1
|
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.
Collapse
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
| | | |
Collapse
|
2
|
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.
Collapse
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
| | | | | | | | | | | | | |
Collapse
|
3
|
Thomas A, Rochette A, George C, Iqbal MZ, Ataman R, St-Onge C, Boruff J, Renaud JS. The Definitions and Conceptualizations of the Practice Context in the Health Professions: A Scoping Review. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:S18-S29. [PMID: 36877816 DOI: 10.1097/ceh.0000000000000490] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Health care professionals work in different contexts, which can influence professional competencies. Despite existing literature on the impact of context on practice, the nature and influence of contextual characteristics, and how context is defined and measured, remain poorly understood. The aim of this study was to map the breadth and depth of the literature on how context is defined and measured and the contextual characteristics that may influence professional competencies. METHODS A scoping review using Arksey and O'Malley's framework. We searched MEDLINE (Ovid) and CINAHL (EBSCO). Our inclusion criteria were studies that reported on context or relationships between contextual characteristics and professional competencies or that measured context. We extracted data on context definitions, context measures and their psychometric properties, and contextual characteristics influencing professional competencies. We performed numerical and qualitative analyses. RESULTS After duplicate removal, 9106 citations were screened and 283 were retained. We compiled a list of 67 context definitions and 112 available measures, with or without psychometric properties. We identified 60 contextual factors and organized them into five themes: Leadership and Agency, Values, Policies, Supports, and Demands. DISCUSSION Context is a complex construct that covers a wide array of dimensions. Measures are available, but none include the five dimensions in one single measure or focus on items targeting the likelihood of context influencing several competencies. Given that the practice context plays a critical role in health care professionals' competencies, stakeholders from all sectors (education, practice, and policy) should work together to address those contextual characteristics that can adversely influence practice.
Collapse
Affiliation(s)
- Aliki Thomas
- Dr. Thomas: Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada . Dr. Rochette: Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut universitaire sur la réadaptation en défience physique de Montréal (IURDPM), Montreal, Quebec, Canada. Ms. George: School of Physical and Occupational Therapy, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Dr. Iqbal: Post-doctoral fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Ms. Ataman: School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Dr. St-Onge: Professor, Department of Medicine and Center for Health Professions Pedagogy, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke - Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Ms. Boruff, Associate Librarian, Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada. Dr. Renaud: Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Ogata Y, Fujinami K, Itoh S, Kashiwagi M, Lapreziosa N, Yonekura Y. Developing the nursing practice environment scale for home health care: A trial study in Japan. Nurs Open 2021; 8:3593-3605. [PMID: 34312989 PMCID: PMC8510777 DOI: 10.1002/nop2.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 02/22/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022] Open
Abstract
AIM To develop the nursing practice environment scale in home health care (NPES-HHC), which measures the attractiveness of nursing practice environments in Japan. DESIGN Cross-sectional study. METHODS The answers of 1,050 mail surveys conducted for nurses at 421 home-visit nursing agencies in Japan were analysed. Exploratory and confirmatory factor analyses of the NPES-HHC's candidate items were performed. Relationships between the newly developed NPES-HHC and participants' intention to remain at the workplace, job satisfaction and quality of care were also tested. RESULTS A seven-dimensional model with 37 items was obtained by exploratory factor analysis (Cronbach's alpha: 0.77-0.92). Confirmatory factor analysis supported this model. NPES-HHC scores had significant positive relations with participants' intention to remain at the workplace, job satisfaction and quality of care (p < .01). The NPES-HHC is a reliable and valid instrument to assess the attractiveness of the practice environment for home-visit nursing agencies.
Collapse
Affiliation(s)
- Yasuko Ogata
- Gerontological Nursing and Healthcare Systems Management, Graduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)TokyoJapan
| | - Keiko Fujinami
- Gerontological Nursing and Healthcare Systems Management, Graduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)TokyoJapan
| | - Sakiko Itoh
- Nursing Career Pathway Center, Graduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)TokyoJapan
| | - Masayo Kashiwagi
- Department of Innovation in Fundamental and Scientific Nursing Care, Graduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)TokyoJapan
| | | | - Yuki Yonekura
- Graduate School of Nursing ScienceSt. Luke's International UniversityTokyoJapan
| |
Collapse
|
5
|
Pahlevan Sharif S, Bolt EET, Ahadzadeh AS, Turner JJ, Sharif Nia H. Organisational support and turnover intentions: A moderated mediation approach. Nurs Open 2021; 8:3606-3615. [PMID: 33979031 PMCID: PMC8510732 DOI: 10.1002/nop2.911] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 12/18/2022] Open
Abstract
Aim The current study aims to examine the moderating role of psychological ownership in the process that translates organisational support into nurses’ turnover intentions through job satisfaction. Design A cross‐sectional research design was used to test the hypotheses. Method Using a purposive sampling 341 self‐completed survey data were collected from nurses working in two public hospitals in Iran. Structural equation modelling was used to analyse the data. Result The research revealed that organisational support and job satisfaction were negatively related to a healthcare professionals’ turnover intention. Moreover, job satisfaction mediated the negative relationship between organisational support and turnover intention. The research also revealed that psychological ownership strengthened the positive relationship between organisational support and job satisfaction.
Collapse
Affiliation(s)
| | | | | | | | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
6
|
Pahlevan Sharif S, Ahadzadeh AS, Sharif Nia H. Mediating role of psychological well-being in the relationship between organizational support and nurses’ outcomes: A cross-sectional study. J Adv Nurs 2017; 74:887-899. [DOI: 10.1111/jan.13501] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol; Mazandaran University of Medical Sciences; Sari Iran
| |
Collapse
|
7
|
Norman RM, Sjetne IS. Measuring nurses' perception of work environment: a scoping review of questionnaires. BMC Nurs 2017; 16:66. [PMID: 29200962 PMCID: PMC5697362 DOI: 10.1186/s12912-017-0256-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/02/2017] [Indexed: 11/22/2022] Open
Abstract
Background Nurses’ work environment has been shown to be associated with quality of care and organizational outcomes. In order to monitor the work environment, it is useful for all stakeholders to know the questionnaires that assess or evaluate conditions for delivering nursing care. The aim of this article is: to review the literature for assessed survey questionnaires that measure nurses’ perception of their work environment, make a brief assessment, and map the content domains included in a selection of questionnaires. Methods The search included electronic databases of internationally published literature, international websites, and hand searches of reference lists. Eligible papers describing a questionnaire had to be; a) suitable for nurses working in direct care in general hospitals, nursing homes or home healthcare settings; and b) constructed to measure work environment characteristics that are amenable to change and related to patient and organizational outcomes; and c) presented along with an assessment of their measurement properties. Results The search yielded 5077 unique articles. For the final synthesis, 65 articles met inclusion criteria, consisting of 34 questionnaires measuring nursing work environments in different settings. Most of the questionnaires that we found were developed, and tested, for registered nurses in a general hospital setting. Six questionnaires were developed specifically for use in nursing home settings and one for home healthcare. The content domains covered by the questionnaires were both overlapping and unique and the terminology in use was inconsistent. The most common content domains in the work environment questionnaires were supportive managers, collaborative relationships with peers, busyness, professional practice and autonomy. Conclusions The findings from this review enhance the understanding of how “work environment” can be measured by an overview of existing questionnaires and domains. Our results indicate that there are very many work environment questionnaires with varying content. Electronic supplementary material The online version of this article (10.1186/s12912-017-0256-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rebecka Maria Norman
- Norwegian Institute of Public Health (FHI), PO Box 4404 Nydalen, N-0403 Oslo, Norway.,University of Oslo, Faculty of Medicine, Institute of Health and Society, Department of Health Management and Health Economics, PO Box 1130 Blindern, N-0318 Oslo, Norway
| | | |
Collapse
|
8
|
Noguchi-Watanabe M, Yamamoto-Mitani N, Takai Y. How does collegial support increase retention of registered nurses in homecare nursing agencies? a qualitative study. BMC Nurs 2016; 15:35. [PMID: 27257406 PMCID: PMC4890275 DOI: 10.1186/s12912-016-0157-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/24/2016] [Indexed: 11/10/2022] Open
Abstract
Background Collegial workplace support has been linked to higher registered nurse (RN) retention in various clinical settings. In Japan, homecare agencies experience high RN turnover. The purpose of this study was to develop a conceptual framework to describe how perceived support from colleagues affects RNs’ decision to remain in an agency. Methods A qualitative research method based on grounded theory was used. Participants were RNs with at least 4 years of experience at the same homecare agency. Participants were theoretically sampled via managers of 12 homecare nursing agencies. Semi-structured interviews and supplementary participant observations were conducted. Data were analyzed using a constant comparative technique, and the process of how workplace support affected participants’ decision to remain at their agency was clarified. Results In total, 26 RNs were interviewed, 23 of whom were observed in their practice setting. Participants’ perception of support from colleagues was framed as being “encouraged to grow in one’s own way”, which comprised practicing with protected autonomy in an insight-producing environment. Participants reported that they were able to practice with protected autonomy, receiving 1) mindful monitoring, 2) semi-independent responsibility, 3) help as needed, and 4) collegial empathy and validation. RNs also felt supported in an insight-producing environment by 1) enlightening dialogue, 2) being set for one’s next challenges, and 3) being able to grow at one’s own pace. Reportedly, these were defining characteristics in their decision to continue working in their agencies. Conclusions For RNs to willingly stay at a homecare nursing agency, it is essential that they are able to practice with protected autonomy in an insight-producing environment that encourages them to grow in their own way. Further research is needed to explore ways to create and enhance such environments to lower RN turnover.
Collapse
Affiliation(s)
- Maiko Noguchi-Watanabe
- Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Noriko Yamamoto-Mitani
- Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Yukari Takai
- School of Nursing, Gunma Prefectural College of Health Sciences, 323-1 Kamioki-machi, Maebashi, Gunma 371-0052 Japan
| |
Collapse
|
9
|
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
Collapse
|
10
|
Wong CA, Cummings GG, Ducharme L. The relationship between nursing leadership and patient outcomes: a systematic review update. J Nurs Manag 2013; 21:709-24. [DOI: 10.1111/jonm.12116] [Citation(s) in RCA: 295] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Carol A. Wong
- Arthur Labatt Family School of Nursing; Faculty of Health Sciences; Health Sciences Addition (HSA); The University of Western Ontario; London Ontario Canada
| | - Greta G. Cummings
- Faculty of Nursing; Edmonton Clinic Health Academy; University of Alberta; Edmonton Alberta Canada
| | - Lisa Ducharme
- Nursing Professional Scholarly Practice; London Health Sciences Centre (LHSC); London Ontario Canada
| |
Collapse
|
11
|
Samia LW, Ellenbecker CH, Friedman DH, Dick K. Home care nurses' experience of job stress and considerations for the work environment. Home Health Care Serv Q 2013; 31:243-65. [PMID: 22974083 DOI: 10.1080/01621424.2012.703903] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Home care nurses report increased stress in their jobs due to work environment characteristics that impact professional practice. Stressors and characteristics of the professional practice environment that moderate nurses' experience of job stress were examined in this embedded multiple case study. Real life experiences within a complex environment were drawn from interviews and observations with 29 participants across two home care agencies from one eastern U.S. state. Findings suggest that role overload, role conflict, and lack of control can be moderated in agencies where there are meaningful opportunities for shared decision making and the nurse-patient relationship is supported.
Collapse
Affiliation(s)
- Linda W Samia
- School of Nursing, University of Southern Maine, P.O. Box 9300, Portland, ME 04104, USA.
| | | | | | | |
Collapse
|
12
|
Bourgeault IL, Sutherns R, Macdonald M, Luce J. Problematising public and private work spaces: midwives' work in hospitals and in homes. Midwifery 2012; 28:582-90. [PMID: 22925395 DOI: 10.1016/j.midw.2012.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 05/09/2012] [Accepted: 06/05/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVES as the boundaries between public and private spaces become increasingly fluid, interest is growing in exploring how those spaces are used as work environments, how professionals both construct and convey themselves in those spaces, and how the lines dividing spaces traditionally along public and private lines are blurred. This paper draws on literature from critical geography, organisational studies, and feminist sociology to interpret the work experiences of midwives in Ontario, Canada who provide maternity care both in hospitals and in clients' homes. DESIGN qualitative design involving in-depth semi-structured interviews content coded thematically. SETTING Ontario, Canada. PARTICIPANTS community midwives who practice at home and in hospital. FINDINGS the accounts of practicing midwives illustrate the ways in which hospital and home work spaces are sites of both compromise and resistance. With the intention of making birthing women feel more `at home', midwives describe how they attempt to recreate the woman's home in the hospital. Similarly, midwives also reorient women's homes to a certain degree into a more standardised work space for home birth attendance. Many midwives also described how they like `guests' in both settings. KEY CONCLUSIONS there seems to be a conscious or unconscious convergence of midwifery work spaces to accommodate Ontario midwives' unique model of practice. IMPLICATIONS FOR PRACTICE we link these findings of midwives' place of work on their experiences as workers to professional work experiences in both public and private spaces and offer suggestions for further exploration of the concept of professionals as guests in their places of work.
Collapse
Affiliation(s)
- Ivy Lynn Bourgeault
- University of Ottawa, Interdisciplinary School of Health Sciences, 1 Stewart Street, Ottawa, Ontario, Canada K1N 6N5.
| | | | | | | |
Collapse
|
13
|
Abstract
The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides insights into professional dignity in nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness.
Collapse
|
14
|
Clarkson Q. A process for developing a principle-centred district nursing service philosophy. Br J Community Nurs 2011; 16:554-557. [PMID: 22067573 DOI: 10.12968/bjcn.2011.16.11.554] [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: 05/31/2023]
Abstract
While it is well known that team vision and values statements in nursing can promote person-centred care, practitioner role clarity and empowerment, and service effectiveness, especially during times of change, their use in district nursing is limited. Accepted practice is to formulate vision and values statements 'from the top', and then seek buy-in from other staff groups, however, this inhibits practitioner engagement. This paper describes the use of group facilitation, based on principle-centred leadership practices, to engage practitioners in all the creative aspects of developing a values statement. Increasing practitioner engagement would be expected to provide the above benefits by improving communication with service-users and other key stakeholders and by motivating performance evaluation and improvement.
Collapse
|
15
|
Gasparino RC, de Brito Guirardello E, Aiken LH. Validation of the Brazilian version of the Nursing Work Index-Revised (B-NWI-R). J Clin Nurs 2011; 20:3494-501. [DOI: 10.1111/j.1365-2702.2011.03776.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
16
|
Cho SH, Mark BA, Yun SC, June KJ. Differences in intensive care unit work environments among and within hospitals using subscales and a composite measure of the Revised Nursing Work Index. J Adv Nurs 2011; 67:2637-48. [DOI: 10.1111/j.1365-2648.2011.05713.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
Royer L. Empowerment and commitment perceptions of community/public health nurses and their tenure intention. Public Health Nurs 2011; 28:523-32. [PMID: 22092462 DOI: 10.1111/j.1525-1446.2011.00947.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A descriptive, nonexperimental study of community/public health nurses' (C/PHN) perceptions of their work and their workplace was conducted for the purpose of identifying factors that may affect tenure intention and, by extension, health care delivery, at a time when nursing workforce capacity is in crisis, a subject not studied well among the C/PHN workforce. It was thought that findings would potentially contribute to decisions about curriculum development, hiring practices, and work design by nurse educators, leaders, and administrators. Spreitzer's Theory of Structural and Psychological Empowerment and Meyer and Allen's Commitment theory were utilized together as a framework. DESIGN AND SAMPLE A paper-pen survey was mailed to 688 C/PHNs in 10 states seeking national accreditation serving in community-oriented and population-focused roles and selected randomly in local health departments with a census of 10 or more eligible nurses. The return of 478 completed surveys yielded a response rate of 76%. MEASURES Data were examined with descriptive statistics, correlation, and multiple logistic regression methods. RESULTS Results revealed 1/3 of C/PHNs were in some way considering leaving the job in spite of significant relationships among empowerment factors and between empowerment and commitment factors. CONCLUSIONS These data beg for a clearer understanding of C/PHNs' perceptions of empowerment and the reasons for intent to leave.
Collapse
Affiliation(s)
- Linda Royer
- Florida Hospital College of Health Sciences, Orlando, Florida, USA.
| |
Collapse
|
18
|
Flynn L, Liang Y, Dickson GL, Aiken LH. Effects of nursing practice environments on quality outcomes in nursing homes. J Am Geriatr Soc 2010; 58:2401-6. [PMID: 21054327 PMCID: PMC3392023 DOI: 10.1111/j.1532-5415.2010.03162.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The objective of this study was to determine whether nurse staffing levels and modifiable characteristics of the nursing practice environment are associated with important quality indicators represented by the percentage of residents with pressure ulcers and numbers of deficiency citations in nursing homes. A cross-sectional design linked nurse survey data, aggregated to the facility level, with Nursing Home Compare, a publicly available federal database containing nursing home-level measures of quality. The facility sample consisted of 63 Medicare- and Medicaid-certified nursing homes in New Jersey, and the nurse survey sample comprised 340 registered nurses providing direct resident care. Characteristics of the practice environment were measured using the Practice Environment Scale of the Nursing Work Index, included in the nurse survey. The total number of deficiency citations, the percentage of residents with pressure ulcers, nurse staffing levels, and facility characteristics were extracted from the Nursing Home Compare database. Results indicated that a supportive practice environment was inversely associated with the percentage of residents with pressure ulcers and fully mediated the effect of profit status on this important outcome. The nursing practice environment and facility size explained 25% of the variance in quality deficiencies. There were no associations between staffing levels and quality indicators. Findings indicate that administrative initiatives to create environments that support nursing practice may hold promise for improving quality indicators in nursing homes.
Collapse
Affiliation(s)
- Linda Flynn
- Rutgers College of Nursing, The State University of New Jersey, Newark, New Jersey 07102, USA.
| | | | | | | |
Collapse
|
19
|
Slater P, O'Halloran P, Connolly D, McCormack B. Testing of the Factor Structure of the Nursing Work Index-Revised. Worldviews Evid Based Nurs 2010; 7:123-34. [DOI: 10.1111/j.1741-6787.2009.00158.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Parker D, Tuckett A, Eley R, Hegney D. Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses. Int J Nurs Pract 2010; 16:352-8. [DOI: 10.1111/j.1440-172x.2010.01851.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
21
|
GALVIN GERALDINE, TIMMINS FIONA. A phenomenological exploration of intellectual disability: nurse's experiences of managerial support. J Nurs Manag 2010; 18:726-35. [DOI: 10.1111/j.1365-2834.2010.01101.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Hinno S, Partanen P, Vehviläinen-Julkunen K, Aaviksoo A. Nurses' perceptions of the organizational attributes of their practice environment in acute care hospitals. J Nurs Manag 2010; 17:965-74. [PMID: 19941570 DOI: 10.1111/j.1365-2834.2009.01008.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. METHODS A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. RESULTS Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. CONCLUSIONS The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. IMPLICATIONS FOR NURSING MANAGEMENT There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.
Collapse
Affiliation(s)
- Saima Hinno
- Department of Nursing Science, University of Kuopio, FIN-70211 Kuopio, Finland.
| | | | | | | |
Collapse
|
23
|
Chen YM, Johantgen ME. Magnet Hospital attributes in European hospitals: a multilevel model of job satisfaction. Int J Nurs Stud 2010; 47:1001-12. [PMID: 20129609 DOI: 10.1016/j.ijnurstu.2009.12.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 12/18/2009] [Accepted: 12/23/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Magnet Recognition Program in the USA has been based on 14 hospital characteristics that were common in hospitals that were "magnets" for professional nurses. While the program has expanded to other countries, no research has explored how the concept translates to other cultures and healthcare systems, nor have multilevel approaches been used. OBJECTIVE The primary aim of this study was to explore the presence of Magnet Hospital attributes in hospitals in two European countries. In addition, the relationship between Magnet Hospital attributes and nurses' job satisfaction was examined at both the nurse and the hospital level. DESIGN A secondary data analysis with cross-sectional design was conducted. A multilevel approach was taken to account for the hospital effect due to the nested nature of the data. SETTINGS Nurses practicing in acute care hospitals in Germany (16) and Belgium (15) were examined. Hospitals that had less than five respondents were excluded. PARTICIPANTS Survey responses from 2303 registered nurses (RNs) from Belgium and 2646 RNs from Germany were included. Non-RN providers, RNs with administrative positions, and those working in non-inpatient areas were excluded. The final sample was 3182 staff nurses working in acute care hospitals. METHODS Magnet Hospital attributes that might be represented in NEXT survey items were reviewed by an expert panel before psychometric testing. Only six Magnet Forces could be measured. Latent constructs of these forces and job satisfaction were established. The measurement models and structural regression models were estimated using multilevel modeling in Mplus 4.21. RESULTS Six Magnet Forces were validated by two-level confirmatory factor analyses, with good fit to the data as demonstrated by the fit indices. All six Magnet Forces significantly predicted job satisfaction at the nurse level, with personnel policies having the strongest effect (b=0.96). At the hospital level, management style had the strongest effect (b=0.84) in predicting job satisfaction, followed by professional development, interdisciplinary relationship, and autonomy. CONCLUSIONS Magnet Hospital attributes are evident in hospitals in two European countries and were found to be associated with job satisfaction. Further multilevel research should explore these attributes particularly at the nursing unit-level where work environment is experienced.
Collapse
Affiliation(s)
- Yao-Mei Chen
- Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Faculty of Nursing, College of Nursing, Kaohsiung Medical University, Taiwan.
| | | |
Collapse
|
24
|
Gasparino RC, Guirardello EDB. Tradução e adaptação para a cultura brasileira do "Nursing Work Index - Revised". ACTA PAUL ENFERM 2009. [DOI: 10.1590/s0103-21002009000300007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Traduzir e adaptar o "Nursing Work Index - Revised", para a cultura brasileira. MÉTODOS: Para o procedimento metodológico seguiram-se as etapas recomendadas internacionalmente: tradução; retro-tradução; avaliação por um grupo de juízes e pré-teste. RESULTADOS: As etapas de tradução e retro-tradução foram realizadas satisfatoriamente e a avaliação da versão síntese pelo comitê de juízes resultou em alteração na maioria dos itens assegurando as equivalências entre as versões original e traduzida. Durante o pré-teste, verificou-se a necessidade de reformulações de alguns itens tornando-os mais claros e de fácil compreensão. CONCLUSÃO: Destaca-se que apesar da complexidade do instrumento, o processo de tradução e adaptação cultural do Nursing Work Index - Revised, para a cultura brasileira, foi concluído com sucesso.
Collapse
|
25
|
Tullai-McGuinness S. Home healthcare practice environment: predictors of RN satisfaction. Res Nurs Health 2008; 31:252-60. [PMID: 18481253 DOI: 10.1002/nur.20257] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Since 2000, Medicare-certified home healthcare agencies have undergone significant regulatory changes that directly affect registered nurses. The satisfaction of 201 nurses from 19 home healthcare agencies was examined. Home healthcare nurses reported slightly lower satisfaction than hospital nurses and were approximately 50% less satisfied than they were in 2000. Satisfaction had a negative relationship with years worked as a home healthcare nurse (r= -.25, p< .01). Controlling for years of home healthcare experience, control over practice decisions and practice setting decisions were significant predictors of satisfaction. With the demand for home healthcare nurses expected to increase 109% by 2020, development of a National Database of Nursing Quality Indicators for home healthcare that includes satisfaction as a nurse-sensitive outcome might be helpful.
Collapse
Affiliation(s)
- Susan Tullai-McGuinness
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA
| |
Collapse
|
26
|
Public health nurses’ perceptions of the professional practice environment in New Zealand. Prim Health Care Res Dev 2008. [DOI: 10.1017/s1463423608000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
27
|
Krebs JP, Madigan EA, Tullai-McGuinness S. The rural nurse work environment and structural empowerment. Policy Polit Nurs Pract 2008; 9:28-39. [PMID: 18492940 DOI: 10.1177/1527154408316255] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.
Collapse
|
28
|
Abstract
AIM This paper is a report of a study to (1) ascertain the relationship among self-nurturance, perceived Magnet features and life satisfaction and (2) evaluate the predictive effects of self-nurturance and Magnet features on life satisfaction. BACKGROUND Promoting health is a global priority for nurses and for the public who depend upon them to provide quality care. Health gains can be realized by modifying the work environment and by modifying lifestyle choices (self-nurturance). A study of nurses that examined perceptions of workplace features that enable nurses' professional practice (Magnet features), self-nurturance and healthy outcomes (life satisfaction) was not found in the literature. METHODS Survey data collected in May 2003 from a convenience sample of 310 Registered Nurses were used for this descriptive, correlational study. FINDINGS Self-nurturing nurses were more satisfied with life and perceived that more Magnet features were present in the workplace. Nurses with a master's degree were more self-nurturing than nurses without a baccalaureate degree. The synergistic effect of both self-nurturance and workplace factors predicted 29% of variance in nurses' life satisfaction. CONCLUSION Higher levels of perceived Magnet features and frequent self-nurturance choices are important health influences on nurses' life satisfaction. Greater life satisfaction is known to reduce job dissatisfaction while improving retention. Approaches that incorporate both self-nurturance and workplace Magnet features are suggested to improve the health and retention of experienced nurses.
Collapse
Affiliation(s)
- Mary Ann Nemcek
- Decker School of Nursing, Binghamton University, and Our Lady of Lourdes Memorial Hospital, Ascension Health System, Binghamton, NY, USA.
| | | |
Collapse
|
29
|
Abstract
Organizational attributes in work environments that support nursing practice are theoretically associated with superior nurse and patient outcomes, and lower frequencies of adverse events. This study explored associations between organizational support for nursing practice in home health care agencies and (a) the frequency of nurse-reported adverse events, (b) nurse-assessed quality of care, (c) nurse job satisfaction, and (d) nurses' intentions to leave their employing agency. Data were collected from a sample of 137 registered nurses employed as home health staff nurses in the United States and analyzed using descriptive techniques and bivariate correlation. As anticipated, organizational support for nursing was negatively associated with nurse-reported adverse patient events and intent to leave, and positively associated with nurse-assessed quality of care and job satisfaction. These findings may be helpful to nursing administrators who seek to create work environments in home health agencies that maximize patient outcomes and nurse satisfaction.
Collapse
Affiliation(s)
- Linda Flynn
- The New Jersey Collaborating Center for Nursing, College for Nursing, Rutgers, State University of New Jersey, Newark, USA
| |
Collapse
|
30
|
Abstract
OBJECTIVE The purpose of this study was to determine what home health nurses perceived to be the Essentials of Magnetism in the home healthcare setting. BACKGROUND Research in the acute care setting has established relationships between organizational attributes, nurse satisfaction, and quality outcomes. However, little is known in the home health setting on the importance and the impact of these relationships. More research is needed to further understand the implications to home healthcare. METHODS Registered nurses (N = 260) were asked to identify the top 10 attributes from the 37-item Dimensions of Magnetism instrument developed by Kramer and Schmalenberg. The top 10 Essentials of Magnetism attributes were obtained by tabulation of the number of respondents to each question. RESULTS The results showed that 7 of the top 8 Essentials of Magnetism items chosen by the home health nurses (n = 106) were the same Essentials of Magnetism items chosen by acute care nurses in previous studies. A test-retest of the top 10 items revealed a high level of reliability (.77). CONCLUSION Although the results demonstrate similar attributes as those identified in the acute care setting, noted differences need further review to understand their role in registered nurse satisfaction and quality.
Collapse
|
31
|
Abstract
RATIONALE The nurse shortage is increasing in the developed world. Organisational context is important in determining issues associated with nurse shortages, such as retention, recruitment, and job satisfaction. Recent research has utilised the Nursing Work Index-Revised (NWI-R) as a measure of organisational context traits. Within the NWI-R a four-factor model has been reported as being important in determining good organisational context, yet researchers have recently questioned the stability of the four-factor structure. AIM No known study has attempted to replicate the four-factor structure reported in the NWI-R. The aim of this research is to examine the factor structure of the 15 items that comprise the four factors of the NWI-R. METHODS The NWI-R is an instrument that is focused on capturing organisational attributes that characterise professional nursing environments. A random sample of 172 (50%) acute care hospital nurses completed the NWI-R as part of a larger research project. The sample was diverse concerning nursing grade and specialty. Data were analysed using SPSS.11.0 to extract factors' structures (principal component and maximum likelihood), measures of homogeneity and descriptive statistics were generated from the findings. RESULTS The four-factor structure of the NWI-R was not replicated in the data analysis. Instead a modified three-factor structure was identified accounting for 57% of the variance. Measures of internal consistency were acceptable. DISCUSSION Previous research utilised the four factors of the NWI-R as a method to identify supportive organisational context and practice. The three-factor model raises questions regarding the stability of the findings using the NWI-R. This research shows the synthesis of the two models in light of previous findings. CONCLUSIONS/IMPLICATIONS The findings might have far reaching implications for research that has utilised the NWI-R as a measure of organisational context. Further research is required to examine this study's findings and literature.
Collapse
Affiliation(s)
- Paul Slater
- School of Nursing, University of Ulster, Jordanstown and Royal Hospitals Trust, Belfast, Northern Ireland.
| | | |
Collapse
|
32
|
Abstract
BACKGROUND Although it is widely recognized that the effectiveness of mission statements is contingent upon the extent to which they are communicated to the organization's members, there is virtually no literature on how organizational members perceive the mission statement. PURPOSES To address these shortcomings, a research project was set up to seek (a) to assess how managers and nonmanagers perceive the mission statement and (b) to determine if there is a perception gap between both groups. METHODOLOGY/APPROACH In total, 102 nurses, nurse managers, and senior managers in a 217-bed Flemish hospital filled up a questionnaire, based on the Competing Values Framework for Managerial Communication, to assess their perception of the organizational mission statement. FINDINGS There is a mission statement perception gap between managers and nonmanagers. The scores of the management group are, in almost all cases, significantly higher. These findings suggest that managers have a more positive attitude toward the mission statement. PRACTICE IMPLICATIONS To optimize the impact of the mission statement, managers should measure the perception of the mission statement and try to remediate possible mission statement perception gaps. The Competing Values Framework for Managerial Communication is offered as a tool to assess (a) the presence, (b) the direction, and (c) the intensity of possible mission statement perception gaps.
Collapse
Affiliation(s)
- Sebastian Desmidt
- Department of Management and Entrepreneurship, Faculty of Economics and Business Administration, Ghent University, Belgium.
| | | |
Collapse
|
33
|
Abstract
Organizational climate generally refers to staff members' perceptions of organizational features like decision making, leadership, and norms. It is widely acknowledged that these perceptions influence patient, employee, and system outcomes. However, there has been little consensus on how best to measure these important relationships. This article examines how organizational climate has been defined and measured in health services research and identifies factors most important in home healthcare delivery. Standardization of climate measures will facilitate the ultimate goal of translating results into evidence-based management practices to improve the quality of care delivery.
Collapse
|
34
|
Abstract
As the nation faces a growing nursing shortage, it is imperative that home care leaders implement evidence-based strategies to improve nurse recruitment and retention. Previous research indicates that characteristics of the work environment that support nursing practice enhance nurses' job satisfaction and reduce turnover. Yet, there is little evidence to assist in prioritizing initiatives to improve the work environment of nurses. In this nationwide survey, home care nurses were asked to rate the importance of specific agency work environment traits, as listed on the Nursing Work Index-Revised, in supporting their home care practice. The 10 agency traits rated as most important are presented, and evidence-based recommendations for creating a culture of nurse retention are discussed.
Collapse
Affiliation(s)
- Linda Flynn
- New Jersey Collaborating Center for Nursing, College of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey 07102, USA.
| |
Collapse
|