Abstract
Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.
Highlights
The “Magnet” concept was first applied to the field of healthcare in 1983, in a historical study [1] that proved the capability of certain hospitals in the United States of America to ‘retain’ nurses in a context where they were in scarce supply
The objective of this study was to identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10
We believe that determining the existence of fundamental items that show stability in different contexts and cultures may contribute to improved nursing work environments
Summary
The “Magnet” concept was first applied to the field of healthcare in 1983, in a historical study [1] that proved the capability of certain hospitals in the United States of America to ‘retain’ nurses in a context where they were in scarce supply This model of hospital achieved better outcomes for patients with a better quality of care [2]; lower mortality rates and fewer complications [3] and greater professional development [4], resulting in organizations that operate more efficiently, keeping administrative and running costs contained [5]. In the study’s structure and design in PHC, the authors hypothesized that if a clear relationship between the organization model and quality of care in a hospital environment existed, the same might occur in the home care environment They analyzed the organization of the professional practice environment and the outcomes in home health care by applying the EOM1 scale. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26)
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