Abstract
Resumo Objetivo Comparar e identificar o ambiente de trabalho de hospitais públicos sendo um acreditado e o outro não. Métodos Abordagem quantitativa, dois estudos transversais em paralelo, com 106 enfermeiros dos hospitais entre janeiro a setembro de 2014. Hospital A, não acreditado, e B acreditado. Coleta de dados por meio de um questionário com dados sóciodemográficos laborais e Nursing Work Index - Revised - Versão Brasileira (B-NWI-R) com 57 itens e quatro domínios. A confiabilidade do instrumento foi medida pelo alpha de Cronbach. Resultados Participaram 50 enfermeiros do hospital A e 56 do B. Comparados os hospitais, houve significância estatística na satisfação salarial (hospital A tem maior satisfação com o salário) e na jornada de trabalho (de 30 a 36 horas semanais no B enquanto no A 40 horas). O ambiente foi favorável aos quatro domínios da B-NWI-R em ambos hospitais, independentemente da acreditação ou não. Conclusão A aplicação do instrumento evidenciou que a acreditação hospitalar não interferiu no ambiente de trabalho dos enfermeiros.
Highlights
Ing practice environments [7,8] It is an instrument that consists of 57 items, whose “objective is to measure the presence of certain characteristics of the work environment that favor the professional nursing practice”(8) The total number of items has four subscales: autonomy, control over the work environment, relationship between nurses and physicians, and support of organizations.[8]
In addition to the high competition, lack of contentment with the salary level can lead to stress, which when added to other factors leads to burnout syndrome. This syndrome comes from chronic occupational stress, absorbing negative consequences related to the individual, profession, family, society and institution, which leads the employee to lose the ability to reorganize and find fulfillment in existing demands.[20,21,22] This situation is explained considering the features of nursing work, such as extended shifts, multiples jobs, in addition to domestic work that is characteristic with women, leading to a double or even a triple workday.[23]
The application of B-Nursing Work Index - Revised (NWI-R) in this study revealed that the sample of nurses from Hospital A and B had autonomy and control over their environment, respect between physicians and nurses and favorable organizational support, as values presented below 2.5, regardless of where they worked
Summary
Health organizations have sought to improve quality of care for patients, which imply the continuous improvement of their practices that are mainly related to people and their development in the work process.The environment is closely related to job satisfaction of health professionals, among these, nurses and their team, and the quality of care.[1]In addition to influencing patient outcomes, the work environment influences nursing outcomes due to work overload, poor working conditions, conflicting interpersonal relationships, lack of professional expectation, minimal professional autonomy, and ambiguity of functions that can compromise the work process as a whole.[2]The evaluation of the quality of the work environment is a key indicator to support the practice of nurses who, as team leaders, need to have knowledge of the pillars that organize their practice in order to ensure quality of care.[3]an appropriate work environment is fundamental, for optimum results in terms of patient care, and to provide an innovative climate for health staff, as a healthy work environment has a positive impact on the effectiveness of their own work.[4]One of the possibilities for identifying the work environments of health organizations is the use of instruments that can measure objective aspects present in those environments.The use of scales contributes to innovation and creation of new models, functions and changes, which can be identified and which contribute to the work of nurses, through the exploration of new ideas.[4]For emphasizing the importance of this subject, studies were conducted with the prospect of identifying and analyzing the work environment of nurses and how this can affect the quality of care.[1,3,4,5,6,7,8]Among the instruments developed, the Nursing Work Index - Revised (NWI-R) has been used in different cultures and professional nurs-54 Acta Paul Enferm. 2016; 29(1):53-9.ing practice environments [7,8] It is an instrument that consists of 57 items, whose “objective is to measure the presence of certain characteristics of the work environment that favor the professional nursing practice”(8) The total number of items has four subscales: autonomy, control over the work environment, relationship between nurses and physicians, and support of organizations.[8]. Health organizations have sought to improve quality of care for patients, which imply the continuous improvement of their practices that are mainly related to people and their development in the work process. The environment is closely related to job satisfaction of health professionals, among these, nurses and their team, and the quality of care.[1]. One of the possibilities for identifying the work environments of health organizations is the use of instruments that can measure objective aspects present in those environments. Ing practice environments [7,8] It is an instrument that consists of 57 items, whose “objective is to measure the presence of certain characteristics of the work environment that favor the professional nursing practice”(8) The total number of items has four subscales: autonomy, control over the work environment, relationship between nurses and physicians, and support of organizations.[8]
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