguesa, Rua de Diogo Botelho, Porto, 1327, 4169-005, Portugal
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Ockerby C, Wood O, Le CO, Redley B, Yuen E, Thornton R, Hutchinson AM. Exploring the relationship between compassion, the practice environment, and quality of care as perceived by paediatric nurses. J Pediatr Nurs 2023; 73:e549-e555. [PMID: 37923614 DOI: 10.1016/j.pedn.2023.10.032] [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] [Received: 05/03/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To (1) explore associations between paediatric nurses' perceptions of their own compassion, the practice environment, and quality of care, and (2) identify factors that influence perceived quality of care. DESIGN AND METHODS Cross-sectional survey of paediatric nurses (n = 113) from a hospital network in Melbourne, Australia. The survey included the Compassion Scale, Practice Environment Scale of the Nurse Work Index (PES-NWI), a single quality of care item, and demographic items. Hierarchical regression was used to explore factors that predicted perceived care quality. RESULTS There were moderate positive correlations between perceived care quality and both compassion (rho = 0.36, p < .001) and practice environment (i.e., total PES-NWI: rho = 0.45, p < .001). There were significant differences in perceived care quality based on nurses' work area (i.e., critical care vs medical/surgical wards). The final hierarchical regression analysis included compassion (Step 2) and four of five PES-NWI subscales (Step 3), controlling for work area (Step 1). The model was statistically significant and explained 44% of variance in perceived quality; compassion and PES-NWI subscale 2 (Nursing foundations for quality of care) were statistically significant predictors. CONCLUSIONS Paediatric nurses' perceptions of quality were influenced by their own compassion for others and elements of the practice environment, particularly nursing foundations for care quality, which is characterised by a clear nursing philosophy and model of care, with programs and processes to support practice. PRACTICE IMPLICATIONS The findings offer insights into potentially modifiable individual and workplace factors that contribute to paediatric nurses' perceptions of care quality.
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Affiliation(s)
- Cherene Ockerby
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Olivia Wood
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Celine Oanh Le
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Eva Yuen
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Rebecca Thornton
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
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Curtis K, Fry M, Shaban RZ, Wolf L, Delao A, Kolbuk ME, Kennedy B, Considine J. Emergency nurses' perceptions of the utility, adaptability and feasibility of the emergency nursing framework HIRAID TM for practice change in US: An exploratory study. Int Emerg Nurs 2023; 71:101377. [PMID: 37972519 DOI: 10.1016/j.ienj.2023.101377] [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] [Received: 06/12/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAIDTM, an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAIDTM resulted in significant improvements to nurse-led communication and reduced adverse patient events. OBJECTIVES First, to explore United States (US) emergency nurses' perceptions of the evidence-informed emergency nursing framework, HIRAIDTM; second, to determine factors that would influence the feasibility and adaptability of HIRAIDTM into nursing clinical practice in EDs within the US. METHODS A cross-sectional cohort study using a survey method with a convenience sample was conducted. A 4-hour workshop introduced the HIRAIDTM framework and supporting evidence at the Emergency Nurses Association's (ENA) conference, Emergency Nursing 2022. Surveys were tested for face validity and collected information on nurse-nurse communication, self-efficacy, the practice environment and feedback on the HIRAIDTM framework. RESULTS The workshop was attended by 48 emergency nurses from 17 US States and four countries. Most respondents reported that all emergency nurses should use the same standardised approach in the assessment of patients. However, the greatest barriers to change were a lack of staff and support from management. The most likely interventions reported to enable change were face-to-face education, the opportunity to ask questions and support in the clinical environment. CONCLUSION HIRAIDTM is an acceptable and suitable emergency nursing framework for consideration in the US. Successful uptake will depend on training methods and organizational support. HIRAIDTM training should incorporate face-to-face interactive workshops.
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Affiliation(s)
- Kate Curtis
- Emergency and Trauma Nursing RC Mills Building, Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia.
| | - Margaret Fry
- Emergency and Critical Care, Conjoint Clinical Chair, Northern Sydney Local Health District, Australia; University of Technology Sydney Faculty of Health School of Nursing and Midwifery, PO Box 123 Broadway, NSW 2007, Australia.
| | - Ramon Z Shaban
- Communicable Diseases Control and Infection Prevention, Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Communicable Diseases Control, Public Health Unit, Centre for Population Health. Director and Chief Infection Control Practitioner Western Sydney LHD, Building 68, 5 Fleet Street, North Parramatta, NSW 2151, Australia; New South Wales Biocontainment Centre, Australia.
| | - Lisa Wolf
- Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL, USA; Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA, USA.
| | - Altair Delao
- Research, Emergency Nurses Association, 930 Woodfield Rd., Schaumburg, IL 60173, USA.
| | - Monica Escalante Kolbuk
- Novice Nurse Education Programs, Emergency Nurses Association, 930 E. Woodfield Road, Schaumburg, IL 60173, USA.
| | - Belinda Kennedy
- The University of Sydney, Rm 169, RC Mills, Camperdown, NSW 2006, Australia.
| | - Julie Considine
- Chair in Nursing (Eastern Health), Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia.
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Simonetti M, Aiken LH, Lake ET. Association between the nurse work environment and patient experience in Chilean hospitals: A multi-hospital cross-sectional study. J Nurs Scholarsh 2023; 55:1248-1257. [PMID: 36991497 DOI: 10.1111/jnu.12898] [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] [Received: 07/08/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION International evidence shows that nurses' work environments affect patient outcomes, including their care experiences. In Chile, several factors negatively affect the work environment, but they have not been addressed in prior research. The aim of this study was to measure the quality of the nurse work environment in Chilean hospitals and its association with patient experience. DESIGN A cross-sectional study of 40 adult general high-complexity hospitals across Chile. METHODS Participants included bedside nurses (n = 1632) and patients (n = 2017) in medical or surgical wards, who responded to a survey. The work environment was measured through the Practice Environment Scale of the Nursing Work Index. Hospitals were categorized as having a good or poor work environment. A set of patient experience outcomes were measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Adjusted logistic regression models were used to test associations between the environment and patient experiences. RESULTS For all outcomes, the percentage of patients satisfied was higher in hospitals with good as compared to poor work environments. In good environment hospitals patients had significantly higher odds of being satisfied with communication with nurses (OR 1.46, 95% CI: 1.10-1.94, p = 0.010), with pain control (OR 1.52, 95% CI: 1.14-2.02, p = 0.004), and with nurses' timely responses in helping them to go to the bathroom (OR 2.17, 95% CI: 1.49-3.16, p < 0.0001). CONCLUSIONS Hospitals with good environments outperform hospitals with poor environments in most patient care experience indicators. Efforts to improve nurses' work environment hold promise for improving patient experiences in Chilean hospitals. CLINICAL RELEVANCE Hospital administrators and nurse managers should value, especially in the context of financial constraints and understaffing, the implementation of strategies to improve the quality of nurses´ work environments so that they can provide patients with a better care experience.
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Affiliation(s)
- Marta Simonetti
- Universidad de los Andes, Chile, Escuela de Enfermería, Santiago, Chile
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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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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18
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Lake ET, Rosenbaum KEF, Sauveur C, Buren C, Cho P. Translations of the Practice Environment Scale of the Nursing Work Index: A systematic review. Nurs Health Sci 2023; 25:365-380. [PMID: 37464947 PMCID: PMC10528485 DOI: 10.1111/nhs.13034] [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: 12/24/2022] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023]
Abstract
Since 2002, the Practice Environment Scale of the Nursing Work Index has been used worldwide to evaluate nurse work environments. High quality translations in different languages can help advance science and inform practice globally. The study purposes were to conduct a systematic review of published translations of the instrument and to assess their linguistic equivalence and psychometric performance. We conducted a comprehensive search, a quality assessment and synthesis of linguistic equivalence, reliability, and validity data. Studies published through July 2021 were identified in the CINAHL, LILACS, EMCare, and Scopus databases. Thirty-eight publications were selected, comprising 46 translations into 24 languages and 15 language variants, and 35 countries. Translations are in predominantly European, Southeast Asian, and Middle Eastern languages. Two-thirds of the translations reflected medium to high fulfillment of translation quality criteria. The GRADE ratings, reflecting satisfactory fulfillment of cross-cultural equivalence and psychometric properties, were predominantly high (n = 23), then low (n = 15), then moderate (n = 8). The identified translations will support the advancement of global science and the improvement of nurses' work environments.
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Affiliation(s)
- Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | | | - Christina Sauveur
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Catherine Buren
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Priscilla Cho
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Al-Moteri M, Alzahrani AA, Althobiti ES, Plummer V, Sahrah AZ, Alkhaldi MJ, Rajab EF, Alsalmi AR, Abdullah ME, Abduelazeez AEA, Caslangen MZM, Ismail MG, Alqurashi TA. The Road to Developing Standard Time for Efficient Nursing Care: A Time and Motion Analysis. Healthcare (Basel) 2023; 11:2216. [PMID: 37570456 PMCID: PMC10418769 DOI: 10.3390/healthcare11152216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The amount of time nurses spend with their patients is essential to improving the quality of patient care. Studies have shown that nurses spend a considerable amount of time on a variety of activities--which are often not taken into account while estimating nurse-to-patient care time allocation--that could potentially be eliminated, combined or delegated with greater productivity. The current study aimed to calculate standard time for each activity category by quantifying the amount of time required by nurses to complete an activity category and determine the adjustment time that can be given during work, as well as determine factors that can be altered to improve the efficiency of nursing care on inpatient general wards of a governmental hospital. (2) Method: A time and motion study was conducted over two weeks using 1-to-1 continuous observations of nurses as they performed their duties on inpatient general wards, while observers recorded each single activity, and specifically the time and movements required to complete those activities. (3) Result: There was 5100 min of observations over 10 working days. Nurses spent 69% (330 min) of time during their 8 h morning shift on direct patient care, (19.4%) ward/room activities (18%), documentation (14%), indirect patient care (12%) and professional communication (5%). Around 94 min of activities seem to be wasted and can be potentially detrimental to nurses' overall productivity and threaten patient care quality. The standard number of hours that represents the best estimate of a general ward nurse regarding the optimal speed at which the staff nurse can provide care related activities was computed and proposed. (4) Conclusions: The findings obtained from time-motion studies can help in developing more efficient and productive nursing work for more optimal care of patients.
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Affiliation(s)
- Modi Al-Moteri
- Nursing Department, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Amer A. Alzahrani
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Ensherah Saeed Althobiti
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Virginia Plummer
- Institute of Health and Wellbeing, Federation University, Berwick, VIC 3806, Australia;
| | - Afnan Z. Sahrah
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Maha Jabar Alkhaldi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Eishah Fahad Rajab
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Amani R. Alsalmi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Merhamah E. Abdullah
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | | | - Mari-zel M. Caslangen
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Mariam G. Ismail
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
| | - Talal Awadh Alqurashi
- King Abdulaziz Specialist Hospital, Ministry of Health, Taif 21944, Saudi Arabia; (A.A.A.); (E.S.A.); (E.F.R.); (M.E.A.); (T.A.A.)
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Agostinho P, Potra T, Lucas P, Gaspar F. The Nursing Practice Environment and Patients' Satisfaction with Nursing Care in a Hospital Context. Healthcare (Basel) 2023; 11:1850. [PMID: 37444684 DOI: 10.3390/healthcare11131850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Nursing, being a profession in health, aims to improve the quality of the response to patients' demands, which have repercussions on the attitudes, behaviors and performance of nurses. BACKGROUND The aim of the study was to evaluate the relationships among the nursing practice environment, nurse-patient interactions and patients' satisfaction with nursing care in a hospital context. METHODS The study applied a descriptive analysis. Based on the initial exploration of the data, we decided to perform a simple linear regression of the dimensions of the scales. RESULTS The latent variables and interactions between the different dimensions of the three constructs (the nursing practice environment (PES-NWI), nurse-patient interactions (NPIS-22-PT) and patients' satisfaction in the hospital context (SAPSNC-18)) were submitted to confirmatory analysis. The model was statistically significant, with a good fit with the data (χ2/gl = 128.6/41 (0.000); GFI = 0.900; AGFI = 0.831; TLI = 0.910; CFI = 0.907; RMSEA = 0.102). CONCLUSIONS The study showed favorable rates of overall satisfaction on the part of patients, such as the nurses' skills in dealing with their illness/health situation, ability to solve problems in a timely manner, responsiveness to patients' needs and technical competence.
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Affiliation(s)
- Paula Agostinho
- Unidade Local de Saúde de Castelo Branco, 6000-085 Castelo Branco, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Teresa Potra
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Pedro Lucas
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Filomena Gaspar
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
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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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22
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Skela-Savič B, Sermeus W, Dello S, Squires A, Bahun M, Lobe B. How nurses' job characteristics affect their self-assessed work environment in hospitals- Slovenian use of the practice environment scale of the nursing work index. BMC Nurs 2023; 22:100. [PMID: 37024874 PMCID: PMC10077322 DOI: 10.1186/s12912-023-01261-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Nurses' work environment influences nursing practice. Inappropriate working conditions are the result of underdeveloped workplace infrastructure, poor work organisation, inadequate education, and inappropriate staffing norms. The aim of this study was to describe and examine the predictors that affect nurses' work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI). METHODS The validation of the PES-NWI was made. Nurse-reported job characteristics were used as independent variables. The sample included 1,010 nurses from adult surgical and medical units at 10 Slovenian hospitals. The Nurse Forecasting (RN4CAST) protocol was used. Permission to conduct the study was obtained from the National Medical Ethics Committee. RESULTS The PES-NWI mean (2.64) was low, as were job and career satisfaction at 2.96 and 2.89, respectively. The PES-NWI can be explained in 48% with 'Opportunities for advancement', 'Educational opportunities', 'Satisfaction with current job', 'Professional status', 'Study leave', and 'Level of education'. A three-factor solution of PES-NWI yielded eight distinct variables. CONCLUSIONS The obtained average on the Nursing Work Index was one of the lowest among previously conducted surveys. Nurses should be recognized as equals in the healthcare workforce who need to be empowered to develop the profession and have career development opportunities. Inter-professional relations and equal involvement of nurses in hospital affairs are also very important. TRIAL REGISTRATION This is a non-intervention study - retrospectively registered.
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Affiliation(s)
- Brigita Skela-Savič
- Angela Boškin Faculty of Health Care, Spodnji Plavž 3, Jesenice, 4270, Slovenia.
| | - Walter Sermeus
- Leuven Institute for Healthcare Policy, Department of Public Health & Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 35/4, Leuven, 3000, Belgium
| | - Simon Dello
- Leuven Institute for Healthcare Policy, Department of Public Health & Primary Care, Katholieke Universiteit Leuven, Kapucijnenvoer 35/4, Leuven, 3000, Belgium
| | - Allison Squires
- Dept. of General Internal Medicine, Grossman School of Medicine, Meyers College of Nursing, New York University, New York, USA
| | - Mateja Bahun
- Angela Boškin Faculty of Health Care, Spodnji Plavž 3, Jesenice, 4270, Slovenia
| | - Bojana Lobe
- Faculty of Social Sciences, University of Ljubljana, Kardeljeva ploščad 5, Ljubljana, 1000, Slovenia
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Another Piece of the Practice Environment Puzzle: Development and Validation of a Team Virtuousness Instrument. Nurs Adm Q 2023; 47:150-160. [PMID: 36862567 DOI: 10.1097/naq.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The Practice Environment Scale of the Nursing Work Index, a widely used practice environment instrument, does not measure vital coworker interrelations. Team virtuousness measures coworker interrelations, yet the literature lacks a comprehensive instrument built from a theoretical foundation that captures the structure. This study sought to develop a comprehensive measure of team virtuousness built from Aquinas' Virtue Ethics Theory that captures the underlying structure. Subjects included nursing unit staff and master of business administration (MBA) students. A total of 114 items were generated and administered to MBA students. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were run on randomly split halves. Based on analyses, 33 items were subsequently administered to nursing unit staff. EFA and CFA were repeated on randomly split halves; CFA item loadings replicated EFA. Three components emerged from the MBA student data: integrity, α = .96; group benevolence, α = .70; and excellence, α = .91. Two components emerged from the nursing unit data: wisdom, α = .97; and excellence, α = .94. Team virtuousness varied significantly among units and correlated significantly with engagement. The two component instrument, named the Perceived Trustworthiness Indicator, is a comprehensive measure of team virtuousness built from a theoretical framework that captures the underlying structure, demonstrates adequate reliability and validity, and measures coworker interrelations on nursing units. Forgiveness and relational and inner harmony emerged as elements of team virtuousness, broadening understanding.
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Rodwell J, Hendry T, Johnson D. Analyzing and Validating a Structure for Measuring the Nurse Practice Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5266. [PMID: 37047883 PMCID: PMC10094027 DOI: 10.3390/ijerph20075266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Nurse shortages pose a challenge in many countries and retaining existing nursing staff is crucial to addressing these shortages. To inform possible interventions aimed at retaining nurses, managers need a comprehensive understanding of the nature of the nurse practice environment. The scales from two of the main instruments used to assess nurses' practice environments are tested. A survey of an online panel obtained responses from 459 Australian nurses. Analyses determined a combination of items with good construct validity and improved predictive utility for outcomes of interest for individual nurses. By essentially combining the best items from each instrument, a more comprehensive representation of the nurse work environment is obtained with improved predictive utility. The resulting combined set of scales is recommended for analyses of the nurse working environment and uses a combined set of scales from each of the two source instruments, namely: nurse participation in hospital affairs, recognition, nursing process, peer work standards, nursing competence, orientation, managers, resources, nurse-physician collaboration, and positive scheduling climate. Future research can then build on that strong set of items with a validated structure and predictive utility to inform management and interventions.
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Affiliation(s)
- John Rodwell
- Department of Management and Marketing, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Thomas Hendry
- Department of Management and Marketing, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Dianne Johnson
- Griffith Business School, Griffith University, Brisbane, QLD 4111, Australia
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Yang Y, Hatanaka K, Takahashi K, Shimizu Y. Working Conditions Among Chinese Nurses Employed in Japan: A Cross-Sectional Survey-Based Study. SAGE Open Nurs 2023; 9:23779608231169382. [PMID: 37101830 PMCID: PMC10123888 DOI: 10.1177/23779608231169382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/22/2023] [Accepted: 03/24/2023] [Indexed: 04/28/2023] Open
Abstract
Introduction Although the number of Chinese nurses employed in Japan is increasing, the situation regarding their work conditions has not been clarified. It is necessary to understand such conditions to consider support for Chinese nurses in Japan. Objective This study examined the professional nursing practice environment, occupational career, and work engagement of Chinese nurses in Japan. Methods Using a cross-sectional study design, 640 paper questionnaires were mailed to 58 Japanese hospitals that employed Chinese nurses and included a QR code for online responses. A survey request form and URL were sent to the Wechat app, where Chinese nurses in Japan communicate. The contents include attribute-related questions, the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Career Scale, and Utrecht Work Engagement Scale. Either Wilcoxon's rank-sum or the Kruskal-Wallis test was performed to compare scores of the study variables between subgroups. Results A total of 199 valid responses were obtained, of which 92.5% were female, and 69.3% had a university degree or higher. The PES-NWI score was 2.74, and the work engagement score was 3.10. The group with a university degree or higher had significantly lower scores on PES-NWI and work engagement than those with diplomas. Regarding the subscale of occupational career, scores of forming and coordinating interpersonal relationships, self-development, and accumulating a variety of experience were 3.80, 2.58, and 2.71, respectively. The scores were significantly higher with more than 6 years of nursing experience in Japan than those with 0-3 years or 3-6 years. Conclusion Most participants had university degrees or higher, and their scores of PES-NWI and work engagement tended to be lower than those with diploma degrees. Participants showed low self-ratings in self-development and lacked a variety of experience. Understanding Chinese nurses' work conditions in Japan enables hospital administrators to develop measures for continuing education and support.
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Affiliation(s)
- Yuchun Yang
- Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Yuchun Yang, Division of Health Science, Osaka University Graduate School of Medicine,1-7 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Kaori Hatanaka
- Department of Nursing, Baika Women's University, Ibaraki, Osaka, Japan
| | - Kei Takahashi
- Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasuko Shimizu
- Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Smith S, Lapkin S, Halcomb E, Sim J. Job satisfaction among small rural hospital nurses: A cross-sectional study. J Nurs Scholarsh 2023; 55:378-387. [PMID: 36065145 PMCID: PMC10087136 DOI: 10.1111/jnu.12800] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 06/05/2022] [Accepted: 06/17/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To explore the relationships between job satisfaction, community satisfaction, practice environment, burnout, and intention to leave of nurses working in Australian small rural hospitals. DESIGN A national cross-sectional survey of 383 nurses from Australian rural public hospitals of less than 99 beds during 2018. METHODS Job satisfaction was measured on a four-point Likert scale. Factors associated with community satisfaction, practice environment, burnout and intention to leave were analyzed using multiple linear regression to explore the predictors of job satisfaction. FINDINGS Overall job satisfaction was positive, with most nurses moderately (n = 146, 38.1%) or very satisfied (n = 107, 27.9%) with their current job. Emotional exhaustion, nurse manager ability, leadership and support of nurses were the most significant predictors of job satisfaction. CONCLUSION This study provides new insight into the factors impacting the job satisfaction of nurses working in rural hospitals. The knowledge gained is important to inform strategies to retain nurses in rural areas and, in turn, ensure rural communities have access to quality health care. CLINICAL RELEVANCE The impact of nurses' job satisfaction on burnout, patient safety, and intention to leave is well recognized; however, there is limited understanding of job satisfaction in a rural hospital context. This study provides an understanding of the factors that impact job satisfaction of nurses working in small rural hospitals and highlights the importance of improving the practice environment to reduce the high attrition rates of this workforce.
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Affiliation(s)
- Sarah Smith
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Samuel Lapkin
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,School of Nursing & Midwifery, University of Newcastle, Newcastle, NSW, Australia
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Association of burnout and intention-to-leave the profession with work environment: A nationwide cross-sectional study among Belgian intensive care nurses after two years of pandemic. Int J Nurs Stud 2023; 137:104385. [PMID: 36423423 PMCID: PMC9640385 DOI: 10.1016/j.ijnurstu.2022.104385] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Intensive care unit (ICU) nurses are at an increased risk of burnout and may have an intention-to-leave their jobs. The COVID-19 pandemic may increase this risk. OBJECTIVE The objective of this study was to describe the prevalence of burnout risk and intention-to-leave the job and nursing profession among ICU nurses and to analyse the relationships between these variables and the work environment after two years of the COVID-19 pandemic. DESIGN A national cross-sectional survey of all nurses working in Belgian ICUs was conducted between December 2021 and January 2022 during the 4th and 5th waves of the COVID-19 pandemic in Belgium. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to measure the work environment, intention-to-leave the hospital and/or the profession was assessed. The risk of burnout was assessed using the Maslach Burnout Inventory scale including emotional exhaustion, depersonalisation, and reduced personal accomplishment. SETTING Nurses in 78 out of 123 Belgian hospital sites with an ICU participated in the survey. PARTICIPANTS 2321 out of 4851 nurses (47.8%) completed the entire online survey. RESULTS The median overall risk of burnout per hospital site (high risk in all three subdimensions) was 17.6% [P25: 10.0 - P75: 28.8] and the median proportion of nurses with a high risk in at least one subdimension of burnout in Belgian ICUs was 71.6% [56.7-82.7]. A median of 42.9% [32.1-57.1] of ICU nurses stated that they intended-to-leave the job and 23.8% [15.4-36.8] stated an intent-to-leave the profession. The median overall score of agreement with the presence of positive aspects in the work environment was 49.0% [44.8-55.8]. Overall, nurses working in the top 25% of best-performing hospital sites with regard to work environment had a statistically significant lower risk of burnout and intention-to-leave the job and profession compared to those in the lowest performing 25% of hospital sites. Patient-to-nurse ratio in the worst performing quartile was associated with a higher risk for emotional exhaustion (OR = 1.53, 95% CI:1.04-2.26) and depersonalisation (OR = 1.48, 95% CI:1.03-2.13) and intention-to-leave the job (OR = 1.46, 95% CI:1.03-2.05). CONCLUSIONS In this study, a high prevalence of burnout risk and intention-to-leave the job and nursing profession was observed after two years of the COVID-19 pandemic. Nevertheless, there was substantial variation across hospital sites which was associated with the quality of the work environment. TWEETABLE ABSTRACT "Burnout & intention to leave was high for Belgian ICU nurses after 2 years of COVID, but wellbeing was better with high quality work environments and more favourable patient to nurse ratios".
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Measures of Nursing Environment Multidimensionality and Patient Centricity Using Importance-Performance Map Analysis. NURSE MEDIA JOURNAL OF NURSING 2022. [DOI: 10.14710/nmjn.v12i3.47508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: The nursing environment has become a consideration for an organization in improving service quality, especially in the implementation of patient-centred care. The various dimensions make it necessary to know which sectors need to be prioritized. However, there is still limited research that is more specific in linking the dimensions to become more operational. Purpose: This study aimed to analyze the relationship between nursing environment dimensions and patient centricity through the Importance-Performance Map Analysis (IPMA).Methods: A quantitative survey with a cross-sectional approach was conducted in June 2022 to test the conceptual framework on the population obtained from non-managerial inpatient nurses who worked for above two years in a general hospital in East Java, Indonesia. The constructs were measured using a set of indicators in The Practice Environment Scale of the Nursing Work Index (PES-NWI) and Patient Centricity. During the data collection, a total sampling technique was performed, resulting in 89 respondents being acquired. The data were analyzed through partial least squared structural equation modelling (PLS-SEM).Results: At the construct level, the mean total effect and performance were 0.192 and 56.302, respectively. From the IPMA chart, it was found that the construct in the right lower quadrant with the largest total effect value but not having adequate performance was nursing manager ability (total effect: 0.294, performance: 34.563), making it a construct with the highest importance and requiring priority for improvement among all dimensions.Conclusion: The nursing environment dimensions have to get attention to achieve patient centricity in inpatient ward nurses, where nursing manager ability is the dimension that has the most vulnerable performance. Leadership development is needed for the head nurse of the inpatient unit to strengthen the ability to lead and change the culture in nurturing subordinates so that kinship between nursing professionals can be established.
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Zárate-Grajales RA, Benítez-Chavira LA, Hernández-Corral S, Serván-Mori E, Nigenda G, Amaya-Aguilar JA, Interial-Gúzman MG, Fabián-Victoriano R, López-Cruz EA, Ortíz-López G, Moreno-Monsiváis MG. Nursing practice environment and missed care at highly specialised hospitals in Mexico: A cross-sectional observational study. Int J Health Plann Manage 2022; 38:628-642. [PMID: 36540043 DOI: 10.1002/hpm.3606] [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: 08/14/2022] [Revised: 11/26/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The influence of the work environment on missed care and service quality has been well documented. However, available evidence concerning this relationship comes mostly from developed countries. Few studies have been conducted in low- or middle-income countries. We assessed the relationship between the work environment and missed nursing care in highly specialised hospitals in Mexico. METHODS We conducted an observational cross-sectional study with data collected from January 2019 to February 2020 in 11 highly specialised hospitals (n = 510 nurses). We estimated missed nursing care utilising the MISSCARE questionnaire and used the Practice Environment Scale-Nursing Work Index instrument to assess the work environment. After describing the main attributes of the study sample according to the type of work environment, we constructed five adjusted fractional regression models, the first concerning the overall index of missed care, and the others pertaining to its various dimensions. RESULTS The sample analysed was balanced as regards adjustment variables according to the type of work environment. The adjusted estimates confirmed an inverse relationship between the missed care index and enjoying an enhanced, or favourable, work environment. Overall, the difference was 9 percentage points (pp); however, by dimension of missed care, the major differences between enhanced and attenuated, or unfavourable, work environments were registered for basic care, followed by patient education and discharge planning (4pp) and individual needs (8pp). CONCLUSIONS The work environment determines the frequency of missed nursing care, both overall and by dimension. Nursing managers need to create short- and mid-term strategies favouring positive work environments in order to improve working conditions for nursing professionals.
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Affiliation(s)
- Rosa A Zárate-Grajales
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Luis A Benítez-Chavira
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Sandra Hernández-Corral
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico.,National Institute of Rehabilitation, Mexico City, Mexico
| | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
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Pogue CA, Li P, Swiger P, Gillespie G, Ivankova N, Patrician PA. Associations among the nursing work environment, nurse-reported workplace bullying, and patient outcomes. Nurs Forum 2022; 57:1059-1068. [PMID: 35908259 PMCID: PMC9771862 DOI: 10.1111/nuf.12781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/15/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bullying may undermine patient safety in healthcare organizations threatening quality improvement and patient outcomes. PURPOSE To explore the associations between the nursing work environment, nurse-reported workplace bullying, and patient outcomes. METHOD Cross-sectional analysis of nurse survey data (N = 943). The Practice Environment Scale of the nursing work index was used to measure the work environment, nurse-reported bullying was measured with the short negative acts questionnaire, and single items measured care quality and patient safety grade. Random effects logistic regressions were used to determine associations controlling for individual, employment, and organizational factors. FINDINGS Fourty percent of nurses reported experiencing bullying. A higher work environment composite score was significantly associated with a lower risk of bullying (OR = 0.16 [0.12, 0.22], p < .0001). Nurses experiencing bullying were less likely to report good/excellent quality of care (OR = 0.28 [0.18, 0.44], p < .0001) or a favorable patient safety grade (OR = 0.36 [0.25, 0.51], p < .0001). DISCUSSION The nursing work environment influences the presence of bullying, which can negatively impact patient outcomes. Improving nurse work environments is one mechanism to better address nurse bullying.
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Affiliation(s)
- Colleen A. Pogue
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Peng Li
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Pauline Swiger
- Center for Nursing Science & Clinical Inquiry, Manson, Washington, USA
| | - Gordon Gillespie
- University of Cincinnati College of Nursing, Cincinnati, Ohio, USA
| | - Nataliya Ivankova
- University of Alabama at Birmingham School of Health Professions, Birmingham, Alabama, USA
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Walia I, Krainovich-Miller B, Djukic M. Nurses' Lived Experience With Nurse-Physician Collaboration. J Contin Educ Nurs 2022; 53:397-403. [PMID: 36041203 DOI: 10.3928/00220124-20220805-05] [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: 11/20/2022]
Abstract
Background Quality patient care requires collaboration among health professionals. In 2016, 250,000 U.S. citizens died from preventable medical errors. One individual does not cause such errors. Researchers cite a lack of nurse-physician collaboration (NPC) as a contributing factor. Method Streubert's phenomenological design guided this study. A rigorous analysis of eight nurse interviews was conducted and reached data saturation. Results A developed formalized "exhaustive description" of nurses' lived experiences with NPC was validated by all nurse participants. One new finding was that nurses had difficulty initiating NPC for their patients early in their career and this remained an issue at times. Conclusion This is the first U.S. qualitative study in which nurses described their positive and negative experiences with NPC and their desire to improve NPC for enhanced patient outcomes. Implications for nurse educator specialists, hospital administrators, and researchers were derived. [J Contin Educ Nurs. 2022;53(9):397-403.].
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Heistad A, Goldsworthy S, Reilly S, Perez G. How do intensive work environments affect nurses' absenteeism and turnover intent? Appl Nurs Res 2022; 66:151608. [DOI: 10.1016/j.apnr.2022.151608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/07/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022]
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A Conceptual Model of Nurses' Turnover Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138205. [PMID: 35805865 PMCID: PMC9266265 DOI: 10.3390/ijerph19138205] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 01/09/2023]
Abstract
The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses' turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.
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Kassahun CW, Abate AT, Tezera ZB, Beshah DT, Agegnehu CD, Getnet MA, Abate HK, Yazew BG, Alemu MT. Working environment of nurses in public referral hospitals of West Amhara, Ethiopia, 2021. BMC Nurs 2022; 21:167. [PMID: 35751081 PMCID: PMC9229886 DOI: 10.1186/s12912-022-00944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 06/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background Healthy working environment for nurses is a foundation for promoting patients’ and nurses’ safety in hospitals. However, in Ethiopia, there is scarcity of data on this issue. Therefore, the objective of this study was to assess the working environment of nurses in Public Referral Hospitals in Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. Methods An institution based cross-sectional study was conducted among 423 nurses from January to February 2021. Systematic random sampling was used to select nurses from each hospital. Structured, self-administered questionnaires were used to collect the data. EPI- DATA and SPSS were used for data entry and analysis respectively. Frequency, percentages, and means were calculated. Practice Environment Scale of the Nursing Work Index tool was used to measure the outcome variable. Binary and multivariable logistic regression analyses were computed to identify associated factors. Finally, texts, tables and graphs were used to report findings. Results The response rate for the study was 96.2%. Around 210 (51.6%) of the study participants were male. One hundred eighty eight (46.2%) nurses reported that their working environment was healthy, while 219 (53.8%,) reported it as not healthy. Nurses who were working in pediatrics wards (AOR = 0.13, 0.02, 0.1) and nurses who gave care for 7–12 patients per day (AOR = 0.21, 0.05, 0.98) were less likely to have a healthy working environment, respectively. Nurses who reported the Ministry of Health to give focus to the nursing profession were 73% more likely to have a healthy work environment (AOR = 0.27; 0.09, .82). Conclusion and recommendations. More than half of nurses reported that their working environment was not healthy to appropriate practice. Hence, introducing systems to improve participation of nurses in hospital affairs and patient care is essential. It is also important to give attention to nurses who are working at pediatrics wards, and for nurses who give care more than the standards.
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Affiliation(s)
- Chanyalew Worku Kassahun
- Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Addisu Taye Abate
- Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewdu Baye Tezera
- Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Debrework Tesgera Beshah
- Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chilot Desta Agegnehu
- Community Nursing Unit, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Adem Getnet
- Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailemichael Kindie Abate
- Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Mahlet Temesgen Alemu
- Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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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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Harolds JA, Miller LB. Quality and Safety in Health Care, Part LXXX: The National Database for Nursing Quality Indicators and the Practice Environment Scale of the Nursing Work Index. Clin Nucl Med 2022; 47:e472-e474. [PMID: 33031231 DOI: 10.1097/rlu.0000000000003275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The National Database for Nursing Quality Indicators is an important source of information used to benchmark nursing by unit category in multiple areas related to not only structure and process but also outcome. It also provides some information regarding best practices and the cost to achieve certain results. The Practice Environment Scale of the Nursing Work Index is a frequently used way to measure the professional practice environment of nurses and the relationship of the latter to quality, safety, and other outcomes.
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Affiliation(s)
- Jay A Harolds
- From the Advanced Radiology Services and the Division of Radiology and Biomedical Imaging, College of Human Medicine, Michigan State University, Grand Rapids, MI
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Warshawsky NE, Cramer E, Grandfield EM, Schlotzhauer AE. The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals. J Nurs Manag 2022; 30:1981-1989. [PMID: 35474621 DOI: 10.1111/jonm.13649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 11/27/2022]
Abstract
AIMS Identify and examine drivers of nurse manager competency and high-quality practice environments. BACKGROUND Nurse managers are a key predictor of positive professional practice environments which are, in turn, associated with nurse, patient, and organizational outcomes. However, little work has examined the factors that contribute to nurse manager competency. METHODS Nurse managers completed online surveys which were matched to unit-level aggregate data of their subordinate direct care nurses' responses on the National Database of Nursing Quality Indicators. This resulted in a final sample of 541 nurse managers across 47 U.S. hospitals. Multilevel path analysis was utilized to assess a model of the antecedents and consequences of nurse manager competency. RESULTS Nurse manager competency and practice environments were predictive of missed nursing care and nurse-reported quality of care. Nurse manager experience was found to have twice the effect on competency as advanced education. CONCLUSIONS Nurse manager competency and its downstream effects are achieved through nurse manager experience and advanced education. IMPLICATIONS FOR NURSING MANAGEMENT Nurse manager competency yields better practice environments and nursing care. Considering the influence of experience, careful attention should be paid to the competency development process of more novice nurse managers.
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Affiliation(s)
| | - Emily Cramer
- Research Faculty, Health Services and Outcomes Research, Children's Mercy Kansas City.,Associate Professor, School of Medicine, University of Missouri-, Kansas City
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Xiuwen C, Tao Z, Tang Y, Yan X. Status and Associations of Nursing Practice Environments in Intensive Care Units: a cross‐sectional study in China. J Nurs Manag 2022; 30:2897-2905. [PMID: 35403326 DOI: 10.1111/jonm.13616] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Chen Xiuwen
- Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University
| | - Zirong Tao
- Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University
| | - Yinying Tang
- Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University
| | - Xiaochen Yan
- Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University
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Pignatiello GA, Tsivitse E, O’Brien J, Kraus N, Hickman RL. Decision fatigue among clinical nurses during the COVID-19 pandemic. J Clin Nurs 2022; 31:869-877. [PMID: 34291521 PMCID: PMC8447365 DOI: 10.1111/jocn.15939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/05/2021] [Accepted: 05/11/2021] [Indexed: 01/15/2023]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS). BACKGROUND Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID-19 pandemic on psychological well-being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue. DESIGN This study was a secondary analysis of a parent study using a cross-sectional descriptive design. METHODS A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample. RESULTS The EFA yielded a single factor, 9-item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency. CONCLUSIONS This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID-19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision-making among registered nurses. RELEVANCE TO CLINICAL PRACTICE Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision-making among clinical nurses.
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Affiliation(s)
- Grant A. Pignatiello
- Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandOHUSA
| | - Emily Tsivitse
- Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandOHUSA
| | - Julia O’Brien
- Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandOHUSA
| | - Noa Kraus
- Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandOHUSA
| | - Ronald L. Hickman
- Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandOHUSA
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Chang YC, Chang HY, Feng JY. Appraisal and evaluation of the instruments measuring the nursing work environment: A systematic review. J Nurs Manag 2022; 30:670-683. [PMID: 35146825 DOI: 10.1111/jonm.13559] [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: 09/27/2021] [Revised: 12/13/2021] [Accepted: 02/04/2022] [Indexed: 11/28/2022]
Abstract
AIMS To appraise the current instruments available for measurement the nursing work environment and re-examine the definition and construct of the nursing work environment. BACKGROUND A psychometrically sound instrument is fundamental to understanding and improving the nursing work environment. The nursing work environment is a complex construct, and its definition remains inconclusive. None of the instruments available is considered as the gold standard. EVALUATION A comprehensive searching was undertaken in August 2021 in six databases according to PRISMA. The COSMIN and modified GRADE were applied to assess the methodological quality and measurement properties of the instruments. Instruments were categorized into three levels. The definition and construct of nursing work environment were revisited. KEY ISSUES 41 studies (19 instruments) were included. One, fourteen, and four instruments are respectively appraised as A-, B-, and C-level recommendation. Definition and eight labels of nursing work environment are identified. CONCLUSION This paper provides recommendations for selecting a proper instrument for the nursing work environment. IMPLICATIONS FOR NURSING MANAGEMENT This study helps nurse managers to select instruments and understand the construct of the nursing work environment. The eight labels can be used as a reference for tailoring policy aimed at creating a favorable nursing work environment.
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Affiliation(s)
- Yu-Chun Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsin-Yi Chang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Taylor-Clark TM, Swiger PA, Anusiewicz CV, Loan LA, Olds DM, Breckenridge-Sproat ST, Raju D, Patrician PA. Identifying Potentially Preventable Reasons Nurses Intend to Leave a Job. J Nurs Adm 2022; 52:73-80. [PMID: 35025828 PMCID: PMC9008872 DOI: 10.1097/nna.0000000000001106] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to describe the relationships between intent to leave, reasons nurses intend to leave, and the nursing work environment in military hospitals. BACKGROUND Intention to leave is a precursor of nurse turnover. The reasons nurses intend to leave may be influenced by leader interventions and potentially preventable. METHODS This descriptive, correlational secondary analysis included 724 nurse survey responses from 23 US Army hospitals. Bivariate correlations and predictive modeling techniques were used. RESULTS Forty-nine percent of nurses indicated they intended to leave, 44% for potentially preventable reasons. Dissatisfaction with management and the nursing work environment were the top potentially preventable reasons to leave. Nurses who intended to leave for potentially preventable reasons scored aspects of the nursing work environment significantly lower than those intending to leave for nonpreventable reasons. CONCLUSIONS Identifying potentially preventable reasons in conjunction with intent to leave can provide leaders opportunities to intervene and influence turnover intention.
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Affiliation(s)
- Tanekkia M Taylor-Clark
- Author Affiliations: US Army Nurse Corps Officer (Dr Taylor-Clark), Associate Professor and Executive DNP Pathway Director (Dr Loan), and Professor and Rachel Z. Booth Endowed Chair (Dr Patrician), School of Nursing, University of Alabama at Birmingham; Deputy Chief (Dr Swiger), Center for Nursing Science and Clinical Inquiry, US Army, Landstuhl, Germany; Postdoctoral Fellow (Dr Anusiewicz), School of Nursing, University of Pennsylvania, Philadelphia; Research Assistant Professor (Dr Olds), School of Nursing, The University of Kansas; Consultant (Dr Breckenridge-Sproat), US Army Retired, Santa Fe, New Mexico; and Statistician (Dr Raju), Vidence, LLC, Boca Raton, Florida
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Mattos JCDO, Gasparino RC, Cardoso MLAP, Bernardes A, Cunha ICKO, Balsanelli AP. LIDERANÇA COACHING DOS ENFERMEIROS RELACIONADA COM AMBIENTE DA PRÁTICA PROFISSIONAL NA ATENÇÃO PRIMÁRIA À SAÚDE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0332pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: correlacionar autopercepção dos enfermeiros e percepção dos auxiliares de enfermagem sobre liderança coaching dos enfermeiros com o ambiente da prática profissional na Atenção Primária à Saúde. Método: estudo transversal e correlacional com 150 profissionais de enfermagem, sendo: 75 enfermeiros e 75 auxiliares de enfermagem de 13 Unidades Básicas de Saúde localizadas na Zona Sul de São Paulo, SP, Brasil. Foram aplicados Practice Environment Scale - versão brasileira, Questionário de Autopercepção do Enfermeiro no Exercício da Liderança e Questionário de Percepção de Técnicos e Auxiliares de Enfermagem no Exercício da Liderança, no período de janeiro a maio de 2019. Foram utilizados Análise de Variância Univariada e Multivariada, Teste de Correlação de Pearson (p<0,05) e tamanho do efeito de Rosenthal. Resultados: entre os enfermeiros, duas correlações significantes entre os domínios dos instrumentos foram observadas: comunicação e fundamentos de enfermagem voltados para a qualidade do cuidado (r=0,265; p=0,022) e comunicação com relações colegiais entre enfermeiros e médicos (r=0,263; p=0,023). Nos auxiliares de enfermagem, destacam-se comunicação e fundamentos de enfermagem voltados para a qualidade do cuidado (r=0,416) e valor total do Questionário de Percepção de Técnicos e Auxiliares de Enfermagem no Exercício da Liderança e relações colegiais entre médicos e enfermeiros (r=0,409). Conclusão: para os enfermeiros, a comunicação contribuiu para melhor percepção da qualidade do cuidado e boas relações com médicos. Nos auxiliares, todos os domínios da liderança coaching colaboraram para percepções positivas do ambiente. A liderança coaching parece contribuir para que ambientes mais favoráveis à prática profissional sejam estabelecidos na atenção primária à saúde.
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Mattos JCDO, Gasparino RC, Cardoso MLAP, Bernardes A, Cunha ICKO, Balsanelli AP. NURSES’ COACHING LEADERSHIP RELATED TO PRACTICE ENVIRONMENT WITHIN PRIMARY HEALTH CARE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0332en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to correlate the nurses’ self-perception and the perception of nursing aides regarding coaching leadership and the practice environment within Primary Health Care. Method: cross-sectional and correlational study addressing 150 nursing workers: 75 nurses and 75 nursing aides of 13 Basic Health Units located in the south of São Paulo, SP, Brazil. The Brazilian version of the Practice Environment Scale, Questionário de Autopercepção do Enfermeiro no Exercício da Liderança [Questionnaire on Self-Perception of Nurses of Exercise of Leadership], and Questionário de Percepção de Técnicos e Auxiliares de Enfermagem no Exercício da Liderança [Questionnaire on Perception of Nurse Technicians and LPNs of Exercise of Leadership] were applied between January and May 2019. Univariate and Multivariate Analyses, and the Pearson’s Correlation test (p<0.05) were used, besides Rosenthal effect size. Results: two significant correlations were found among the nurses between the instruments’ domains: communication and nursing foundations for quality care (r=0.265; p=0.022) and communication and collegial nurse-physician relationships (r=0.263; p=0.023). The following stand out among the nursing aides: communication and nursing foundations for quality care (r=0.416) and the total score obtained in the Questionnaire on Perception of Nurse Technicians and LPNs of Exercise of Leadership and collegial nurse-physician relationships (r=0.409). Conclusion: for the nurses, communication contributed to a better perception of quality care and good relationships with physicians. For the nursing aides, all the domains of coaching leadership collaborate for environments that favor their practice within PHC.
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Krupp A, Lasater KB, McHugh MD. Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment. AACN Adv Crit Care 2021; 32:381-390. [PMID: 34879139 DOI: 10.4037/aacnacc2021383] [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] [Indexed: 11/01/2022]
Abstract
BACKGROUND Across hospitals, there is wide variation in ICU utilization after surgery. However, it is unknown whether and to what extent the nurse work environment is associated with a patient's odds of admission to an intensive care unit. PURPOSE To estimate the relationship between hospitals' nurse work environment and a patient's likelihood of ICU admission and mortality following surgery. METHODS A cross-sectional study of 269 764 adult surgical patients in 453 hospitals was conducted. Logistic regression models were used to estimate the effects of the work environment on the odds of patients' admission to the intensive care unit and mortality. RESULTS Patients in hospitals with good work environments had 16% lower odds of intensive care unit admission and 15% lower odds of mortality or intensive care unit admission than patients in hospitals with mixed or poor environments. CONCLUSIONS Patients in hospitals with better nurse work environments were less likely to be admitted to an intensive care unit and less likely to die. Hospitals with better nurse work environments may be better equipped to provide postoperative patient care on lower acuity units.
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Affiliation(s)
- Anna Krupp
- Anna Krupp is Assistant Professor, University of Iowa, College of Nursing, 480 CNB, Iowa City, IA 52242
| | - Karen B Lasater
- Karen B. Lasater is Assistant Professor, Center for Health Outcomes and Policy Research, School of Nursing, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew D McHugh
- Matthew D. McHugh is Professor of Nursing, Center for Health Outcomes and Policy Research, School of Nursing, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Lake ET, Roberts KE, Agosto PD, Ely B, Bettencourt A, Schierholz E, Frankenberger W, Catania G, Aiken LH. The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care. J Patient Saf 2021; 17:e1546-e1552. [PMID: 30601233 PMCID: PMC6599539 DOI: 10.1097/pts.0000000000000559] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Eighteen years ago, the Institute of Medicine estimated that medical errors in hospital were a major cause of mortality. Since that time, reducing patient harm and improving the culture of patient safety have been national health care priorities. The study objectives were to describe the current state of patient safety in pediatric acute care settings and to assess whether modifiable features of organizations are associated with better safety culture. METHODS An observational cross-sectional study used 2015-2016 survey data on 177 hospitals in four U.S. states, including pediatric care in general hospitals and freestanding children's hospitals. Pediatric registered nurses providing direct patient care assessed hospital safety and the clinical work environment. Safety was measured by items from the Agency for Healthcare Research and Quality's Culture of Patient Safety survey. Hospital clinical work environment was measured by the National Quality Forum-endorsed Practice Environment Scale. RESULTS A total of 1875 pediatric nurses provided an assessment of safety in their hospitals. Sixty percent of pediatric nurses gave their hospitals less than an excellent grade on patient safety; significant variation across hospitals was observed. In the average hospital, 46% of nurses report that mistakes are held against them and 28% do not feel safe questioning authority regarding unsafe practices. Hospitals with better clinical work environments received better patient safety grades. CONCLUSIONS The culture of patient safety varies across U.S. hospital pediatric settings. In better clinical work environments, nurses report more positive safety culture and higher safety grades.
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Affiliation(s)
- Eileen T. Lake
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | | | - Paula D. Agosto
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beth Ely
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | - Amanda Bettencourt
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | - Elizabeth Schierholz
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
| | | | - Gianluca Catania
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
- University of Genoa, School of Medicine and Pharmaceutical Sciences, Genoa, Italy
| | - Linda H. Aiken
- University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania
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Zárate-Grajales RA, Benítez-Chavira LA, Serván-Mori E, Hernández-Corral S, Cadena-Estrada JC, Nigenda G. Sociodemographic and work environment correlates of missed nursing care at highly specialized hospitals in Mexico: A cross-sectional study. Int J Nurs Stud 2021; 126:104140. [PMID: 34933165 DOI: 10.1016/j.ijnurstu.2021.104140] [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: 01/15/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite its direct relevance to quality of care, little is known about missed nursing care or its sociodemographic and work environment correlates at highly specialized hospitals in low- and middle-income countries. OBJECTIVE To analyze the frequency of missed nursing care among Mexican nursing professionals, and to assess its associated sociodemographic and labor-related predictors. DESIGN AND METHODS A cross-sectional, observational study based on data collected from 315 nursing professionals in 11 highly specialized public hospitals in Mexico. We assessed missed nursing care both as a total figure and according to the four dimensions of the MISSCARE inventory. We estimated its sociodemographic and work-related predictors using fractional logistic analysis. RESULTS The global score for missed nursing care was 15.21%: 7.94% concerned individual needs, 9.37% discharge planning and patient education, 18.10% basic care, and 1.59% care under continuous assessment. The odds of engaging in missed nursing care increased with age and were higher among women and night-shift workers. In contrast, they decreased among nursing professionals who were satisfied with their jobs, and among those working in suitable environments. CONCLUSIONS Missed nursing care in highly specialized public hospitals is associated with the sociodemographic characteristics and labor-related conditions -including the work environments- of the nurses. Given its impact on both health-care users and institutions, further research on the subject is urgently needed. It is essential to improve the design, implementation and evaluation of comprehensive strategies aimed at reducing the frequency of missed nursing care and achieving universal health coverage.
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Affiliation(s)
- Rosa A Zárate-Grajales
- National School of Nursing and Obstetrics (ENEO) of the National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Luis A Benítez-Chavira
- National School of Nursing and Obstetrics (ENEO) of the National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
| | - Edson Serván-Mori
- Center for Health Systems and Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics (ENEO) of the National Autonomous University of Mexico (UNAM), Mexico City, Mexico
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Jarrar M, Al-Bsheish M, Aldhmadi BK, Albaker W, Meri A, Dauwed M, Minai MS. Effect of Practice Environment on Nurse Reported Quality and Patient Safety: The Mediation Role of Person-Centeredness. Healthcare (Basel) 2021; 9:healthcare9111578. [PMID: 34828624 PMCID: PMC8618501 DOI: 10.3390/healthcare9111578] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 patients. Higher workload was associated with unfavorable outcomes. Nurses working in 12-h shifts reported a lower work environment rating (3.46 ± 0.41, p < 0.01) and person-centered care (3.55 ± 0.35, p < 0.01). Nurses assigned to more than 15 patients were less likely to report a favorable practice environment (3.53 ± 0.41, p < 0.05), perceived lower person-centered care (3.61 ± 0.36, p < 0.01), and rated lower patient safety (3.54 ± 0.62, p < 0.05). Person-centeredness mediates the effect of nurse work environment dimensions on quality and patient safety. Medical and surgical nurses, working in a healthy environment, had a high level of person-centeredness, which, in turn, positively affected the reported outcomes. The function of person-centeredness was to complement the effects of the nurse work environment on care outcomes. Improving the nurse work environment (task-oriented) with a high level of person-centeredness (patient-oriented) was a mechanism through which future initiatives could improve nursing care and prevent patient harm.
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Affiliation(s)
- Mu’taman Jarrar
- Vice Deanship for Quality and Development, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Correspondence: or
| | - Mohammad Al-Bsheish
- Healthcare Administration Department, Batterjee Medical College, Jeddah 21442, Saudi Arabia;
| | - Badr K. Aldhmadi
- Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il 81451, Saudi Arabia;
| | - Waleed Albaker
- Department of Internal Medicine/Endocrinology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Ahmed Meri
- Department of Medical Instrumentation Techniques Engineering, Al-Hussain University College, Karbala 56001, Iraq;
| | - Mohammed Dauwed
- Department of Medical Instrumentation Techniques Engineering, Dijlah University College, Baghdad 10022, Iraq;
- Department of Computer Science, College of Science, University of Baghdad, Baghdad 10070, Iraq
| | - Mohd Sobri Minai
- College of Business, Universiti Utara Malaysia, Kedah 06010, Malaysia; or
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Simonetti M, Cerón C, Galiano A, Lake ET, Aiken LH. Hospital work environment, nurse staffing and missed care in Chile: A cross-sectional observational study. J Clin Nurs 2021; 31:2518-2529. [PMID: 34723415 DOI: 10.1111/jocn.16068] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To characterise the problem of missed nursing care in Chilean hospitals and to test associations with hospital organisational variables. BACKGROUND Missed nursing care is a common problem in different countries, but it has not been studied in Chile. DESIGN Multihospital cross-sectional study (Supplementary file 1: STROBE guideline). METHODS Study population of 45 adult high-complexity hospitals and 1853 registered nurses (RN) working on medical-surgical units. Primary data were collected through a nurse survey. Nurses reported, out of a list of nursing care activities, the ones left undone during their last shift. The main independent variables were the work environment, measured through the Practice Environment Scale of the Nursing Work Index, patient-to-nurse ratios and RN skillmix. Adjusted logistic regression analyses were used to test associations, accounting for clustering of nurses working in the same hospital. RESULTS The hospital response rate was 88.9% and, for nurses, 88.1%. The mean patient-to-nurse ratio was 14.5 (range 6-23). The average skillmix was 31% RN. Eighty-six percent of nurses missed at least one activity. The activities most frequently missed included patient education, comforting patients and surveillance. The adjusted model showed a significant association between the work environment, staffing ratios and missed care. The RN skillmix was not associated. CONCLUSIONS Missed care is highly prevalent problem in Chilean hospitals. Clinical activities were the least missed. It is necessary to improve work environments and reduce the number of patients per nurse to improve the safety and quality of care. RELEVANCE FOR CLINICAL PRACTICE The study results are relevant since they provide new data to Chile. Better work environments and adequate human resources are modifiable factors that can be addressed from a managerial perspective, with low-cost strategies to effectively reduce missed care and improve safety and quality.
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Affiliation(s)
- Marta Simonetti
- Universidad de los Andes, Chile, Escuela de Enfermería, Chile
| | - Consuelo Cerón
- Universidad de los Andes, Chile, Escuela de Enfermería, Chile
| | | | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Pennsylvania, USA
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Pennsylvania, USA
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Smith S, Halcomb E, Sim J, Lapkin S. Nurses’ perceptions of the practice environment in small rural hospitals. Collegian 2021. [DOI: 10.1016/j.colegn.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Urashima S, Greiner C, Ryuno H, Yamaguchi Y. Factors affecting the quality of dementia care at acute care hospitals: A cross-sectional study. J Clin Nurs 2021; 31:2198-2207. [PMID: 34490678 DOI: 10.1111/jocn.16036] [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: 03/24/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES The purpose of this study was to investigate which factors are associated with the quality of dementia care in acute care hospitals. BACKGROUND The number of people with dementia who are admitted to acute care hospitals is increasing. Improving the quality of dementia care in acute care hospitals is an important issue. Prior studies have demonstrated that not only knowledge and nursing experience, but also psychological factors and the nursing practice environment are related to high-quality care on general wards. DESIGN Cross-sectional hypothesis-testing design. METHODS Participants were nurses providing care to people with dementia at acute care hospitals. Questionnaires were distributed to 300 acute care hospitals in Japan, 10 copies each and 773 valid responses were received. Based on the hypothesis model, variables were tested using multiple regression analysis. The model described the relationship between quality of care, personal attributes and the nursing practice environment. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. RESULTS Almost 90% of the study sample was female, the mean age was 37.4 ± 9.3 years, and the mean nursing experience was 14.0 ± 8.7 years. The results showed that nursing foundations for quality of care, staffing and resource adequacy, specialist consultation, promoting systematic recreation and exchange, knowledge, and feelings towards people with dementia were associated with the quality of dementia care in acute care hospitals. The adjusted coefficient of determination was 0.367. CONCLUSION This study identified factors associated with the quality of dementia care in acute care hospitals. Knowledge and feelings towards people with dementia are important, and the nursing practice environment plays an important role in improving the quality of dementia care. RELEVANCE TO CLINICAL PRACTICE Not only improving nurse's practical ability but also a supportive nursing practice environment enhances the quality of dementia care in acute care hospitals.
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Affiliation(s)
- Shoko Urashima
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka Suma-ku, Kobe-City, Japan
| | - Chieko Greiner
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka Suma-ku, Kobe-City, Japan
| | - Hirochika Ryuno
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka Suma-ku, Kobe-City, Japan
| | - Yuko Yamaguchi
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka Suma-ku, Kobe-City, Japan
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