Creating Healthful Work Environments to Deliver on the Quadruple Aim: A Call to Action

Relationship Between Emotional Intelligence, Occupational Well-Being, and Work Engagement Among Chinese Clinical Nurses

PURPOSE

To identify the relationship between emotional intelligence, occupational well-being, and work engagement among Chinese clinical nurses.

METHODS

This cross-sectional study is based on survey responses provided by 1744 registered nurses from a Chinese hospital. The survey utilized emotional intelligence, occupational well-being, and work engagement scales.

RESULTS

A questionnaire was distributed to nurses, and among them, 1744 filled it in. Work engagement was related to demographic characteristics. The nurses' work engagement score was 28.99±5.46. Work engagement was positively correlated with emotional intelligence (r=.94, p < .01) and occupational well-being (r=.96, p < .01).

CONCLUSIONS

The current work engagement of nurses in China is at a medium level. It is influenced by emotional intelligence and occupational well-being.

Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model

BACKGROUND

Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship.

METHODS

Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS.

RESULTS

1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers.

CONCLUSIONS

Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.

Systematic RADaR analysis of responses to the open-ended question in the Culture of Care Barometer survey of a Dutch hospital

OBJECTIVES

Systematically measuring the work environment of healthcare employees is key to continuously improving the quality of care and addressing staff shortages. In this study, we systematically analyse the responses to the one open-ended question posed in the Dutch version of the Culture of Care Barometer (CoCB-NL) to examine (1) if the responses offered new insights into healthcare employees' perceptions of their work environment and (2) if the original CoCB had any themes missing.

DESIGN

Retrospective text analysis using Rigorous and Accelerated Data Reduction technique.

SETTING

University hospital in the Netherlands using the CoCB-NL as part of the annual employee survey.

PARTICIPANTS

All hospital employees were invited to participate in the study (N=14 671). In total, 2287 employees responded to the open-ended question.

RESULTS

2287 comments were analysed. Comments that contained more than one topic were split according to topic, adding to the total (n=2915). Of this total, 372 comments were excluded because they lacked content or respondents indicated they had nothing to add. Subsequently, 2543 comments were allocated to 33 themes. Most comments (n=2113) addressed the 24 themes related to the close-ended questions in the CoCB-NL. The themes most commented on concerned questions on 'organisational support'. The remaining 430 comments covered nine additional themes that addressed concerns about work environment factors (team connectedness, team effectiveness, corporate vision, administrative burden and performance pressure) and themes (diversity and inclusion, legal frameworks and collective bargaining, resilience and work-life balance, and personal matters).

CONCLUSIONS

Analysing responses to the open-ended question in the CoCB-NL led to new insights into relevant elements of the work environment and missing themes in the COCB-NL. Moreover, the analysis revealed important themes that not only require attention from healthcare organisations to ensure adequate improvements in their employees' work environment but should also be considered to further develop the CoCB-NL.

Measuring the work environment among healthcare professionals: Validation of the Dutch version of the Culture of Care Barometer

OBJECTIVES

A positive work environment (WE) is paramount for healthcare employees to provide good quality care. To stimulate a positive work environment, employees' perceptions of the work environment need to be assessed. This study aimed to assess the reliability and validity of the Dutch version of the Culture of Care Barometer (CoCB-NL) survey in hospitals.

METHODS

This longitudinal validation study explored content validity, structural validity, internal consistency, hypothesis testing for construct validity, and responsiveness. The study was conducted at seven departments in two Dutch university hospitals. The departments were included based on their managers' motivation to better understand their employees' perception of their WE. All employees of participating departments were invited to complete the survey (n = 1,730).

RESULTS

The response rate was 63.2%. The content of the CoCB-NL was considered relevant and accessible by the respondents. Two factor models were found. First, confirmative factor analysis of the original four-factor structure showed an acceptable fit (X2 2006.49; df 399; p = <0.001; comparative fit index [CFI] 0.82; Tucker-Lewis index [TLI] 0.80; root mean square error of approximation [RMSEA] 0.09). Second, explanatory factor analysis revealed a five-factor model including 'organizational support', 'leadership', 'collegiality and teamwork', 'relationship with manager', and 'employee influence and development'. This model was confirmed and showed a better fit (X2 1552.93; df 395; p = < 0.00; CFI 0.87; TLI 0.86; RMSEA 0.07). Twelve out of eighteen hypotheses were confirmed. Responsiveness was assumed between the measurements.

CONCLUSIONS

The CoCB-NL is a valid and reliable instrument for identifying areas needing improvement in the WE. Furthermore, the CoCB-NL appears to be responsive and therefore useful for longitudinal evaluations of healthcare employees' work environments.

Work-Family Balance and Managing Spillover Effects Communicatively during COVID-19: Nurses' Perspectives

Work-family balance has received meaningful attention from researchers and practitioners alike. Work and family are usually seen as two separate domains that are interdependent, with boundaries that have some level of permeability. Crisis situations can alter permeability of these boundaries, enhancing integration of the two domains due to exchange of ideas and spillover of concerns between these domains. This study looks at how these boundaries are impacted for nurses working directly with COVID-19 patients. The study conducted 24 semi-structured interviews with nurses. Through a thematic analysis the study found that the work-family boundaries have blurred due to concerns around the contagiousness and anxiety associated with the virus. In order to cope with these spillover and possible crossover effects, nurses use prosocial distortion and avoidance and create sub-boundaries at home.

“Everything Is Changing, but I Am Not Alone”: Nurses’ Perceptions of Social Support during COVID-19

COVID-19 has created numerous stressors for nurses, which have impacted their work, self-efficacy, and wellness. Social support helps manage stress and burnout. Through 24 semi-structured interviews, the current article explores the perspectives of nurses who worked with COVID-19 patients in the initial days of the pandemic in the United States. This study unpacks the types and sources of social support nurses sought during this time, especially as they faced significant burnout. Through thematic analysis, the current study found that these nurses interacted with the crisis situation to evaluate their social support needs and the plausibility of fulfilling these needs. They focused on the support that was available or at least perceived to be available and let go of certain needs that could not plausibly be addressed in that moment. Peer-to-peer support was critical during this process, and nurses avoided sharing concerns with their families as they enacted protective buffering. The findings also highlight the complex and dynamic nature of social support as nurses interact with their peers and evaluate the support they receive. Peers helped with haptic support like providing hugs to coworkers, and at times even became surrogates for coworkers’ family members as they participated in communal coping. Organizational support was critical for sharing information centrally with nurses and for organizational sustainability.

The effectiveness of an educational intervention to enhance undergraduate nursing students' competence with interprofessional collaboration

BACKGROUND

Interprofessional collaboration and teamwork have been identified as priorities for delivering quality client care. Improved teamwork, communication, and collaboration among healthcare professionals improve client outcomes. Nurse professionals are challenged to be equally engaged with other healthcare professionals to develop a culturally competent client-centered plan of care.

PURPOSE

The purpose of the current project was to examine the effectiveness of a multifaceted educational intervention on prelicensure nursing students' development of interprofessional competencies with teams and teamwork, communication, roles and responsibility, values, and ethics.

METHODS

Metrics used included the Interprofessional Collaboration Competency Attainment (ICCAS) and the Assessment of Collaborative Environments (ACE-15) surveys.

RESULTS

The results support practical and statistical significance in the students' self-reported collaborative competence across all items of the ICCAS at p < 0.000 level, and across each individual item.

CONCLUSIONS

The multifaceted educational strategy effectively engaged prelicensure nursing students with other healthcare disciplines to develop a client-centered plan of care and achieve interprofessional competencies.

Acute stress of the healthcare workforce during the COVID-19 pandemic evolution: a cross-sectional study in Spain

OBJECTIVES

To determine the volume of health professionals who suffered distress due to their care of patients with COVID-19 and to analyse the direction in which the response capacity of the professionals to face future waves of COVID-19 is evolving.

DESIGN

A cross-sectional study.

SETTING

Primary care and hospitals in Spain.

PARTICIPANTS

A non-randomised sample of 685 professionals (physicians, nurses and other health staff).

PRIMARY AND SECONDARY OUTCOME MEASURES

Frequency and intensity of stress responses measured by the Acute Stress of Health Professionals Caring COVID-19 Scale (EASE). Variation of stress responses according to the number of deaths per day per territory and the evolutionary stage of the COVID-19 outbreak measured by the Kruskal-Wallis and the Mann-Whitney U tests.

RESULTS

The average score on the EASE Scale was 11.1 (SD 6.7) out of 30. Among the participants, 44.2% presented a good emotional adjustment, 27.4% a tolerable level of distress, 23.9% medium-high emotional load and 4.5% extreme acute stress. The stress responses were more intense in the most affected territories (12.1 vs 9.3, p=0.003) and during the disillusionment phase (12.7 vs 8.5 impact, 10.2 heroic and 9.8 honeymoon, p=0.000).

CONCLUSIONS

The pandemic has affected the mental health of a significant proportion of health professionals which may reduce their resilience in the face of future waves of COVID-19. The institutional approaches to support the psychological needs of health professionals are essential to ensure optimal care considering these results.

Undergraduate health professions students' perceptions of athletic training students before and after an interprofessional case study program

Students pursuing careers in health professions may initially approach their training with preconceived ideas and perceptions of those who practice different health-related careers. Little research has been conducted on athletic training students and professional stereotypes or athletic training students and interprofessional education in general. Because interprofessional education may provide some positive effects on stereotypes, the goal of this study was to measure undergraduate health professions student stereotypes of athletic training students before and after an interprofessional case study program. Undergraduate nursing and public health interprofessional case study program participants assessed various relational and intrapersonal capabilities for their own professions and the athletic training profession, pre-post-program. For nursing student participants with athletic training students on their team, perceptions of their own profession and the athletic training profession significantly (p <.05) increased as compared to those with no athletic training student on their team. For public health student participants, although scores increased, no significant differences were found. Interprofessional collaborative experiences may decrease negative stereotypes of other professions, including athletic training.

Workplace verbal abuse, nurse-reported quality of care and patient safety outcomes among early-career hospital nurses

AIMS

To examine the differences in early-career nurses' verbal abuse experiences based on their sociodemographic characteristics, and to investigate the associations of verbal abuse experiences with nurse-reported care quality and patient safety outcomes.

BACKGROUND

Few studies have examined the relationships between early-career nurses' verbal abuse experiences and nurse-reported patient care quality and safety outcomes.

METHODS

Cross-sectional survey data from 799 early-career hospital nurses in the United States were analysed. Items assessed verbal abuse experiences from patients or their families, physicians and other employees. Associations between verbal abuse experiences and nurse-reported care quality and patient safety outcomes were examined using multiple logistic regression analyses.

RESULTS

There were significant differences in verbal abuse experiences by age, gender and work unit. Nurses who experienced verbal abuse, regardless of the perpetrator, were less likely to report high-quality care and a favourable safety grade. Nurses who experienced verbal abuse specifically from physicians or other employees were also less likely to feel comfortable reporting safety problems.

CONCLUSION

Managing verbal abuse may be important for improving patient care quality and safety. Future intervention study is needed to reduce verbal abuse.

IMPLICATIONS FOR NURSING MANAGEMENT

To optimize patient safety, managers should thoroughly monitor verbal abuse and organisations' need to establish clear expectations and ramifications for when verbal abuse occurs.