Nurses' experiences of Organisational learning: A qualitative descriptive study

Measures and factors for regularly and effectively holding case conferences to improve quality of care provided by public health nurses for individuals and families: A qualitative descriptive study

OBJECTIVE

This study clarified the measures and necessary factors for regularly and effectively conducting case conferences to improve the quality of public health nurses' care for individuals and families.

DESIGN

We employed a qualitative descriptive design.

SAMPLE

The study fields were three Japanese municipalities that regularly held case conferences for at least a year to improve the quality of public health nurses' care for individuals and families. The first author conducted semi-structured interviews with three lead public health nurses and two nurses responsible for case conference projects.

MEASUREMENTS

The audio recordings of the interviews were transcribed verbatim and categorized. Interviews were conducted between December 2021 and May 2022.

RESULTS

Measures to regularly and effectively conduct case conferences included "creating a system to promote case conferences," "preparations to achieve case conference objectives," and "case conference progress management." Factors included "resources for promoting case conferences in the organization," "public health nurses' attitudes toward care," and "an environment that allows discussions about care."

CONCLUSION

Lead public health nurses can use the results as a reference to implement the identified measures in their organizations. The factors can enable lead public health nurses to evaluate the status of their organization regarding conducting case conferences.

Facilitating Organizational Learning in Nursing Teams

Organizational learning is an effective strategy professional development educators and other nurse leaders can use to improve individual, team, and organizational outcomes. Professional development educators can foster organizational learning by implementing certain actions, called mechanisms, associated with organizational learning. This article highlights five such mechanisms, presents practical examples of each, and suggests evidence-based recommendations professional development educators and nurse leaders can use to better facilitate organizational learning. [J Contin Educ Nurs. 2022;53(8):379-384.].

Contextual Factors Associated With Organizational Learning in Hospitals: An Instrument Development Study

AIM

Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals.

BACKGROUND

A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning.

METHODS

The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multi-level analyses. Construct validity was assessed using multi-level confirmatory factor analysis and coefficient omega was used to assess internal reliability.

RESULTS

Participants were 1063 nurses in 120 inpatient units in 11 Magnet® hospitals. Results were as follows: Item-level content validity=0.86-1.0, scale-level content validity=0.95, intraclass correlation coefficients=0.171-0.270, coefficient omega=0.945-0.982, and standardized factors loadings=0.672-0.964. Model fit statistics were: CFI=0.963, TLI=0.961, and RMSEA=0.059.

CONCLUSIONS

Initial testing indicates the Organizational Learning Instrument-Context has adequate levels of reliability, content validity, and construct validity.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital leaders and researchers may begin using this instrument to improve and study contextual factors associated with organizational learning in hospital units.

Developmental stages associated with organizational learning in hospitals: An instrument development study

AIM

To develop and test the Organizational Learning Instrument: Development Stages instrument, a measure of hospital units' readiness to engage in organizational learning.

DESIGN

Cognitive interviewing, expert review and a quantitative, cross-sectional survey.

METHODS

Item development was informed by previous research on organizational learning. Content validity was assessed and strengthened using cycles of cognitive interviewing and expert review. The resulting instrument was distributed by email to all nurses providing direct patient care in inpatient units in 11 Magnet® hospitals. Data were collected in 2018. Intraclass correlations, using hospital unit as the grouping variable, indicated the need to use multilevel methods to analyse the survey data. Thus, coefficient omega and multilevel confirmatory factor analysis were used to estimate the instrument's reliability and construct validity, respectively.

RESULTS

The Organizational Learning Instrument: Development Stages is a 35-item survey comprised of four scales: Identity & Ownership, Team & Respect, Accountability & Support and Reliability & Sustainability. The expert review yielded scale-level content validity scores from 0.90 to 1.0 and item-level content validity scores from 0.86 to 1.0. Survey participants were 1212 nurses, working in 99 inpatient units, across 11 Magnet® hospitals. Intraclass correlations ranged from 0.113 to 0.158. Coefficient omega reliability for the four scales was 0.981-0.993. Standardized factor loadings for the 35 items were 0.699-0.961, with acceptable model fit statistics (comparative fit index = 0.980, Tucker-Lewis Fit Index = 0.979, and root mean squared error of approximation = 0.060).

CONCLUSIONS

These results indicate the instrument meets or exceeds generally accepted criteria for content validity, reliability and construct validity instrument, and is suitable for further use and testing.

IMPACT

Nurse administrators, managers and researchers now have a valid, reliable instrument to better foster and study organizational learning in hospital units. Advances in organizational learning are expected to improve a variety of patient, staff and organizational outcomes in hospital units.

Organizational learning during COVID-19: A qualitative study of nurses' experiences

Aim

The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID‐19 pandemic.

Background

Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID‐19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation.

Methods

Semi‐structured interviews were conducted to gather 19 nurses' first‐hand experiences of organizational learning during the COVID‐19 pandemic. Data were analysed using deductive thematic analysis.

Results

Nurses' experiences of organizational learning generally aligned with the tenets of the model. Specifically, effective organizational learning occurred when the contextual factors and mechanisms portrayed in the model converged. Model and contrary cases illustrate this phenomenon.

Conclusions

This study validates and adds context to the model. It offers practical examples of the contextual factors and mechanisms of organizational learning. Leaders can use the model to guide their efforts to foster organizational learning.

Implications for Nursing Management

This study reaffirms the importance of nurse leaders' central role in organizational learning. Nurse leaders can use the Organizational Learning in Hospitals model, and the practical examples provided, to foster organizational learning during challenging times.

Creating a Work Environment Conducive to Organizational Learning

Through organizational learning, health care teams can consistently provide excellent patient care in a complex and changing environment. Nurse managers, educators, and other leaders can facilitate organizational learning within their teams by promoting certain contextual factors in the clinical work environment. This article provides an overview of contextual factors associated with organizational learning, includes practice-based examples of these factors, and offers evidence-based recommendations for creating a learning-focused work environment. [J Contin Educ Nurs. 2021;52(6):281-285.].