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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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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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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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Jarrar M, Al-Bsheish M, Albaker W, Alsaad I, Alkhalifa E, Alnufaili S, Almajed N, Alhawaj R, Al-Hariri MT, Alsunni AA, Aldhmadi BK, Alumran A. Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events. Risk Manag Healthc Policy 2023; 16:1-13. [PMID: 36636034 PMCID: PMC9830421 DOI: 10.2147/rmhp.s392523] [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: 10/07/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background "Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. Objective This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. Methods A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Results Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. Conclusion This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.
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Affiliation(s)
- Mu’taman Jarrar
- Medical Education Department, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia,College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Correspondence: Mu’taman Jarrar, Al-Khobar, 34445, Saudi Arabia, Tel +966 54 471 8523, Email ;
| | - Mohammad Al-Bsheish
- Health Management Department, Batterjee Medical College, Jeddah, Saudi Arabia,Al-Nadeem Governmental Hospital, Ministry of Health, Amman, Jordan,Mohammad Al-Bsheish, Jeddah, 21442, Saudi Arabia, Tel +966 59 103 6065, Email
| | - Waleed Albaker
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ibtihal Alsaad
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Eiman Alkhalifa
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sara Alnufaili
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nour Almajed
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Alhawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad T Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed A Alsunni
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badr K Aldhmadi
- Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il, Saudi Arabia
| | - Arwa Alumran
- Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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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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Phillips LA, de Los Santos N, Ntanda H, Jackson J. The impact of the work environment on the health-related quality of life of Licensed Practical Nurses: a cross-sectional survey in four work environments. Health Qual Life Outcomes 2022; 20:44. [PMID: 35305650 PMCID: PMC8934126 DOI: 10.1186/s12955-022-01951-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses are known to have negative health outcomes related to their work. While it is acknowledged that nursing work is associated with things like back injuries and burnout, there is limited evidence as to what factors in the work environment contribute to these issues. PURPOSE The aims of this study were to assess how Licensed Practical Nurses (LPNs) report their Health-related quality of life (HRQoL), and how nurses' health is impacted by their work environment. METHODS These data used for analysis comes from a cross-sectional survey administered online to all LPNs in Alberta (2018). The survey collected data on the following variables: participant's demographics, the SF-36 HRQoL, Practice Environment Scale of the Nursing Work Index (PES-NW) and the CD-RISC measure of resilience. The beta distribution was used to model HRQoL outcomes. In instances where optimal health (score of '1') was observed then an extended version of beta distribution (called one-inflated beta) was applied. RESULTS 4,425 LPNs responded to the survey. LPNs (mean age: 40) report lower scores on each SF-36 subscale than the general Canadian population aged 35-44. LPNs who work 'causal' had better physical health, (OR 1.21, CI 1.11-1.32, p = 0.000), and mental health (OR 1.22, CI 1.12-1.30, p = 0.000) than LPNs who work full time, even after controlling for resilience. LPNs' views on the adequacy of staffing and resources in their workplaces have an influence across all dimensions of health. CONCLUSION This study suggests that improvements in the work environment could positively impact health outcomes and that adequate resourcing could support the nursing workforce.
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Affiliation(s)
- Leah Adeline Phillips
- Alberta College of Family Physicians, #370, 10403-172 Street, Centre 170, Edmonton, AB T5S 1K9 Canada
| | - Nyla de Los Santos
- College of Licenced Practical Nurses of Alberta, St. Albert Trail Place, 12163-146 Street, Edmonton, AB Canada
| | - Henry Ntanda
- Cumming School of Medicine, Department of Paediatrics, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Jennifer Jackson
- Faculty of Nursing, University of Calgary, Professional Faculties Building, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
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Phillips LA, de Los Santos N, Jackson J. Licenced practical nurses' perceptions of their work environments and their intention to stay: A cross-sectional study of four practice settings. Nurs Open 2021; 8:3299-3305. [PMID: 34432374 PMCID: PMC8510757 DOI: 10.1002/nop2.1046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/26/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022] Open
Abstract
Aims and objectives This study aimed to understand how licenced practical nurses perceive their work environments across different work settings and to analyse the association between these nurses’ perceptions of their work environments and their intentions to stay employed at their current nursing unit. Design A cross‐sectional descriptive survey was conducted with Licensed Practical Nurses in Alberta, Canada. Methods The study population consisted of 598 licenced practical nurses. Survey measures included demographic information, the Perceived Work Environment‐Nursing Work Index, and an intention to stay scale. Descriptive statistics were calculated and mean scores for perceptions about the work environment were compared by work setting. The associations between perceived work environment and intention to stay were analysed using linear regression. Results Overall, licenced practical nurses rated their work environment as mixed, with statistically significantly lower scores in acute care settings. Nurse manager ability and adequate staffing and resources were the highest contributing variables.
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Validation of the Psychometric Properties of the Practice Environment Scale of Nursing Work Index in Primary Health Care in Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126422. [PMID: 34198495 PMCID: PMC8296248 DOI: 10.3390/ijerph18126422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 12/03/2022]
Abstract
Studies related to the work environment in primary health care are scarce in the literature. The present study aimed to validate the psychometric properties of the Practice Environment Scale of Nursing Work Index (PES-NWI) in primary health care (PHC) and to evaluate its construct validity through exploratory and confirmatory factor analyses in a sample of Portuguese nurses. A quantitative, cross-sectional, and validation study design was implemented. Methods: The sample consisted of 1059 nurses from the PHC units of all 55 health center groups (HCGs) in mainland Portugal, 15 health centers in the Autonomous Region of Madeira, and 6 health centers in the Autonomous Region of the Azores. The study tested different structural models using exploratory and confirmatory factor analysis techniques. The reliability of the scale was tested by determining Cronbach’s alpha coefficient. Results: The internal consistency of the PES-NWI was 0.91. Exploratory and confirmatory factor analyses were performed on the PES-NWI model in PHC with five factors: NPOA, NFQC, NMALSN, SRA, and CNPR. The results show that the scale presents acceptable fit quality indexes in the final factorial solution and adequate convergent validity. Conclusion: The PES-NWI in PHC has an adequate, robust, and reliable five-factor structure. The scale is valid and can be used in clinical practice, nursing management, and PHC research.
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Montgomery AP, Azuero A, Baernholdt M, Loan LA, Miltner RS, Qu H, Raju D, Patrician PA. Nurse Burnout Predicts Self-Reported Medication Administration Errors in Acute Care Hospitals. J Healthc Qual 2021; 43:13-23. [PMID: 33394839 DOI: 10.1097/jhq.0000000000000274] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Every one out of 10 nurses reported suffering from high levels of burnout worldwide. It is unclear if burnout affects job performance, and in turn, impairs patient safety, including medication safety. The purpose of this study is to determine whether nurse burnout predicts self-reported medication administration errors (MAEs). METHODS A cross-sectional study using electronic surveys was conducted from July 2018 through January 2019, using the Copenhagen Burnout Inventory. Staff registered nurses (N = 928) in acute care Alabama hospitals (N = 42) were included in this study. Descriptive statistics, correlational, and multilevel mixed-modeling analyses were examined. RESULTS All burnout dimensions (Personal, Work-related, and Client-related Burnout) were significantly correlated with age (r = -0.17 to -0.21), years in nursing (r = -0.10 to -0.17), years of hospital work (r = -0.07 to -0.10), and work environment (r = -0.24 to -0.57). The average number of self-reported MAEs in the last 3 months was 2.13. Each burnout dimension was a statistically significant predictor of self-reported MAEs (p < .05). CONCLUSIONS Nurse burnout is a significant factor in predicting MAEs. This study provides important baseline data for actionable interventions to improve nursing care delivery, and ultimately health care, for Alabamians.
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Almeida S, Nascimento A, Lucas PB, Jesus É, Araújo B. RN4CAST Study in Portugal: Validation of the Portuguese Version of the Practice Environment Scale of the Nursing Work Index. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.3.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aims to validate the Portuguese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and assess construct validity through exploratory and confirmatory factor analyses.
Materials and Methods: This cross-sectional study validates the psychometric properties of the PES-NWI in Portugal. Exploratory factorial analysis is used to analyze the psychometric properties of the PES-NWI in a sample of 5,075 Portuguese nurses; the data sample covers all geographic regions in the country. Confirmatory factor analysis is performed to confirm the model’s data adequacy.
Results: Factorial analysis explained 54.6 % of the variance and a five-dimension structure. The five factors identified were Nurse Participation in Hospital Affairs, Nurse Manager Ability, Leadership and Support of Nurses, Nursing Foundations for Quality of Care, Staffing and Resource Adequacy, and Nurse-Physician Relations. The confirmatory analysis showed that the five-factor model fit well with the data in the Portuguese context.
Conclusion: In a Portuguese health context, the PES-NWI is a valid scale to access the nursing environment and improve working conditions.
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12
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Campbell CM, Prapanjaroensin A, Anusiewicz CV, Baernholdt M, Jones T, Patrician PA. Variables associated with missed nursing care in Alabama: A cross‐sectional analysis. J Nurs Manag 2020; 28:2174-2184. [DOI: 10.1111/jonm.12979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/08/2020] [Accepted: 02/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Marianne Baernholdt
- School of Nursing University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Terry Jones
- School of Nursing Virginia Commonwealth University Richmond Virginia
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Stone L, Arneil M, Coventry L, Casey V, Moss S, Cavadino A, Laing B, McCarthy AL. Benchmarking nurse outcomes in Australian Magnet® hospitals: cross-sectional survey. BMC Nurs 2019; 18:62. [PMID: 31827388 PMCID: PMC6892144 DOI: 10.1186/s12912-019-0383-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background Positive reports of nursing-related outcomes such as quality nursing care, nursing engagement with work and good practice environment are crucial in attaining and maintaining Magnet® designation. The majority of Magnet®-designated organisations (N = 482) are in the USA, with their aggregate nursing outcomes widely published as benchmark data. Australian Magnet® outcomes have not been aggregated or published to date. Methods The aims are to benchmark educational preparation, occupational burnout, job satisfaction, intention to leave and working environment of nurses in Australian Magnet®-designated facilities and to determine the reliability of the Practice Environment Scale-Australia. The design is a cross-sectional multisite survey set in all three Australian Magnet®-designated organisations. The demographics included age, gender, level of education, years in practice, level of seniority and position title. Two items measured job satisfaction and intent to stay in current employment. The Maslach Burnout Inventory explored the three domains of nursing engagement: depersonalisation, personal achievement and emotional exhaustion. The Australian version of the Practice Environment Scale interrogated participants’ perceptions of their work environments. Results 2004 nurses participated (response rate 45.9%). Respondents’ mean age was 39.2 years (range 20–72). They were predominantly female and had worked in their current facility for more than 5 years. Eighty five percent had a minimum of a Bachelor’s degree. Eighty-six percent of respondents were satisfied or very satisfied with their current position. Eighty eight percent had no intention of leaving their current employer within the next 12 months. Participants rated their hospitals highly in all domains of the practice environment. Respondents reported less burnout in the personal accomplishment and depersonalisation domains than in the emotional exhaustion domain, in which they reported average levels of burnout. The internal consistency of the Practice Environment Scale-Australia was confirmed in this sample (Cronbach α’s 0.87–0.9 for subscales and 0.89 for composite score). Conclusion In this paper, we present nursing outcome data from all Australian Magnet® hospitals for the first time. This provides a benchmark that facilitates comparison with nursing outcomes published by Australian non-Magnet® hospitals and with international Magnet® organisations.
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Affiliation(s)
- L Stone
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,2University of Queenland, Brisbane, Queensland Australia
| | - M Arneil
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia
| | - L Coventry
- 3Sir Charles Gairdner Hospital, Nedlands, Western Australia.,4Edith Cowan University, Joondalup, Western Australia
| | - V Casey
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,2University of Queenland, Brisbane, Queensland Australia.,5University of Queensland, Brisbane, Queensland Australia
| | - S Moss
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia
| | - A Cavadino
- 6University of Auckland, Auckland, New Zealand
| | - B Laing
- 5University of Queensland, Brisbane, Queensland Australia
| | - A L McCarthy
- 1Princess Alexandra Hospital, Woolloongabba, Queensland Australia.,5University of Queensland, Brisbane, Queensland Australia.,6University of Auckland, Auckland, New Zealand.,7Mater Health Services, South Brisbane, Queensland Australia
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Ambani Z, Al-Hamdan Z, Al-Touby S, Ghanim A, Al Jarameez F, Squires A. Content Validation of the Arabic Translation of the Practice Environment Scale of the Nursing Work Index-Revised. J Nurs Meas 2019; 27:234-246. [PMID: 31511407 DOI: 10.1891/1061-3749.27.2.234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE There is no reliable and valid version of the Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R) in Arabic. The purpose of this study was to describe the systematic instrument translation and validation of the PES-NWI-R. METHODS Using the Content Validity Indexing-based approach, 32 expert nurses from four countries in the Eastern Mediterranean Region (Jordan, Oman, Saudi Arabia, and United Arab Emirates) participated in the validation of this translation. RESULTS The content validity index score of the overall scale was excellent (0.87 for the relevancy, and 0.95 for the quality of Arabic translation). CONCLUSION Our study supported the content validity of the Arabic version of the instrument which provided the first valid Arabic translation of the instrument.
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Affiliation(s)
- Zainab Ambani
- King Saud bin Abdulaziz University for Health Sciences, College of Nursing, Al Ahsa, Saudi Arabia
| | - Zaid Al-Hamdan
- Faculty of Nursing, Jordan University of Science and Technology, Jordan, Middle East
| | | | - Amani Ghanim
- Jordan University of Science and Technology, Irbid, Jordan
| | | | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York, NY
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Tabakakis C(K, McAllister M, Bradshaw J, To QG. Psychological resilience in New Zealand registered nurses: The role of workplace characteristics. J Nurs Manag 2019; 27:1351-1358. [DOI: 10.1111/jonm.12815] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/04/2019] [Accepted: 06/13/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Costantinos (Kosta) Tabakakis
- School of Nursing, Midwifery and Social Sciences Central Queensland University Noosa Queensland Australia
- Research and Enterprise University of Otago Christchurch New Zealand
| | - Margaret McAllister
- School of Nursing, Midwifery and Social Sciences Central Queensland University Noosa Queensland Australia
| | - Julie Bradshaw
- School of Nursing, Midwifery and Social Sciences Central Queensland University Rockhampton Queensland Australia
| | - Quyen G. To
- School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia
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Sheehy A, Smith RM, Gray JE, Homer CS. Midwifery pre-registration education and mid-career workforce participation and experiences. Women Birth 2019; 32:e182-e188. [DOI: 10.1016/j.wombi.2018.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/10/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
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Zangaro GA, Jones K. Practice Environment Scale of the Nursing Work Index: A Reliability Generalization Meta-Analysis. West J Nurs Res 2019; 41:1658-1684. [DOI: 10.1177/0193945918823779] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A healthy work environment is a critical factor in nurse satisfaction, retention, and patient outcomes. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is the most commonly used instrument to measure the nursing practice environment. This study uses meta-analysis to examine the reliability generalization of the PES-NWI. A meta-analysis of 51 studies representing a total of 80,563 subjects was conducted. The mean score reliability for the PES-NWI based on 38 studies ( n = 68,278) was .922 ( p < .05). The Mean Weighted Effect Size was stronger for studies conducted in the United States versus non-U.S. (.946 vs. .907). For studies rated high and moderate quality, the mean score reliability was .911 and .946, respectively. Scores on the PES-NWI are reliable for measuring the nursing practice environment across samples in the United States and non-U.S. countries.
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Affiliation(s)
| | - Kimmith Jones
- University of Maryland Medical Center, Baltimore, MD, USA
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Adaptation and validation of the Cyprus version of the Practice Environment Scale of the Nursing Work Index: a methodological study. BMC Res Notes 2018; 11:791. [PMID: 30390712 PMCID: PMC6215668 DOI: 10.1186/s13104-018-3896-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study was to adapt and validate the Revised Practice Environment Scale of the Nursing Work Index, to be utilized among the Cyprus nurses’ population. Validated research scales are valuable tools in the hands of researchers in their attempt to recommend alterations within health care systems, especially during reform periods. Results Internal consistency reliability of the scale was satisfactory (alpha = 0.94). Exploratory factor analysis produced a five-factor structure solution. Experts in the field provided further guidance. The findings demonstrated that the Cyprus version of the Revised Practice Environment Scale of the Nursing Work Index is a reliable and valid research instrument, however differences with previous studies on the factor structure were observed, mainly due to cultural reasons. As a valid and reliable scale, it can capture the views of nurses concerning their work environment. The Cyprus version of the Revised Practice Environment Scale of the Nursing Work Index can be used by nurse managers and policy makers to introduce changes that may improve the quality of nursing care provided and enhance the patients’ satisfaction from the health system as a whole.
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Neves TMA, Parreira PMSD, Graveto JMGN, Rodrigues VJL, Marôco Domingos JP. Practice environment scale of the nursing work index: Portuguese version and psychometric properties. J Nurs Manag 2018; 26:833-841. [PMID: 30133033 DOI: 10.1111/jonm.12606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/28/2022]
Abstract
AIM To assess the psychometric properties regarding the Portuguese version of the Practice Environment Scale of the Nursing Work Index. BACKGROUND The Practice Environment Scale of the Nursing Work Index is the most widely used measure for assessing the practice environment. A model with a higher number of factors appears to be more adequate to Portuguese settings. METHOD A confirmatory factor analysis was performed to the Practice Environment Scale of the Nursing Work Index using a sample of 850 Portuguese nurses. Three models were tested: the original model, a seven-factor model and a higher-order model. An analysis of invariance was performed in two subsets to confirm the stability of the solution. RESULTS The seven-factor model fit better to the data than the original model. After refinement, this solution showed suitability and a stable factor structure. Reliability, convergent validity and discriminant validity were confirmed. A second-order factor solution also showed suitability. CONCLUSION The seven-factor structure of the Practice Environment Scale of the Nursing Work Index showed a better goodness-of-fit to Portuguese settings than the original structure. The second-order factor solution allows an overall assessment of practice environments. IMPLICATIONS FOR NURSING MANAGEMENT The Portuguese version of the Practice Environment Scale of the Nursing Work Index is a valuable tool for assessing Portuguese nursing practice environments. The seven-factor solution of the Practice Environment Scale of the Nursing Work Index showed high specificity.
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Ogata Y, Sasaki M, Yumoto Y, Yonekura Y, Nagano M, Kanda K. Reliability and validity of the practice environment scale of the nursing work index for Japanese hospital nurses. Nurs Open 2018; 5:362-369. [PMID: 30062030 PMCID: PMC6056431 DOI: 10.1002/nop2.148] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/05/2018] [Indexed: 11/10/2022] Open
Abstract
AIMS The aim of this study was to examine the reliability and validity of the Practice Environment Scale of the Nursing Work Index (PES-NWI) for hospital nurses in Japan. DESIGN A cross-sectional mail survey. METHODS Participants in this study were 1,219 full-time ward nurses from 27 hospitals in Japan, using 31 items of the Japanese version of the PES-NWI questionnaire, from December 2008-March 2009. Construct validity, criterion-related validity and internal consistency of the PES-NWI were tested. RESULTS The PES-NWI showed reliable internal consistency. The five-factor structure was supported by confirmatory factor analysis. The PES-NWI correlated significantly with job satisfaction, burnout and the nurses' intention to stay on the job, supporting criterion-related validity.
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Affiliation(s)
- Yasuko Ogata
- Department of Gerontological Nursing and Care System DevelopmentGraduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)Bunkyo‐kuTokyoJapan
| | - Miki Sasaki
- Department of Gerontological Nursing and Care System DevelopmentGraduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)Bunkyo‐kuTokyoJapan
| | - Yoshie Yumoto
- Department of Gerontological Nursing and Care System DevelopmentGraduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)Bunkyo‐kuTokyoJapan
| | - Yuki Yonekura
- Graduate School of Nursing ScienceSt. Luke's International UniversityChuo‐kuTokyoJapan
| | - Midori Nagano
- Department of Adult NursingSchool of NursingThe Jikei UniversityChofu‐shiJapan
| | - Katsuya Kanda
- Faculty of Health ScienceAino UniversityIbaraki‐shiOsakaJapan
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Cummings GG, Tate K, Lee S, Wong CA, Paananen T, Micaroni SPM, Chatterjee GE. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud 2018; 85:19-60. [PMID: 29807190 DOI: 10.1016/j.ijnurstu.2018.04.016] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. METHODS The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. RESULTS A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. CONCLUSIONS The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings.
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Affiliation(s)
- Greta G Cummings
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada.
| | - Kaitlyn Tate
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Sarah Lee
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Carol A Wong
- Arthur Labatt Family School of Nursing, University of Western Ontario, Room 3306, FIMS & Nursing Building, London, Ontario, N6A 5B9, Canada
| | - Tanya Paananen
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Simone P M Micaroni
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Gargi E Chatterjee
- Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
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Ross AM, Ilic K, Kiyoshi-Teo H, Lee CS. Psychometric analysis of the leadership environment scale (LENS): Outcome from the Oregon research initiative on the organisation of nursing (ORION). J Nurs Manag 2017; 26:467-476. [PMID: 29277942 DOI: 10.1111/jonm.12572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2017] [Indexed: 12/01/2022]
Abstract
AIM The purpose of this study was to establish the psychometric properties of the new 16-item leadership environment scale. BACKGROUND The leadership environment scale was based on complexity science concepts relevant to complex adaptive health care systems. METHODS A workforce survey of direct-care nurses was conducted (n = 1,443) in Oregon. Confirmatory factor analysis, exploratory factor analysis, concordant validity test and reliability tests were conducted to establish the structure and internal consistency of the leadership environment scale. RESULTS Confirmatory factor analysis indices approached acceptable thresholds of fit with a single factor solution. Exploratory factor analysis showed improved fit with a two-factor model solution; the factors were labelled 'influencing relationships' and 'interdependent system supports'. Moderate to strong convergent validity was observed between the leadership environment scale/subscales and both the nursing workforce index and the safety organising scale. Reliability of the leadership environment scale and subscales was strong, with all alphas ≥.85. CONCLUSIONS The leadership environment scale is structurally sound and reliable. IMPLICATIONS FOR NURSING MANAGEMENT Nursing management can employ adaptive complexity leadership attributes, measure their influence on the leadership environment, subsequently modify system supports and relationships and improve the quality of health care systems. The leadership environment scale is an innovative fit to complex adaptive systems and how nurses act as leaders within these systems.
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Affiliation(s)
- Amy M Ross
- Oregon Health & Science University School of Nursing, Portland, OR, USA
| | - Kelley Ilic
- Oregon Center for Nursing, Portland, OR, USA
| | | | - Christopher S Lee
- Oregon Health & Science University School of Nursing and Knight Cardiovascular Institute, Portland, OR, USA
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Retention of early career registered nurses: the influence of self-concept, practice environment and resilience in the first five years post-graduation. J Res Nurs 2017. [DOI: 10.1177/1744987117709515] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gasparino RC, Guirardello EDB. Validation of the Practice Environment Scale to the Brazilian culture. J Nurs Manag 2017; 25:375-383. [PMID: 28303619 DOI: 10.1111/jonm.12475] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 11/30/2022]
Abstract
AIM To validate the Brazilian version of the Practice Environment Scale. BACKGROUND The Practice Environment Scale is a tool that evaluates the presence of characteristics that are favourable for professional nursing practice because a better work environment contributes to positive results for patients, professionals and institutions. METHOD Methodological study including 209 nurses. Validity was assessed via a confirmatory factor analysis using structural equation modelling, in which the correlations between the instrument and the following variables were tested: burnout, job satisfaction, safety climate, perception of quality of care and intention to leave the job. Subgroups were compared and the reliability was assessed using Cronbach's alpha and the composite reliability. RESULTS Factor analysis resulted in exclusion of seven items. Significant correlations were obtained between the subscales and all variables in the study. The reliability was considered acceptable. CONCLUSION The Brazilian version of the Practice Environment Scale is a valid and reliable tool used to assess the characteristics that promote professional nursing practice. IMPLICATIONS FOR NURSING MANAGEMENT Use of this tool in Brazilian culture should allow managers to implement changes that contribute to the achievement of better results, in addition to identifying and comparing the environments of health institutions.
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Bullich-Marín I, Miralles Basseda R, Torres Egea P, Planas-Campmany C, Juvé-Udina ME. [Evaluation of the nurse working environment in health and social care intermediate care units in Catalonia]. Rev Esp Geriatr Gerontol 2016; 51:342-348. [PMID: 26705825 DOI: 10.1016/j.regg.2015.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/19/2015] [Accepted: 10/25/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment. METHODS An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected. RESULTS From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment. CONCLUSIONS In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment.
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Affiliation(s)
- Ingrid Bullich-Marín
- Plan Director Sociosanitario, Departamento de Salud de la Generalitat de Catalunya, Barcelona, España; Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España.
| | - Ramón Miralles Basseda
- Servicio de Geriatría, Parc Salut Mar, Barcelona, España; Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, España
| | - Pilar Torres Egea
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España
| | - Carme Planas-Campmany
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Dirección General de Planificación e Investigación en Salud, Departamento de Salud de la Generalitat de Catalunya, Barcelona, España
| | - María Eulalia Juvé-Udina
- Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Dirección assistencial, Instituto Catalán de la Salud, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España
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Brzyski P, Kózka M, Squires A, Brzostek T. How Factor Analysis Results May Change Due to Country Context. J Nurs Scholarsh 2016; 48:598-607. [PMID: 27706893 DOI: 10.1111/jnu.12249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To present how factor analysis results of a Practice Environment Scale of the Nursing Work Index (PES-NWI) translation changed due to country context. DESIGN Validity and reliability analysis of a cross-culturally adapted, Polish translation of the PES-NWI came from a cross-sectional, national survey that included 2,605 registered nurses working in surgical (50.4%) and medical (49.6%) units of 30 Polish hospitals. METHODS Exploratory factor analysis (EFA) using the principal component analysis (PCA) method with varimax rotation and confirmatory factor analysis (CFA) was used to examine factor structure of the instrument in the Polish context. Zero-order and partial Pearson correlation coefficients were used to establish the range of variance shared by the dimensions of the Polish version. The Cronbach's alpha coefficient determined internal consistency reliability. The internal consistency of the scale was also tested based on Kline's criterion. FINDINGS The PCA conducted in the sample of Polish nurses extracted six factors, explaining together 56% of the total variance. The varimax rotation, however, restricted results to five factors, explaining 52.7% of the total variance and generating a factor structure closer to that based on previous studies. The CFA model, based on a PCA solution with five nonorthogonal factors, fitted data better than the theoretically driven model. CONCLUSIONS Dimensions of the PES-NWI nurses' work environments remain conceptually consistent in Poland, but load differently. Health system or nursing profession factors related to the country context are potential explanations for these differences. CLINICAL RELEVANCE When using a translation of the Practice Environment Scale of the Nursing Work Index-Revised to examine the influences of work environment quality on nursing and patient outcomes, it is important to consider contextual differences when using results to inform policy.
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Affiliation(s)
- Piotr Brzyski
- Chair of Epidemiology and Preventive Medicine and statistician, Jagiellonian University, Medical College, Krakow, Poland
| | - Maria Kózka
- Faculty of Health Sciences, Professor UJ & Faculty Vice-Dean, Jagiellonian University, Medical College, Krakow, Poland
| | - Allison Squires
- Upsilon, Associate Professor, New York University Rory Meyers College of Nursing, New York, NY, USA.
| | - Tomasz Brzostek
- Faculty of Health Sciences, Professor & Faculty Dean, Jagiellonian University, Medical College, Krakow, Poland
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Redknap R, Twigg D, Towell A. What interventions can improve the mental health nursing practice environment? Int J Ment Health Nurs 2016; 25:42-50. [PMID: 26749058 DOI: 10.1111/inm.12187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 08/27/2015] [Accepted: 09/10/2015] [Indexed: 01/17/2023]
Abstract
The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia.
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Affiliation(s)
- Robina Redknap
- School of Nursing and Midwifery, Edith Cowan University.,Graylands Hospital, North Metropolitan Health Service, Perth, Western Australia
| | - Di Twigg
- School of Nursing and Midwifery, Edith Cowan University
| | - Amanda Towell
- School of Nursing and Midwifery, Edith Cowan University
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Jafree SR, Zakar R, Zakar MZ, Fischer F. Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan. BMC Health Serv Res 2016; 16:3. [PMID: 26728071 PMCID: PMC4700678 DOI: 10.1186/s12913-015-1252-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 12/23/2015] [Indexed: 11/29/2022] Open
Abstract
Background There is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses. Methods The authors used the “Practice Environment Scale-Nurse Work Index Revised” to measure the six dimensions of organizational culture. Seven questions were used from the “Survey to Solicit Information about the Culture of Reporting” to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis. Results Three areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace. Conclusion Public healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the development of nursing care plans.
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Affiliation(s)
- Sara Rizvi Jafree
- Institute of Social and Cultural Studies, Sociology Department, University of the Punjab, Lahore, Pakistan.
| | - Rubeena Zakar
- Institute of Social and Cultural Studies, University of the Punjab, New Campus, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Zakria Zakar
- Institute of Social and Cultural Studies, Faculty of Behavioral and Social Sciences, New Campus, University of the Punjab, Lahore, Pakistan.
| | - Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100131, 33501, Bielefeld, Germany.
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Hegney D, Eley R, Osseiran-Moisson R, Francis K. Work and personal well-being of nurses in Queensland: Does rurality make a difference? Aust J Rural Health 2015; 23:359-65. [DOI: 10.1111/ajr.12206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Desley Hegney
- School of Nursing and Midwifery; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Robert Eley
- School of Medicine and Princess Alexandra Hospital Emergency Department; The University of Queensland; Brisbane Queensland Australia
| | - Rebecca Osseiran-Moisson
- School of Nursing and Midwifery; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Karen Francis
- School of Nursing, Midwifery and Indigenous Health; Charles Sturt University; Bathurst New South Wales Australia
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Ferreira MRSDCF, Martins JJPA. Study of adaptation and validation of the Practice environment scale of the nursing work index for the portuguese reality. Rev Esc Enferm USP 2014. [DOI: 10.1590/s0080-623420140000400017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: Testing the psychometric properties of the Portuguese version of the Practice Environment Scale of the Nursing Work Index. Method: A descriptive, analytical and cross-sectional study, for the cross-cultural adaptation and validation of the psychometric properties of the scale. The study participants were 236 nurses from two hospitals in the regions of Lisbon and Vale do Tejo. Results: The 0.92 Cronbach’s alpha was obtained for overall reliability and support of a five-dimension structure. Conclusion: The excellent quality of adjustment of analysis confirms the validity of the adapted version to hospital care settings, although there was no total coincidence of items in the five dimensions
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Liu Y, Hsu HT, Chen HM. Staff nurse decisional involvement: an Internet mixed-method study in Taiwan. J Nurs Manag 2013; 23:468-78. [DOI: 10.1111/jonm.12154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Yi Liu
- Kaohsiung Medical University; Kaohsiung Taiwan
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Ausserhofer D, Zander B, Busse R, Schubert M, De Geest S, Rafferty AM, Ball J, Scott A, Kinnunen J, Heinen M, Sjetne IS, Moreno-Casbas T, Kózka M, Lindqvist R, Diomidous M, Bruyneel L, Sermeus W, Aiken LH, Schwendimann R. Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf 2013; 23:126-35. [PMID: 24214796 DOI: 10.1136/bmjqs-2013-002318] [Citation(s) in RCA: 369] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon. AIM The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors. METHODS Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study. RESULTS Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=-2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out non-nursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone. CONCLUSIONS Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.
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Fuentelsaz-Gallego C, Moreno-Casbas MT, González-María E. Validation of the Spanish version of the questionnaire Practice Environment Scale of the Nursing Work Index. Int J Nurs Stud 2012; 50:274-80. [PMID: 22944284 DOI: 10.1016/j.ijnurstu.2012.08.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 07/31/2012] [Accepted: 08/01/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND The importance of the practice environment in the provision of care and its relation with patient outcomes and nurse-reported outcomes, support the need to have an instrument to measure such practice environment. OBJECTIVE To evaluate the validity and reliability of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI), determining the content validity, test-retest reliability, internal consistency and construct validity. DESIGN A cross-sectional survey of bedside care nurses undertaken in 2009 in medical, surgical and critical care wards of 33 Spanish National Health Service hospitals with more than 150 beds. METHODS The validation process followed the internationally recognized guidelines about psychometric properties of instruments: translation and back-translation, content validity, test-retest reliability, internal consistency and construct validity. Other study variables included, like nurses' intention to leave and job satisfaction. RESULTS The Intraclass Correlation Coefficient (ICC) for an overall score on the 31 item questionnaire was 0.87 (CI 95%: 0.85-0.89). Cronbach's alpha was 0.90 (CI 95%: 0.87-0.93). The weighted Kappa Index obtained for each of the items ranges from 0.24 (CI 95%: 0.22-0.26) to 0.51 (CI 95%: 0.49-0.53). The Content Validity Index score ranges from 0.5 for the item "Opportunities for advancement" to 1. Five of the terms attain this maximum level of agreement: "Active staff development or continuing education programs for nurses", "Enough registered nurses on staff to provide quality patient care", "Enough staff to get the work done", "Management that listens and responds to employee concerns" and "Collaboration between nurses and physicians". CONCLUSIONS The validation process indicates that the Spanish version of the PES-NWI is valid and reliable in its current version and it can be used to measure the practice environment of Spanish nurses working in clinical practice in hospitals of the Spanish NHS.
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Dubois CA, D’Amour D, Tchouaket E, Rivard M, Clarke S, Blais R. A taxonomy of nursing care organization models in hospitals. BMC Health Serv Res 2012; 12:286. [PMID: 22929127 PMCID: PMC3471046 DOI: 10.1186/1472-6963-12-286] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 08/16/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. METHODS This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units' profile data. RESULTS The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses' professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses' perceptions that the practice environment is less supportive of their professional work. CONCLUSIONS This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an "ideal" nursing professional practice model described by some leaders in the contemporary nursing literature. While the two professional models appear closer to this ideal, the two functional models are farther removed.
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Affiliation(s)
- Carl-Ardy Dubois
- Faculty of Nursing Sciences, University of Montreal, Montreal, Canada
| | - Danielle D’Amour
- Faculty of Nursing Sciences, University of Montreal, Montreal, Canada
| | - Eric Tchouaket
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Canada
| | - Michèle Rivard
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Sean Clarke
- RBC Chair in Cardiovascular Nursing Research, University of Toronto and University Health Network, Toronto, Canada
| | - Régis Blais
- Department of Health Administration, Faculty of Medicine, University of Montreal, Montreal, Canada
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Siedlecki SL, Hixson ED. Development and psychometric exploration of the professional practice environment assessment scale. J Nurs Scholarsh 2011; 43:421-5. [PMID: 21981604 DOI: 10.1111/j.1547-5069.2011.01414.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Development of the Professional Practice Environment Assessment Scale (PPEAS) was based on the assumptions that a positive professional practice environment is more than and different from the absence of negative, abusive, or disrespectful behaviors by physicians; a positive professional practice environment improves patient outcomes as well as nurse and physician satisfaction; and a positive professional practice environment is characterized by mutual respect, understanding of roles, collaborative decision making, effective communication, and beliefs in the importance of nurse-physician relationships on patient outcomes. The PPEAS is intended as both a research tool and a method of assessing and monitoring changes in an organization's professional practice environment as it relates specifically to the impact the nurse and physician relationship has on the professional practice environment. The purpose of this study was to examine the psychometric properties of the PPEAS and determine if it was a valid and reliable instrument for assessing the positive attributes of the professional practice environment. DESIGN A large acute care facility in the Midwestern section of the United States provided the setting for this psychometric study. The sample (N= 1,332) consisted of 801 nurses and 531 physicians. METHODS Psychometric examination, which included principal component analysis with varimax rotation and assessment of internal consistency, was conducted to validate the reliability and validity of the PPEAS. FINDINGS Analysis identified a four-factor solution. The four factors were classified as positive physician characteristics (five items), positive nurse characteristics (three items), collaborative decision making (two items), and positive beliefs in the value of the nurse-physician relationship (three items). Cronbach's α for the entire scale was .86, with subscales ranging from .73 to .89. CONCLUSIONS Findings from this analysis support our model and provide evidence of the usefulness of this scale for assessing the presence of a positive professional practice environment. Using the total score, organizations can examine the status of their professional practice environment and examine changes in the environment over time. Subscale analysis can identify specific areas where the organization performs well and those areas in need of improvement. CLINICAL RELEVANCE The professional practice environment has been implicated as a variable that impacts patient outcomes. The absence of negative physician behaviors is an inadequate measure for assessing the positive attributes of the professional practice environment. Instruments for assessing the professional practice environment typically looked at the presence of negative physician behaviors or examined a single aspect of the nurse-physician relationship. This article provides a theoretical framework that can be used to guide both practice and research. The PPEAS was developed within a theoretical framework that can be adapted to a variety of settings, cultures, and countries. The PPEAS is a valid and reliable instrument that can be used to assess the professional practice environment in a variety of settings.
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Affiliation(s)
- Sandra L Siedlecki
- Nursing Research & Innovations, Nursing Institute, Cleveland Clinic, Cleveland, OH, USA.
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