The nursing practice environment and nurses’ satisfaction in the obstetrics hospital context: a scoping review

Abstract

Introduction: The Nursing Practice Environment (NPE) influences the quality of nursing care delivery [1–3], and is predictive of nursing care outcomes associated with professional retention, burnout, intention to leave the organization and job satisfaction (JS). Nurses JS and burnout are strongly associated with the quality of nursing care, patient safety, mortality and patient perception of hospital care [4–6]. The aim of this scoping review is to map and analyze the scientific evidence on the influence of NPE on the JS of nurses and nurses specialists in obstetrics in hospital context. Materials and methods: A total of 255 articles were identified, which, after filtering according to the inclusion and exclusion criteria, resulted in 31 articles. The first step consisted of the research carried out in the electronic databases CINAHL and MEDLINE with the following keywords: nurs * , nursing practice environment, Professional satisfaction in hospital context of obstetrics. In the second step all the indexed terms were used, in ScienceDirect. In the third step, the list of bibliographic references of the identified articles was analyzed in order to research additional studies. As inclusion criteria we considered all studies with nurses of all different categories but in the context of obstetrics. Quantitative, qualitative studies, systematic reviews of the literature and reviews of the literature were included in Portuguese, English and Spanish. The research timeframe comprised January 2012 through June 2017. Data extraction and analysis of the studies were based on the criteria of the Joanna Briggs Institute. Results: There were five thematic categories that reflect the existence of the influence of the NPE in the JS and which are: a) Evaluation of the NPE and JS; b) Dimensions of the NPE; c) Factors with influence on JS; d) Evidence of association between the NPE and JS; e) Evidence of association of the NPE and JS with other variables of organizational behavior. Discussion and conclusions: There is a current worldwide concern with the NPE and the nurses’ JS which is a turnover major factor in these professionals. JS is associated with several organizational, professional and personal variables with negative influence associated with work, such as stress and burnout. NPE has a positive indirect effect in JS through team/work group cohesion, multidisciplinarity, lack of organizational resources/constraints, working conditions/increased workload, labor discrimination, benefits and rewards, lack of clarity in nurses’ responsabilities, patients and doctors’ perceptions, poor leadership skills, promotion and professional development opportunities, distributive justice, negative affectivity. Nurses’ JS is strongly associated with NPE, which is the main factor that affects JS. NPE factors have an indirect positive effect on JS through several variables. Additionally, NPE characteristics have a significant influence on burnout and quality of care and, together with JS, on nurses’ intention to leave [2,4,5,7].