Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors

The Impact of Intensive Care Unit Nurses' Burnout Levels on Turnover Intention and the Mediating Role of Psychological Resilience

BACKGROUND

This study aims to investigate the relationship between burnout levels among intensive care unit (ICU) nurses, turnover intention, and the mediating role of psychological resilience.

METHODS

This survey design was used to collect data from 228 ICU nurses from hospitals in Turkey. The study utilized self-report questionnaires to measure burnout levels, turnover intention, and psychological resilience. The data were analyzed through structural equation modeling.

RESULTS

In the study, a positive relationship between burnout and turnover intention and burnout and psychological resilience is significant (p ≤ 0.001). However, psychological resilience was not found to have a mediating role, indicating that other factors or variables may play a more substantial role in the relation found between burnout and turnover intention. Also, the research model's Standardized Root Mean Square Residual is expected to be less than 0.10 for the model to have an acceptable fit.

CONCLUSION

The findings suggest that levels of burnout among ICU nurses may have significant consequences on turnover intention. However, promoting resilience cannot help diminish the negative effects of burnout on turnover intention. The findings highlight the importance of burnout levels in nursing by synthesizing findings from the previous literature. Then, focusing on the concepts of turnover intention and psychological resilience, it explains the importance of these concepts in the Intensive Care Unit nurses and their relationships with each other.

Healthy work environment: A systematic review informing a nursing professional practice model in the US Military Health System

AIM

The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our findings would likely benefit other nursing populations and environments as well.

DESIGN

Systematic literature review.

DATA SOURCES

We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus.

METHODS

Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments.

RESULTS

Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations.

CONCLUSIONS

This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments.

IMPACT

This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice.

REPORTING METHOD

PRISMA 2020 guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Linkage between role stress and work engagement among specialty nurses: a cross-sectional study of China

OBJECTIVES

Specialty nurses play a significant role in improving patient care; however, little is known about the factors affecting their work engagement. This study aimed to explore the relationship between role stress and work engagement among specialty nurses in China.

DESIGN

A descriptive, cross-sectional study was applied in this study.

SETTING

The study was conducted in the Henan Provincial People's Hospital in China.

PARTICIPANTS

From March to April 2023, we conducted a cross-sectional descriptive study, using convenience sampling to recruit 972 specialty nurses from 42 specialised fields in China.

METHODS

An online questionnaire survey was conducted using the Basic Information Questionnaire, Role Stress Scale and Specialty Nurse Work Engagement Scale. The collected data were analysed by using SPSS 21.0 software. The differences in total work engagement scores between subgroups were investigated using a single-factor analysis of variance. A Spearman's rank correlation and a Pearson's correlation were used to determine the relationship between general information, role stress and work engagement. A ridge regression analysis explored the impact of role stress on work engagement.

RESULTS

The total score of role stress was (52.44±19.92) and the total score of work engagement was (140.27±17.76). Among the scores of various dimensions of specialty nurses' work engagement, the standardised score for work attitude was the highest (4.54±0.56), followed by work values (4.46±0.64); the standardised score of work enthusiasm and focus was the lowest (4.22±0.64). Additionally, role ambiguity (r=-0.352, p<0.001), role conflict (r=-0.367, p<0.001), role overload (r=-0.313, p<0.001) and role stress (r=-0.380, p<0.001) were negatively correlated with work engagement. The total score of role stress was negatively correlated with the total score of work engagement; the results of ridge regression analysis showed that age, professional title and role stress explain 14.6% of the variance in work engagement.

CONCLUSION

Our study found that specialty nurses' work engagement was mid-level or above. Role stress was significantly and negatively correlated with specialty nurses' work engagement, which was an important predictor of their work engagement. Nursing managers should instate effective measures to reduce role stress, thereby increasing work engagement.

Factors associated with work engagement among specialist nurses in china: a cross-sectional study

BACKGROUND

The positive impacts of work engagement among specialist nurses on retention, organizational commitment, and quality of care are well-documented. However, there is a lack of research on the specific differences in work engagement among specialist nurses. Therefore, the purpose of this study is to assess the level of work engagement among specialist nurses in China and identify its influencing factors.

METHODS

A descriptive cross-sectional study was conducted in China from April to July, 2023, with 724 nurses selected from 22 hospitals through convenience sampling involved. The survey was conducted by using self-administered general information questionnaires and work engagement scales. Questionnaire Star was employed as the online data collection tool. The collected data was analyzed by using descriptive statistics and stepwise regression analysis to draw meaningful conclusions from the study.

RESULTS

Among specialist nurses in Xiamen, China, who had a response rate of 97.10%, an average work engagement score is 140.35 (SD=18.17), with the highest score for the work attitude at 4.65 (SD=0.52) and the lowest score for the work recognition at 4.09 (SD=0.85). It was shown through regression analysis that factors such as career satisfaction, involvement in challenging case discussions, marital status, gender, presence of promotion advantage and title accounted for 14.5% of the total variance in the model and were significant explanatory variables that could predict work engagement.

CONCLUSION

It is shown that specialist nurses in Xiamen, China have a high level of work engagement. It is imperative for nursing managers to prioritize the work engagement of specialist nurses, provide the specialist nurses with ample development opportunities and room for growth, and effectively promote the overall development of specialist nurses by improving work engagement in various aspects.

Patient satisfaction with preoperative nursing care and its associated factors in surgical procedures, 2023: a cross-sectional study

BACKGROUND

To enhance patient satisfaction, nurses engaged in preoperative care must possess a comprehensive understanding of the most up-to-date evidence. However, there is a notable dearth of relevant information regarding the current status of preoperative care satisfaction and its impact, despite a significant rise in the number of patients seeking surgical intervention with complex medical requirements.

OBJECTIVE

To assess patient satisfaction with preoperative nursing care and its associated factors in surgical procedures of, 2023.

METHODS

A cross-sectional study was conducted, and the data was collected from the randomly selected 468 patients who had undergone surgery during the study period. The collected data was entered into Epidata version 3.1 and analyzed using SPSS version 25 software.

RESULTS

The complete participation and response of 468 participants resulted in a response rate of 100%. Overall patient satisfaction with preoperative nursing care was 79.5%. Sex (Adjusted odds ratio (AOR): 1.14 (95% confidence interval (CI): 0.21-2.91)), payment status for treatment (AOR: 1.45 (95% CI: 0.66-2.97)), preoperative fear and anxiety (AOR: 1.01, 95% CI: 0.49-2.13)), patient expectations (AOR: 3.39, 95% CI: 2.17-7.11)), and preoperative education (AOR: 1.148, 95% CI: 0.54-2.86)) exhibited significant associations with patient satisfaction with preoperative nursing care.

CONCLUSION

It is important to exercise caution when interpreting the level of preoperative nursing care satisfaction in this study. The significance of preoperative nursing care satisfaction lies in its reflection of healthcare quality, as even minor deficiencies in preoperative care can potentially lead to life-threatening complications, including mortality. Therefore, prioritizing the improvement of healthcare quality is essential to enhance patient satisfaction.

Factors in the Perioperative Nurses' Work Environment That Predict Work Engagement

Perioperative nurse engagement and certification are associated with a culture of safety, which is crucial in perioperative environments. Therefore, examining relationships between engagement, the practice environment, and certification is warranted. The purposes of this study were to examine the relationships between the perioperative practice environment and reported nurse engagement, determine differences in engagement based on certification, and identify facilitators and barriers to attaining and sustaining certification. In this multiphase mixed-methods study, we used a convenience sample of perioperative nurses (N = 379) to examine relationships between engagement, the practice environment, and certification. Qualitative interviews were conducted (n = 15) to supplement the quantitative findings. Leadership support (β = 0.23, P = .001) and nursing foundations for quality care (β = 0.21, P = .01) were significant predictors of engagement. Certified nurses did not have significantly higher mean engagement scores when compared with noncertified peers. Qualitative interviews corroborated the findings.

Defining Vision and Mission of a Medical Psychiatry Unit (MPU) for Older Adults: A Focus Group Study

This study aims to determine the vision and mission of an academic hospital's medical psychiatry unit (MPU) that exclusively treats geriatric patients. All healthcare providers working at an academic hospital's geriatric MPU were invited to reflect on formulate the vision and mission of this ward. Twenty-two of them took part in the focus group interviews. The interviews focused on defining the MPU's functioning, its objectives, how it will reach these objectives, and where the MPU aspires to go. The interviews were transcribed verbatim and analyzed according to the QUAGOL guide. The themes from the analysis emerged from these group discussions. The participants defined the MPU's vision as to excel in integrated mental and physical geriatric inpatient healthcare, inspiring others to shed the stigma related to this vulnerable patient population. The mission that emerged from the focus group discussions is to provide patient-centered, integrated healthcare for older adults with combined mental and physical disorders. To achieve this, involving the patient's network, interdisciplinarity, shared decision-making, clear communication between all stakeholders, and reintegration of patients into their communities emerged as important themes. This study provides a vision and mission of a geriatric MPU in an academic psychiatric hospital. Since there is no consensus in the literature about the characteristics of MPUs despite the international call for integrated care for older persons with combined mental and physical disorders, these vision and mission statements can feed the discussion on how to install excellent healthcare for this vulnerable patient population.

Antecedents and outcomes of work engagement among nursing staff in long-term care facilities-A systematic review

AIM

To determine antecedents and outcomes of work engagement (WE) among nursing staff in long-term care (LTC) using the Job Demand-Resources model.

DESIGN

A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and Synthesis Without Meta-analysis in systematic reviews guideline. A study protocol was registered in PROSPERO (registration number CRD42022336736).

DATA SOURCES

The initial searches were performed in PsycInfo, Medline, Academic Search Premier, CINAHL and Scopus and yielded 3050 unique publications. Updated searches identified another 335 publications. Sixteen studies published from 2010 to 2022 were included.

REVIEW METHODS

The screening of titles and abstracts, and subsequently full-text publications, was performed blinded by two author teams using the inclusion/exclusion criteria. When needed, a mutual consensus was obtained through discussion within and across the teams. A descriptive and narrative synthesis without a meta-analysis of the included studies was performed.

RESULTS

The extent of research on WE in LTC facilities is limited and the factors examined are heterogeneous. Of forty-two unique antecedents and outcomes, only three factors were assessed in three or more studies. Antecedents-in particular job resources-are more commonly examined than outcomes.

CONCLUSION

Existing literature offers scant evidence on antecedents and outcomes of WE among nursing staff in LTC facilities. Social support, learning and development opportunities and person-centred processes are the most examined factors, yet with ambiguous results.

IMPACT

Antecedents and outcomes of engagement among nursing staff in LTC facilities have not previously been reviewed systematically. Engagement has been correlated with both more efficient and higher-quality service delivery. Our findings suggest opportunities to improve health and care services by enhancing engagement, whilst at the same time better caring for employees. This study lays the groundwork for more detailed research into the contributing factors and potential results of increasing caregivers' engagement. No patient or public contribution.

Competence in managing workplace violence among nursing interns: Application of latent class analysis

AIM

To identify subtypes of competence in managing workplace violence (WPV) among nursing interns and to assess between-group differences.

BACKGROUND

Nursing interns are reported to be a vulnerable population for experiencing workplace violence during their clinical placement. Although WPV could have a negative impact on nursing interns' health and attitudes towards the nursing profession, little is known about nursing interns' competence in workplace violence management or its influencing factors.

DESIGN

A cross-sectional study.

METHODS

Between March to April 2023, nursing interns at three tertiary general hospitals in Anhui Province, China, completed questionnaires including a general information questionnaire, the Management of Workplace Violence Competence Scale (MWVCS), the Utrecht Work Engagement Scale (UWES-9), the Emotional Labour Scale for Nurses (ELSN) and were classified into subtypes by latent class analysis. Subsequently, univariate analysis and multivariate logistic regression were performed to identify the influencing factors by subtypes.

RESULTS

A total of 264 questionnaires were valid and the overall mean age of the participants was 21.06 ±1.41 years. Four classes were identified: low competency group (15.5%), low cognition-low coping competency group (18.2%), low cognition-medium to high competency group (21.6%) and high competency group (44.7%). The results of multinomial logistic regression analysis showed that placement hospitals with a WPV management department, emotional control effort in profession dimension and emotional pretense by norms dimension in the Emotional Labour Scale for Nurses, pursuing further education and vigour dimension in the Utrecht Work Engagement Scale were influencing factors of the potential categories of WPV management competence.

CONCLUSIONS

Four classes were identified and there was competence variability among nursing interns. More attention should be given to nursing interns who did not receive WPV-related training in their school or placement hospital.

Work immersion and perceived stress among clinical nurses: a latent profile analysis and moderated mediation analysis

BACKGROUND

Exploration of the relationship between individual work immersion and perceived stress is critical for clinical nurses' effective psychological interventions and human resource management, as well as to alleviate nursing staff shortages. In order to further dissect the influencing factors of perceived stress among nursing staff, our study introduces the concepts of perfectionism and social connectedness to analyze the specific pathways that influence perceived stress in terms of an individual's intrinsic and external personality traits. This study provides relevant recommendations for the development of stress management measures for nursing staff.

METHODS

This was a cross-sectional survey. 993 registered clinical nurses were included from four hospitals in Guangzhou through a convenience sampling method. Clinical nurses' work immersion, perceived stress, perfectionism, and social connectedness were investigated using questionnaires based on latent profile analysis. The relationships between variables were analyzed using t-tests, analysis of variance, Pearson's correlation analysis, latent profile analysis, and moderated mediation analysis.

RESULTS

The results showed that (1) general influences on nurses' perceived stress included only child, labor relationship, labor allowance, and family support; (2) nurses' work immersion contained four subgroups: lowest (12.6%), medium-low (39.8%), medium-high (39.9%), and highest (7.7%); (3) positive and negative perfectionism played a mediating role between the association of work immersion and perceived stress; (4) social connectedness played a moderating role in the mediation model of perceived stress.

CONCLUSIONS

Work immersion, perfectionism, and social connectedness have an important impact on clinical nurses' perceived stress. Nursing managers or leaders should pay attention to the differences of individual work immersion status, adopt reasonable stress management strategies, accurately identify positive perfectionist groups and strengthen the relationship between groups, so as to ensure the quality of nursing care, and reduce nursing turnover and alleviate the problem of staff shortage.

Assessing resource allocation based on workload: a data envelopment analysis study on clinical departments in a class a tertiary public hospital in China

OBJECTIVE

Today, the development mode of public hospitals in China is turning from expansion to efficiency, and the management mode is turning from extensive to refined. This study aims to evaluate the efficiency of clinical departments in a Chinese class A tertiary public hospital (Hospital M) to analyze the allocation of hospital resources among these departments providing a reference for the hospital management.

METHODS

The hospitalization data of inpatients from 32 clinical departments of Hospital M in 2021 are extracted from the hospital information system (HIS), and a dataset containing 38,147 inpatients is got using stratified sampling. Considering the non-homogeneity of clinical departments, the 38,147 patients are clustered using the K-means algorithm based on workload-related data labels including inpatient days, intensive care workload index, nursing workload index, and operation workload index, so that the medical resource consumption of inpatients from non-homogeneous clinical departments can be transformed into the homogeneous workload of medical staff. Taking the numbers of doctors, nurses, and beds as input indicators, and the numbers of inpatients assigned to certain clusters as output indicators, an input-oriented BCC model is built named the workload-based DEA model. Meanwhile, a control DEA model with the number of inpatients and medical revenue as output indicators is built, and the outputs of the two models are compared and analyzed.

RESULTS

Clustering of 38,147 patients into 3 categories is of better interpretability. 14 departments reach DEA efficient in the workload-based DEA model, 10 reach DEA efficient in the control DEA model, and 8 reach DEA efficient in both models. The workload-based DEA model gives a relatively rational judge on the increase of income brought by scale expansion, and evaluates some special departments like Critical Care Medicine Dept., Geriatrics Dept. and Rehabilitation Medicine Dept. more properly, which better adapts to the functional orientation of public hospitals in China.

CONCLUSION

The design of evaluating the efficiency of non-homogeneous clinical departments with the workload as output proposed in this study is feasible, and provides a new idea to quantify professional medical human resources, which is of practical significance for public hospitals to optimize the layout of resources, to provide real-time guidance on manpower grouping strategies, and to estimate the expected output reasonably.

The mediating effect of psychological empowerment on the relationship between work environment and clinical decision-making among midwives: a multicentre cross-sectional study

BACKGROUND

Clinical decision-making is considered an essential behaviour in clinical practice. However, no research has been done to examine the associations among midwives' clinical decision-making, work environment and psychological empowerment. Thus, this study aimed to determine the influence of work environment on midwives' clinical decision-making and confirm the mediating role of psychological empowerment.

METHOD

This study was designed as a multicentre cross-sectional study, and included 602 registered midwives from 25 public hospitals in China. A sociodemographic questionnaire, Work Environment Scale, Psychological Empowerment Scale and Clinical decision-making Scale were applied. A structural equation model was conducted to estimate the hypothesis model of the clinical decision-making among midwives and explore the potential mediating mechanism of midwives' clinical decision-making. This model was employed maximum likelihood estimation method and bootstrapping to examine the statistical significance.

RESULTS

The mean score of clinical decision-making among midwives was 143.03 ± 14.22, at an intermediate level. The data of this hypothesis model fitted well, and the results showed that work environment positively affected psychological empowerment, which in turn positively affected clinical decision-making; psychological empowerment partly mediated the relationship between work environment and clinical decision-making among midwives.

CONCLUSIONS

Midwives' clinical decision-making could be promoted directly or indirectly by providing a healthy work environment and improving psychological empowerment. It is essential for hospital managers to pay attention to the assessment of the midwives' work environment and actively improve it, such as establishing a supportive, fair and just workplace, and maintaining effective communication with midwives. Furthermore, managers can also promote midwives' clinical decision-making behaviour by enhancing their psychological empowerment via enhancing job autonomy.

Predictive roles of organizational and personal factors in work engagement among nurses

Objective: To determine the work engagement levels of hospital nurses and the predictive roles that nurses’ personal and organizational characteristics play.

Methods: A cross-sectional design was employed in this study, which included 549 nurses working in the Central Philippines. Nurses were selected through purposive sampling, and a self-report questionnaire outlining personal and organizational characteristics was employed. The Utrecht Work Engagement Scale (UWES) was applied to gather data about nurse engagement.

Results: The dedication score was the highest among the three dimensions of engagement while the vigor score was the lowest. Overall, Filipino nurses experienced an average level of work engagement. We observed significant relationships between a nurse’s age, years of experience in nursing, years in their present unit, and their position at work and their levels of engagement, vigor, sense of dedication, and absorption. Hospital capacity was a negative predictor of vigor, dedication, absorption, and overall work engagement. Further, the type of nursing contract was a negative predictor of vigor and dedication. The type of hospital and the nurse’s position were positive predictors of vigor, dedication, and absorption.

Conclusions: Filipino nurses were satisfactorily engaged at work. A number of nurses’ personal and organizational characteristics play a predictive role in their work engagement. Thus, nursing administrators must support, develop, and implement activities and measures that engage nurses at work.

The influence of authentic leadership on nurses' turnover intentions and satisfaction with quality of care in Saudi Arabia: A structural equation modelling study

AIM(S)

The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care.

BACKGROUND

Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions.

METHOD(S)

A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included.

RESULTS

Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care.

CONCLUSION(S)

Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments.

IMPLICATIONS FOR NURSING MANAGEMENT

Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses.

Professional quality of life in pediatric services: A cross-sectional study

OBJECTIVE

Determine the quality of working life among the different pediatric nursing professionals, taking into account socio-demographic and work context factors, and the relationship of Burnout, compassion satisfaction and compassion fatigue between different job positions.

METHOD

Cross-sectional descriptive observational study carried out between January-March 2019 at the national territory. The professional quality of life was measured with ProQOL IV and sociodemographic characteristics were recorded. The data was encoded in Microsoft Office Excel, and analyzed with SPPS considering statistically significant differences p &lt; 0.05.

RESULTS

A total of 68 nurses were included in the study. The results obtained show less satisfaction due to compassion in those professionals who have a permanent employment contract, as well as those who carry out their work in hospitalization positions compared to those in the oncology area. In our sample there are very high levels of compassion fatigue, in addition we observed a significant relationship between compassion fatigue and religious belief, being higher in believing professionals.

CONCLUSIONS

It's necessary to identify associated factors in the professional quality of life to propose intervention strategies and improvement conditions, requiring greater involvement of health institutions to improve the professional quality of life in pediatric nursing.

Subtypes of work engagement in frontline supporting nurses during COVID-19 pandemic: A latent profile analysis

AIM

The aim was to examine the subgroups of work engagement in frontline nurses during the COVID-19 pandemic.

BACKGROUND

The pandemic may affect the work engagement of nurses who have direct contact with infected patients and lead to a poor quality of care. Identifying classification features of work engagement and tailoring interventions to support frontline nurses is imperative.

DESIGN

This study utilized a cross-sectional study design.

METHODS

Three hundred fifty-five nurses were enrolled in this cross-sectional study from 14 February to 15 April 2020. A latent profile analysis was performed to identify classification features of work engagement. Multiple logistic regression analyses were used to examine predictors of profile membership.

RESULTS

A four-profile model provided the best fit. The four profiles were titled 'low work engagement' (n = 99), 'high vigour-low dedication and absorption' (n = 58), 'moderate work engagement' (n = 63) and 'high work engagement' (n = 135). A regression analysis suggested that young nurses and nurses who were the only children of their family were more likely to be in the 'low work engagement' and 'high vigour-low dedication and absorption' groups.

CONCLUSION

This study highlights the importance of tailoring interventions for frontline supporting nurses by considering their distinct work engagement patterns, especially during the COVID-19 pandemic, to improve the promotion of work satisfaction and quality of care.

IMPACT

This was the first study to explore the latent profiles of work engagement in frontline nurses during the COVID-19 pandemic. Over 40% of nurses were in the 'low work engagement' and 'high vigour-low dedication and absorption' groups and reported low levels of work engagement. Understanding different patterns of work engagement in frontline nurses can help nursing managers provide emotional, material and organizational support based on the features of each latent profile, which may improve the quality of care and patient safety.

Organizational support and perceived environment impact on quality of care and job satisfaction: a study with Pakistani nurses

Purpose

Referring to the theory of organizational empowerment, the purpose of this study is to examine the relationship of organizational support and perceived environment on quality of care and job satisfaction, with organizational commitment as a mediator for the first variable.

Design/methodology/approach

This study employed a cross-sectional research design and data was collected from seven private and public sector hospitals in Pakistan, involving 352 nurses on a voluntary basis through a self-administered survey.

Findings

The results showed that organizational commitment mediates the relationship between organizational support and job satisfaction with the quality of care. Moreover, the perceived environment has an impact on job satisfaction and quality of care.

Originality/value

Healthcare service quality seems strictly dependent on the perceived quality of care and job satisfaction among healthcare workers. Theoretical and practical implications for policymakers and HR management are discussed.

A Psychometric Analysis of the Nurse Satisfaction with the Quality of Care Scale

The concept of quality of nursing care can vary across healthcare organizations, and many different factors may affect the quality of nursing care as perceived by nurses. Measuring satisfaction with quality of nursing care from the nurse’s perspective is important as a valid and reliable indicator of care quality. The purpose of this study was to measure the psychometric properties of a researcher-developed instrument measuring nurse satisfaction with quality of care. A sample of 200 nurses was randomly selected from three different cities in Saudi Arabia and surveyed with the Nurse Satisfaction with Quality of Care Scale, which is a self-administrated five-item scale. Exploratory factor analysis, confirmatory factor analysis, and internal consistency analysis were conducted to assess aspects of the validity and reliability of the instrument. The results of exploratory factor analysis supported a one-factor structure that consisted of the five items. Confirmatory factor analysis results confirmed that the five items were integral to nurse satisfaction with quality of care. The Cronbach internal consistency of the scale was acceptable. The scale appeared to be a reliable and valid tool for assessing nurse perceptions of their satisfaction with the quality of care provided. Additional studies to further test psychometric properties of this scale in different contexts are warranted.

Association between workplace psychological violence and work engagement among emergency nurses: The mediating effect of organizational climate

Background

Given that increasing attention is being given to the burdens on medical systems, researchers have concentrated their attention on nurses’ work engagement, especially in emergency departments.

Purpose

To investigate the current situation of work engagement of nurses in emergency department, and to find out the impact of psychological violence on work engagement and its impact path.

Basic procedures

The research is a cross-sectional study. Questionnaires were distributed to 243 nurses from the emergency departments of ten tertiary hospitals from September to October 2019. SPSS was used to conducted ANOVA. The AMOS was used to conduct structural equation model to test the mediating effect of organizational climate on the association between psychological violence and dimensions of work engagement.

Main findings

Psychological violence was negatively correlated with organizational climate, vitality, dedication, and focus, and organizational climate was positively correlated with dimensions of work engagement. A negative relationship was found between psychological violence and three dimensions of work engagement, which was mediated by organizational climate.

Conclusion

In order to curb workplace psychological violence and improve the work engagement level of emergency nurses, organizational climate can be used as an intervention measure. The support of leaders, the care of colleagues and the mutual understanding and communication between doctors and patients can alleviate the job burnout of nurses in the face of heavy work, so that nurses can face their daily work with a better mental outlook.

Work Engagement and Patient Quality of Care: A Meta-Analysis and Systematic Review

Past research has demonstrated that work engagement among health care professionals influences patient quality of care. There is, however, no estimate of the strength of this relationship, and existing reviews have not always explained conflicting findings. We conduct a meta-analysis and review of 25 articles, and find a small to medium mean effect size (r = .26, p < .01) for the positive association between engagement and quality of care. Moderator analyses on five factors (type, data source, level of analysis of the quality of care measure, profession, and work engagement measure) indicate that only data source is significant, providing preliminary evidence that the relationship is stronger if quality of care is measured via self-assessments. Although a more consistent conceptualization of quality of care is needed to better determine its association with work engagement, our findings suggest that work engagement is as important as burnout in predicting quality of care.

Perceptions of Safety and Stress Among Health Professionals: The Role of Care Unit Identification as a Protective Factor During the COVID-19 Pandemic

The present study aimed to investigate the role of motivational process and coping resources in health professionals during the COVID-19 emergency examining the role of Care Unit Identification and safety climate perception as resources that can help nurses to cope with stressors. A cross-sectional research design was used and 218 nurses completed a self-report questionnaire measuring: Perception of safety, Care Unit identification, Work Engagement, Psychological Distress, and Burnout. Results revealed that Work Engagement was significantly related with Burnout (b = -0.209, 95%CI [-0.309; -0.109]) and Distress (b = -0.355, 95%CI [-0.529; -0.18]) especially when the Care Unit identification is high (b = -0.303, 95%CI [-0.448; -0.157] and b = -0.523, 95%CI [-0.772; -0.275], respectively). The safety perception was positively related to Work Engagement (b = 0.315, 95%CI [0.198; 0.433]) and had an indirect effect on psychological Distress (b = -0.112, 95%CI [-0.181; -0.042]) and Burnout (b = -0.066, 95%CI [-0.105; -0.027]). High levels of both Care Unit identification and perception of safety, along with personal work engagement, appear to protect nurses from burnout and psychological distress. Findings suggest that the effort to improve teamwork identification and ensures an adequate degree of perceived safety for healthcare professionals need to be maintained and reinforced as they positively impact nurses' wellbeing.

Psychological Capital and Occupational Well-Being: Mediating Effects of Work Engagement Among Chinese Special Education Teachers

This study examines whether psychological capital (PsyCap) indirectly predicts occupational well-being among Chinese special education teachers through work engagement. In total, 615 Chinese special education teachers (female = 567) completed the Psychological Capital Questionnaire, the Special Education Teachers’ Occupational Well-Being Questionnaire, and the Utrecht Work Engagement Scale. The results indicated that PsyCap was positively correlated with occupational well-being and work engagement. Furthermore, work engagement mediated the influence of PsyCap on occupational well-being. Notably, the multiple mediation model indicated that the indirect effects of PsyCap on occupational well-being were mainly due to dedication and absorption. The study’s results illustrate the association between PsyCap, work engagement, and occupational well-being, which may help educational administrators and social workers assist with special education and special education teachers develop and maintain good working conditions.

The Impact of Working Environment on Nurses' Caring Behavior in Sabah, Malaysia

Aims

This study aims to investigate 5 types of work environment influencing nurses' caring behavior, namely (i) participation in hospital affairs, (ii) foundations for quality of care, (iii) manager ability, leadership, and support of nurses, (iv) staffing and resource adequacy, and (v) nurse-physician relations.

Design

This research is a cross-sectional study using the survey method.

Methods

Data were collected from 3,532 nurses working in public hospitals and health clinics within Sabah, Malaysia in 2015. The hypothesized model was evaluated using partial least squares method.

Results

The findings reveal that all forms of work environment have a positive effect on nurses' caring behavior except for staffing and resource adequacy which shows a negative effect on caring behavior.

Conclusion

Overall, this study has added to theoretical contributions in the academic and research fields as well as in practical implications in the field of nursing practice by addressing the influence of work environments on caring behavior.

Implications for Nursing Management

The present research has provided convergent evidence on the role of the working environment in influencing the behavior of nurses working in hospitals and health clinics in Sabah, Malaysia.

A Hospitality Improvement Intervention in Residential Care Does Not Warrant Staff Job Satisfaction or Turnover Intention: A Cross-Sectional Survey Study Investigating the Hostmanship Program

Background

Accountability pressure is rising in healthcare, and this demonstrates that the quality of care provided within a residential care setting is of utmost importance. Hostmanship is a quality improvement program focusing on person-centered care in residential care settings.

Objectives

This study aimed to explore the influencing factors for job satisfaction and intention to leave among healthcare workers and the difference in job satisfaction and intention to leave the employer between residential care centers with and without Hostmanship.

Methods

A quantitative, cross-sectional study was conducted in sixteen Flemish residential care settings in Belgium. A total of 293 participants completed the questionnaire, divided into two groups: the group with Hostmanship (n = 139), at least one year into a change process implementing Hostmanship, and the group without the Hostmanship program (n = 154). Hierarchical logistic regression analysis estimated effects between demographic characteristics (block one), facility management, staffing and Hostmanship (block two), work characteristics (block three), and work engagement or burnout dimensions (block four) as explanatory variables of job satisfaction and turnover intention as outcome variables.

Results

This study confirmed the positive impact of social capital and decision latitude on staff member job satisfaction, as shown in previous findings. Age and workload were associated with turnover intentions. A hierarchical logistic regression model explained 68.7 % of the variance in workers' job satisfaction, and a hierarchical logistic regression explained 49.2% of the variance in their intent to leave. Also, no effects were found for Hostmanship on staff job satisfaction and intention to leave.

Conclusions

This study shows how a quality improvement project such as Hostmanship could produce counterintuitive results for organizations in elderly residential centers. However, results inconsistent with literature were found. It is unclear whether Hostmanship warrants job satisfaction or retaining personnel. Future research must take into consideration success factors when implementing new quality initiatives. A general framework for successful implementation in the healthcare sector should be provided.

Empowerment and turnover of nurse managers before and after a major healthcare reform in Cyprus: A cross sectional study

AIM

To investigate the perceived empowerment and turnover intention of middle nurse managers before and after the implementation of a major reform of the healthcare system in Cyprus, which also includes the transition of public hospitals towards administrative and financial autonomy.

BACKGROUND

The empowerment of Nurse Managers is important since previous studies have shown that it is associated with performance at work and may have an impact on their turnover intention.

METHODS

This is a repeated cross-sectional study, which was conducted in March 2019 (first phase) and was repeated in March 2020 (second phase), after the introduction of major changes. The target population was all nurse managers of the public hospitals. The final sample consisted of 175 (RR 94%) participants in the first phase and 178 (RR 95.6%) in the second.

RESULTS

Measurements at both time points revealed moderate levels of perceived empowerment among Cyprus Nurse Managers. Empowerment appeared slightly lower at the repeat measurement compared to the first, but the observed difference was not statistically significant. Among the categories of empowerment «opportunities» was presenting statistically significant differences between the two phases. At the second phase, mean scores of empowerment were consistently lower among those who stated YES compared to those who stated NO in relation to: a) the intention to change department, b) the intention to change profession and c) the intention to change organization/hospital.

CONCLUSIONS

This study demonstrated lower levels of empowerment among Nurse Managers with turnover intentions. It is therefore needed to be investigated further whether lower empowerment levels are the main reason for turnover intentions. It also suggests the need for senior management to create opportunities and to develop and implement interventions which aim to maintain and further improve the empowerment of the Nurse Managers and assess their effectiveness in terms of turnover intention in the organization.

IMPLICATIONS FOR NURSING POLICY

The senior management of the hospitals need to adopt retention strategies by establishing an empowered positive working environment for Nurse Managers. Nurse Managers need to collaborate with the senior management and seek more access to opportunities, information, support and resources which will enable them to perform their duties with efficiency and be more effective.

Linking nurse practice environment, safety climate and job dimensions to missed nursing care

AIM

This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care.

BACKGROUND

Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established.

METHODS

This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines.

RESULTS

Patient safety climate (β = -0.148, p = 0.001), decision authority (β = -0.101, p = 0.018) and staffing/resource adequacy (β = -0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care.

DISCUSSION

Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.

An Analysis of the Effects of Psychosocial Work Environment on the Retention Intentions of Primary Care Coordinators Nursing Patients with Chronic Illness

This study aimed to investigate the effects of psychosocial work environment on the retention intentions of care coordinators taking care of patients with chronic illness. A descriptive survey study was conducted with a convenience sample of care coordinators who organized patients and treatment teams that offered professional and persistent treatment. A total of 132 participants were recruited from 19 October to 19 November 2020. The data were analyzed through descriptive statistics, t-tests, ANOVA, Scheffé post hoc, and hierarchical multiple regression using SPSS 26.0. The results showed that work organization and job content (β = 0.254, p = 0.014) and value at the workplace (β = 0.245, p = 0.034) had significant effects on the retention intentions of participants. The final model of the study explained 40.1% of participants' retention intentions (F = 11.830, p < 0.001). The development of educational programs and implementation of policies for improving the psychosocial work environment were found to be essential for increasing the retention intentions of professional care coordinators.

Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.

Job demands, job control, and social support as predictors of job satisfaction and burnout in Croatian palliative care nurses

The Job Demands-Control-Support (JDCS) model has seldom been tested in palliative care settings, and occupational well-being of palliative care professionals has never before been investigated in Croatia. Our aim was therefore to fill that gap by testing the JDCS model among Croatian nurses providing palliative care. More specifically, we wanted to see how job demands, job control, and social support at work affect occupational well-being outcomes (i.e. job satisfaction and burnout dimensions of exhaustion and disengagement from work) in terms of the model’s iso-strain and buffer hypotheses. This cross-sectional study included 68 nurses working in various palliative care institutions across Croatia, who answered our online questionnaire. Overall, the nurses did not report high levels of burnout or low job satisfaction. The only significant effect was that of job control on job satisfaction (β=0.38; P<0.01) and disengagement (β=-0.45; P<0.01), while job demands and social support at work had a significant interaction effect on the burnout dimension of exhaustion (β=0.39; P<0.01) in the sense that high social support at work buffered the increase in exhaustion associated with high job demands. These findings suggest that interventions aimed at increasing perceived job control and social support at the workplace could improve occupational well-being of nurses working in palliative care.

A Concept Analysis of Quality Nursing Care

PURPOSE

This study aimed to perform a concept analysis of quality nursing care.

METHODS

Walker and Avant's concept analysis method was used to carry out this study.

RESULTS

The defining attributes identified were as follows: caring, the nurse-patient relationship, and patient needs. Antecedents included patient characteristics, individual factors (age, education, knowledge, competence, and experience), job position, and environmental factors. The consequences of quality nursing care have significant influence on both patients and nurses.

CONCLUSION

The findings can aid researchers in obtaining a better understanding of quality nursing care, and stakeholders can consider the factors related to quality nursing care and its consequences to improve the nursing process.

An Examination of Factors That Predict the Perioperative Culture of Safety

The perioperative setting is an intricate, complicated work environment in which patients are vulnerable to adverse events. Using a convenience sample, we examined relationships between the length of perioperative nurse experience, perioperative nurse engagement, and an OR culture of safety. We explored differences in safety culture scores based on CNOR certification status. There was no significant relationship between the length of perioperative nurse experience and the level of OR culture of safety. However, perioperative nurse engagement had a significant relationship with an OR culture of safety (P < .001), and this factor was a significant predictor of an OR culture of safety (P < .001). Perioperative nurses who held CNOR certification had significantly higher culture of safety scores compared with those who did not (P = .004). Additional research on perioperative nurse engagement and factors relating to patient safety may help perioperative leaders develop and implement engagement strategies.

Exploring the relation between modelled and perceived workload of nurses and related job demands, job resources and personal resources; a longitudinal study

Aim

Calculating a modelled workload based on objective measures. Exploring the relation between this modelled workload and workload as perceived by nurses, including the effects of specific job demands, job resources and personal resources on the relation.

Design

Academic hospital in the Netherlands. Six surgical wards, capacity 15–30 beds. Data collected over 15 consecutive day shifts.

Methods

Modelled workload is calculated as a ratio of required care time, based on patient characteristics, baseline care time and time for non-patient related activities, and allocated care time, based on the amount of available nurses. Both required and allocated care time are corrected for nurse proficiency. Five dimensions of perceived workload were determined by questionnaires. Both the modelled and the perceived workloads were measured on a daily basis. Linear mixed effects models study the longitudinal relation between this modelled and workload as perceived by nurses and the effects of personal resources, job resources and job demands. ANOVA and post-hoc tests were used to identify differences in modelled workload between wards.

Results

Modelled workload varies roughly between 70 and 170%. Significant differences in modelled workload between wards were found but confidence intervals were wide. Modelled workload is positively associated with all five perceived workload measures (work pace, amount of work, mental load, emotional load, physical load). In addition to modelled workload, the job resource support of colleagues and job demands time spent on direct patient care and time spent on registration had the biggest significant effects on perceived workload.

Conclusions

The modelled workload does not exactly predict perceived workload, however there is a correlation between the two. The modelled workload can be used to detect differences in workload between wards, which may be useful in distributing workload more evenly in order prevent issues of over- and understaffing and organizational justice. Extra effort to promote team work is likely to have a positive effect on perceived workload. Nurse management can stimulate team cohesion, especially when workload is high. Registered nurses perceive a higher workload than other nurses. When the proportion of direct patient care in a workday is higher, the perceived workload is also higher. Further research is recommended. The findings of this research can help nursing management in allocating resources and directing their attention to the most relevant factors for balancing workload.

Serial Multiple Mediation of Professional Identity, and Psychological Capital in the Relationship Between Work-Related Stress and Work-Related Well-Being of ICU Nurses in China: A Cross-Sectional Questionnaire Survey

This study aimed to investigate the serial-multiple mediation effect of professional identity, psychological capital (PsyCap), work-related stress, and work-related wellbeing among intensive care unit (ICU) nurses in China. The cross-sectional survey was conducted from January 2017 to May 2017 in two Grade III A general hospitals (with more than 2000 beds) in Jining, Shandong Province, China. Cluster sampling was used to recruit participants from the two hospitals. A total of 330 ICU nurses participated in the study. The nurses’ work stress scale, Chinese nurse’s professional identity scale, the PsyCap questionnaire, and Chinese work-related wellbeing scale were used to collect the data. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, linear regression analysis, and structural equation modeling were used to analyze the data (P < 0.05 was considered statistically significant). The average score for the work-related wellbeing of ICU nurses was 85.91 ± 13.94. Work-related stress, professional identity, and PsyCap correlated significantly with work-related wellbeing. The major predictors of work-related wellbeing were PsyCap, work-related stress, professional identity, and monthly salary. The serial-multiple mediation effects of professional identity and PsyCap in the relationship between work-related stress and work-related wellbeing were statistically significant. Positive professional identity and PsyCap were sequentially associated with decreased work-related stress, which in turn was related to increased work-related wellbeing among ICU nurses. Therefore, this study aims to explore the impact of ICU nurses’ work-related stress on work-related wellbeing, as well as the mediating effect of professional identity and PsyCap. It is hoped that hospital care managers will pay attention to the mental health of ICU nurses, increase their professional identity, and reduce work-related stress to improve the quality of the ICU nursing service and stabilize nursing work.

The association between workplace social capital and authentic leadership, structural empowerment and forms of communication as antecedent factors in hospital nurses: A cross-sectional multilevel approach

AIM

To identify the effects of authentic leadership, structural empowerment and forms of communication as antecedent factors of workplace social capital in nursing.

BACKGROUND

Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members.

METHODS

In 2019, self-administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate relationships between perceived workplace social capital-the dependent variable-and authentic leadership, structural empowerment and forms of communication-the individual- and ward-level independent variables.

RESULTS

Data from 463 nurses and 28 nurse managers were analysed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (standard deviation: 7.00), and 93.5% were female. Ward-level authentic leadership and semi-formal communication were found to be significantly related to workplace social capital.

CONCLUSION

More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals.

IMPLICATIONS FOR NURSING MANAGEMENT

Workplace social capital can be produced by improved management, environment and communication opportunities.

Development of a relational workplace social capital scale for Japanese nurses

BACKGROUND

Although nurses' workplace social capital for a healthy work environment has received considerable attention, few scales about nurses' workplace social capital are based on the attributes of clinical settings in Japan. This study aims to develop a Relational Workplace Social Capital Scale for Japanese Nurses (RWSCS-JN), which includes bonding, linking, and bridging social capital and assessing its reliability and validity.

METHODS

We assessed its reliability and validity using questionnaire survey data collected from 309 nurses in the first survey and 105 nurses in the second survey in four hospitals in Japan. First, we determined the number of factors and items for the RWSCS-JN through the parallel and factor analyses after conducting the item analysis. Then, we confirmed the omega coefficients and intraclass correlation coefficients (ICC) of the RWSCS-JN. Finally, we examined the Pearson product-moment correlation coefficient between the RWSCS-JN score and other variables, including an existing measurement of workplace social capital, work engagement, and turnover intention.

RESULTS

The newly developed RWSCS-JN contained 15 items, comprising three factors as follows: bonding social capital, linking social capital, and bridging social capital. The omega coefficient and the ICC of the RWSCS-JN were 0.90 and 0.85, respectively. The Pearson product-moment correlation coefficient between the RWSCS-JN and the existing scale of the workplace social capital was 0.88 (p < 0.01). Furthermore, the Pearson product-moment correlation coefficient between the RWSCS-JN and work engagement was 0.36 (p < 0.01) and that of the RWSCS-JN and turnover intention was - 0.40 (p < 0.01).

CONCLUSIONS

This study suggests that the RWSCS-JN could be sufficiently useful for a healthy work environment in a clinical setting.

Relationship between patient safety culture and job burnout in Iranian nurses: Assessing the mediating role of second victim experience using structural equation modelling

AIM

The study examined the mediating effect of the second victim experience between safety culture and burnout in Iranian nurses.

METHODS

A convenience sample of 298 nurses from five teaching hospitals of Urmia participated in the study. Hospital Survey on Patient Safety Culture, Maslach Burnout Inventory and The Second Victim Experience and Support Tool were used to measure the major variables. We adopted structural equation modelling to examine the hypotheses.

RESULTS

Safety culture was significantly associated with second victim experience and burnout (p < .01). Second victim experience had a partial mediating role on the relationship between safety culture and burnout (p < .01). The mediating model including major variables showed satisfactory fitness (χ² /df = 2.11, p < .01, Comparative Fit Index = 0.94, root-mean-square error of approximation = 0.062).

CONCLUSIONS

Establishing a safety culture is crucial for decreasing job burnout, and second victim experience has an intervening role clarifying how high level of safety culture reduces burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should plan to promote safety culture and provide sufficient support to staff involved in the patient safety incident, which could reduce staff burnout.

Engagement among psychiatric nurses: Is it different? How and why?

Organizational success requires engaged nurses to prevent turnover and provide high-quality care. Here, the authors share information from a study that investigated engagement levels and the drivers of engagement in a population of psychiatric nurses.

Nursing professional practice environment and its relationship with nursing outcomes in intensive care units: a test of the structural equation model

INTRODUCTION

Burnout, intention to leave and ultimately shortage of skilled nurses are associated with poor practice environments; however, in Iran comprehensive data are unavailable. The aim of this study was to investigate the relationships between the nursing professional practice environment with nurses' burnout and intention to leave in intensive care units, using structural equation modelling analysis.

METHODS

This cross-sectional, multi-centred study was conducted among 320 nurses in twenty ICUs of five teaching hospitals affiliated with Shiraz University of Medical Sciences from September 2018 to June 2019. Valid measurement instruments including Nursing Professional Practice Environment Questionnaire (NPPEQ), Maslach Burnout Inventory (MBI) and Anticipated Turnover Scale (ATS) were used for data collection.

RESULTS

Goodness-of-fit statistics confirmed a model with burnout dimensions in mediating positions between nursing professional practice environment dimensions and intention to leave, explaining 86.4% of the variation.

CONCLUSION

The results confirmed a theoretical model with structural the relationships among the nursing professional practice environment, burnout and intention to leave in nurses working in ICUs. In this model, burnout had a strong direct positive effect on intention to leave. The results can provide guidance for various stakeholders, such as health policymakers and nurse managers attempting to improve the quality of nurses' workplace, by drawing their attention to various factors influencing the retention of technically trained nurses in the critical care units.

A Parsonian Approach to Patient Safety: Transformational Leadership and Social Capital as Preconditions for Clinical Risk Management-the GI Factor

The purpose of this study is to investigate the role of the combination of transformational leadership and social capital in safety capacity building. Drawing on the A-G-I-L concept of Talcott Parsons, we test a model for patient safety. The hypothesis is, that good safety management needs a combination of goal attainment (G) and integration (I), here called the GI factor. We tested this hypothesis by using transformational leadership as a surrogate for goal attainment and social capital as a surrogate for integration in a study of the perceptions of chief medical officers in 551 German hospitals. We conducted a cross-sectional hospital survey combined with secondary data analysis in all German hospitals with at least one internal medicine unit and one surgery unit (N = 1224 hospitals) in the year 2008 with a response rate of 45% (N = 551). The regression model explained 17.9% of the variance in perceived clinical risk management. We found that if both requirements for goal-oriented collective action-transformational leadership and social capital-are met, good safety management is more likely. The tentative conclusion is that it takes transformative leaders and cohesive followers together as a social basis to improve safety in hospitals.

Effect of Anxiety on Empathy: An Observational Study Among Nurses

Empathy, defined as an emotional ability to put oneself in the place of others, read their state of mind, and think how they are feeling, is an essential pillar of nursing care. On the other hand, anxiety is a frequent emotion that can be generated in stressful work environments, like nurses developing their activity. The aim of the present study is to explore the value of empathy and anxiety personal traits in staff nurses. The sample was comprised of 197 staff nurses from tertiary level hospitals from Madrid, Spain, where 79.2% were women and 20.8% were men in the present study. The instrument used for analysis was the Spanish adaptation of the 16PF5 questionnaire. The results showed the following measurements to warmth (5.58), lively (5.25), socially bold (5.6), privacy (5.82), open to change (5.62), self-reliance (6.12), and anxiety (6.38). Furthermore, anxiety affects positively to warmth (t: 2.66; p > 0.0001) and lively (t = 2.36; p < 0.05), but in a negative way to social bold (t = −3.17; p < 0.001) or open to change (t = −5.81; p < 0.0001). However, it was not seen to have any effect over privacy (t = 1.96; p = 0.052) and self-reliance (t = 1.19; p = 0.234). Finally, it is recommended that healthcare professionals reinforce their personal competencies to strengthen their skills to manage anxiety and improve their empathy competencies.

The influence of job satisfaction, resilience and work engagement on turnover intention among village doctors in China: a cross-sectional study

Background

As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. However, the high turnover of village doctors, both individually and collectively, threaten the stability of village medical teams. This research evaluated the influence of job satisfaction, resilience, and work engagement on the village doctors’ turnover intention, and explored the mediating role of work engagement and resilience between job satisfaction and the turnover intention of village doctors in China.

Methods

A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among village doctors with a sample size of 2693 from 1345 rural clinics in Shandong province, China, during May and June 2019. All variables including demographic characteristics, job satisfaction, resilience, work engagement and turnover intention were based on available literature, and measured on a 5- or 6-point Likert scale. Such statistical methods as one-way ANOVA, bivariate correlation, exploratory factor analysis (EFA), and Structural Equation Modelling (SEM) were used.

Results

Up to 46.9% of the subjects had a higher turnover intention and more than 26.3% of them had a medium turnover intention. The job satisfaction of village doctors could not only have a direct negative effect on turnover intention (β = − 0.37, p < 0.001), but also have an indirect effect through work engagement (β = − 0.04,=< 0.001). Meanwhile, work engagement also had a direct negative impact on turnover intention (β = − 0.13, p < 0.001), and resilience had an indirect negative impact on turnover intention through work engagement (β = − 0.09, p < 0.001). The above results of this study strongly confirmed that job satisfaction, resilience, and work engagement were early, powerful predicators of village doctors’ turnover intention.

Conclusion

According to the results, the following should be taken seriously to improve job satisfaction: reasonable and fair income, effective promotion mechanism, fair social old-age security, reasonable workload, and strong psychological coping mechanisms for work stress. The turnover intention of village doctors could be reduced through improving job satisfaction, resilience and work engagement.

Measuring social capital of healthcare organizations reported by employees for creating positive workplaces - validation of the SOCAPO-E instrument

BACKGROUND

In highly segmented and complex healthcare organizations social capital is assumed to be of high relevance for the coordination of tasks in healthcare. So far, comprehensively validated instruments on social capital in healthcare organizations are lacking. The aim of this work is to validate an instrument measuring social capital in healthcare organizations.

METHODS

This validation study is based on a cross-sectional survey of 1050 hospital employees from 49 German hospitals which specialize in breast cancer care. Social capital was assessed by a six-item scale. Reliability analyses and confirmatory factor analyses were conducted to determine the content validity of items within the theory-driven one-dimensional scale structure. The scale's associations with measures of the social aspects of the work environment (identification, social support, open communication climate) were estimated to test convergent validity. Criterion-related validity was evaluated by conducting structural equation modelling to examine the predictive validity of the scale with measures of work engagement, well-being and burnout.

RESULTS

A one-dimensional structure of the instrument could be identified (CFI = .99; RMSEA = .06). Convergent validity was shown by hypothesis-consistent correlations with social support offered by supervisors and colleagues, a climate of open communication, and employee commitment to the organization. Criterion-related validity of the social capital scale was proved by its prediction of employee work engagement (R2 = .10-.13 for the three subscales), well-being (R2 = .13), and burnout (R2 = .06-.11 for the three subscales).

CONCLUSIONS

The confirmed associations between social capital and work engagement, burnout as well as well-being stress the importance of social capital as a vital resource for employee health and performance in healthcare organizations. In healthcare organizations this short instrument can be used as an efficient instrument to measure the organizations' social capital.

Balancing workload of nurses: Linear mixed effects modelling to estimate required nursing time on surgical wards

Aim

Quantifying the relation between patient characteristics and care time and explaining differences in nursing time between wards.

Design

Academic hospital in the Netherlands. Six surgical wards, capacity 15-30 beds, 2012-2014.

Methods

Linear mixed effects model to study the relation between patient characteristics and care time. Estimated marginal means to estimate baseline care time and differences between wards.

Results

Nine patient characteristics significantly related to care time. Most required between 18 and 35 min extra, except "two or more IV/drip/drain" (8) and "one-on-one care" (156). Care time for minimum patient profile: 44-57 min and for average patient profile: 75-88 min. Sources of variation: nurse proficiency, patients, day-to-day variation within patients. The set of characteristics is short, simple and useful for planning and comparing workload. Explained variance up to 36%. Calculating estimated means per ward has not been done before. Nurse proficiency is an important factor.

Determinants of Work Engagement Among Nurses in Northeast India

The present empirical study examines the effects of home and work domain resources (family–work enrichment and supervisor’s support) on work engagement among nurses using the perspective of job-demands resources model. Considering the dearth of literature in government health-care sector especially in North Eastern Region (NER) of India, the study was conducted in Assam. Data were collected using structured questionnaires from government hospitals. The results of multiple hierarchical regression indicated that family–work enrichment and supervisor’s support both play a significant positive role in enhancing the work engagement levels among nurses. Thus, both hypotheses were supported. Limitations, future scope and conclusion are discussed.

Translating Provider and Staff Engagement Results to Actionable Planning and Outcomes

Staff and provider engagement leads to better quality and experience of care and less turnover and burnout. In this program, we describe an approach to better understand underlying factors that lead to low staff and provider engagement and address such factors by creating actionable plans that drive improved engagement measures. Focus groups were conducted with staff, advance practice providers, and faculty to better understand low scored areas in an annual third-party engagement survey. Focus group results were analyzed, and thematic action plans were then developed by a leadership team. These plans and the status of addressing the identified issues were published and disseminated back to all staff and providers using a "stoplight report." The leadership team met every 2 to 4 weeks until all issues were addressed and communicated back to the department. The subsequent year's engagement scores statistically increased across all engagement score domains for both staff and faculty. We conclude that using a qualitative approach to understanding low-scored engagement domains will allow a deeper and authentic understanding of the root factors that drive low engagement scores. This approach allows teams to develop responsive action plans, resulting in higher engagement scores, which will eventually lead to better service and care to patients.

Safety and satisfaction of patients with nurse's care in the perioperative

OBJECTIVE

to investigate the safety and satisfaction of patients and their relationship with nurse's care in the perioperative period.

METHOD

cross-sectional, multi-level, correlational study with 105 nurses in the surgical area and 150 patients operated in a Spanish tertiary hospital. For the nurses the sociodemographic variables, the perception of the work environment, the professional burnout and the satisfaction in the work were collected. For patients, the safety of adverse events and level of satisfaction, through the application of questionnaires. Univariate and multivariate analysis were used.

RESULTS

job satisfaction, professional commitment, and participation in hospital issues were negative predictors for adverse events related to the patient, while postoperative nurse care was a positive predictor.

CONCLUSION

there is an increase in adverse events when nurses are dissatisfied at work, less professional commitment and low availability to participate in the subjects of their unit. On the other hand, adverse events decrease when nurses perform the care in the postoperative period. Satisfaction was good and there was no association with the characteristics of nurses' attention. It is recommended to improve these predictors to increase the safety of surgical patients.