Nursing Practice Environment Research Articles

Association between the Nursing Practice Environment and Safety Perception with Patient Safety Culture during COVID-19.

In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19. We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two scales: PES-NWI and HSOPSC. We used the Shapiro-Wilk test and Spearman's coefficient and estimated two regression models. NPE was reported as favorable by 45.5% of the participants, and PSC was reported as neutral by 61.1%. Safety perception, the workplace, and NPE predict PSC. All NPE factors were correlated with PSC. However, safety perception, support of nurses subscale, the nurse manager's ability, and leadership were predictors of PSC. To promote a safe work culture, health institutions should foster leadership that prioritizes safety, strengthens managers' abilities, encourages interprofessional collaboration, and considers nurses' feedback for constant improvement.

The impact of nursing practice environments on patient safety culture in primary health care: a scoping review protocol.

Patient safety is a key priority for healthcare organisations. It impacts directly on patient health and wellbeing. The increasing complexity of current healthcare settings, which are associated with high work demands and increasingly stressful professional practice environments, contributes to an increased likelihood of errors and adverse events. Primary health care, given its comprehensiveness of care, makes up a large proportion of the care delivered to the population. To map the knowledge about the impact that nursing practice environments have on safety culture in the primary healthcare setting. This knowledge is essential for a more effective and appropriate understanding of this phenomenon and to enable the definition of strategies that can promote the provision of safer care to the population. A scoping review will be conducted based on the method proposed by the JBI, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used. Study selection, data extraction, and synthesis will be performed by two independent reviewers. Based on the Population (or participants), Concept, and Context (PCC) framework, this scoping review will consider studies that address nurses' practice environment and patient safety culture in primary health care. The review will consider all studies, published or unpublished, from 2002 to the present. The results from this scoping review are expected to provide an overview of the importance of the nursing practice environments on patient safety culture, which will be crucial to define an appropriate range of strategies to promote the delivery of the safest health care to the population.

Sustaining and Inspiring the Capacity of the Nursing Profession: The Case for Transformative Practice Education Models.

Decades of commissioned reports have pointed to solutions for nurturing nursing practice environments as essential to sustaining a nursing workforce. Beyond salary compensation and other solutions, we discuss the critical need for collaborative leadership in practice and education as a priority policy agenda aimed at confronting the shortage of nurses. The COVID-19 pandemic has intensified the nursing shortage and shortage of capacity in practice education, and we explore some learning in this context. Our paper draws on two initiatives in the province of British Columbia: the development of a transformative practice education model and an expanded Collaborative Learning Unit initiative. We propose building the following learning cultures: formal collaborative governance processes, intentional supports for graduate transitions and implementation of advanced nursing practice leadership and educator roles across the system. While transformative solutions are a tough sell in crisis-oriented contexts, this paper is a call for nurse leaders in all sectors to advance deep policy solutions with lasting impact on sustainable nursing human resources.

Influence of Shift Work on The Health of Nursing Professionals.

Shift work is increasingly common in health services, subjecting healthcare professionals to work schedules that can alter circadian rhythms and eating habits with consequent repercussions for the intestinal homeostasis. The objective of this study was to describe the relationship of rotating work shifts with the intestinal health, sleep quality, and emotional dimension of nursing professionals. In March and May 2019, an observational and comparative study was conducted among 380 nursing professionals from different Spanish cities and divided into fixed shift (n = 159) and rotating shift (n = 221). To carry out the present work, the variables measured were gastrointestinal symptoms, stool consistency and shape, anxiety, depression, sleep, as well as stress and work environment. Nurses with rotating shifts reported more abdominal pain and symptoms of depersonalization, as well as worse sleep efficiency and worse nursing practice environment. In addition, overall scores of the Gastrointestinal Symptom Rating Scale and Hospital Anxiety and Depression Scale were found to be significantly worse in nurses with these shifts. Rotating shift work by nursing staff may be associated with the occurrence of gastrointestinal and anxiety-related symptoms. These findings, together with the presence of negative and insensitive attitudes towards patients by nurses on rotating shifts, should be considered to maintain the quality of healthcare.

Blueprints for well-being: Modeling the way through Human-Centered Leadership and Pathway to Excellence.

Blueprints for well-being: Modeling the way through Human-Centered Leadership and Pathway to Excellence.

Analyzing and Validating a Structure for Measuring the Nurse Practice Environment

Nurse shortages pose a challenge in many countries and retaining existing nursing staff is crucial to addressing these shortages. To inform possible interventions aimed at retaining nurses, managers need a comprehensive understanding of the nature of the nurse practice environment. The scales from two of the main instruments used to assess nurses' practice environments are tested. A survey of an online panel obtained responses from 459 Australian nurses. Analyses determined a combination of items with good construct validity and improved predictive utility for outcomes of interest for individual nurses. By essentially combining the best items from each instrument, a more comprehensive representation of the nurse work environment is obtained with improved predictive utility. The resulting combined set of scales is recommended for analyses of the nurse working environment and uses a combined set of scales from each of the two source instruments, namely: nurse participation in hospital affairs, recognition, nursing process, peer work standards, nursing competence, orientation, managers, resources, nurse-physician collaboration, and positive scheduling climate. Future research can then build on that strong set of items with a validated structure and predictive utility to inform management and interventions.

Nurse practice environment, perceived organizational support, general well-being, occupational burnout and turnover intention: A moderated multi-mediation model.

To test the relationship between practice environment and turnover intention, considering the moderation of perceived organizational support (POS) and the mediation of general well-being (GWB) and occupational burnout (OB) among the nurse population. A cross-sectional survey design. Based on a sample of 474 nurses from two hospitals between May 2020 and September 2021, a moderated multi-mediation model was tested in which GWB and OB served as two mediators between practice environments and nurses' turnover intention, and POS was regarded as a moderator between practice environments and GWB. This current study supported a moderated multi-mediation model where the relationship between practice environment and turnover intention (B=0.33, p < 0.001) was mediated by GWB (B=0.17, p < 0.001) and OB (B=0.18, p < 0.001), and POS moderated the effect of practice environment and GWB (B=0.19, p < 0.001). The findings of this study can inform the design of effective organizational support and meet nurse emotional needs programmes to reduce the turnover intention among nurses.

From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings?

BackgroundThe COVID-19 pandemic reinforced the need to invest in nursing practice environments and health institutions were led to implement several changes. In this sense, this study aimed to analyze the impact of the changes that occurred in nursing practice environments between the first and fourth critical periods of the pandemic.MethodsQuantitative, observational study, conducted in a University Hospital, with the participation of 713 registered nurses. Data were collected through a questionnaire with sociodemographic and professional characterization and the Scale for the Environments Evaluation of Professional Nursing Practice, applied at two different points in time: from 1 to 30 June 2020 and from 15 August to 15 September 2021. Data were processed using descriptive and inferential statistics.ResultsOverall, the pandemic had a positive impact on nursing practice environments. However, the Process component remained favourable to quality of care, while the Structure and Outcome components only moderately favourable. Nurses working in Medicine Department services showed lower scores in several dimensions of the Structure, Process and Outcome components. On the other hand, nurses working in areas caring for patients with COVID-19 showed higher scores in several dimensions of the Structure, Process and Outcome components.ConclusionsThe pandemic had a positive impact on various dimensions of nursing practice environments, which denotes that regardless of the adversities and moments of crisis that may arise, investment in work environments will have positive repercussions.However, more investment is needed in Medicine Department services, which have historically been characterised by high workloads and structural conditions that make it difficult to promote positive and sustainable workplaces.

A descriptive study on nursing practice environment among public sector nurses in Lahore

Pakistan is a country where the nursing profession still has to get a good working environment as it is directly related to improved patient care. The nursing practice environment is a key factor that contributes to retention. Bearing in mind the importance of the issue the present study is designed to know the current state of the nursing practice environment. The data were collected from the nurses working in the medical wards and critical care units in the Pakistan Institute of Neurosciences, Lahore. Convenience sampling was used to select the respondents and collect the data. A total of 150 questionnaires were distributed among the nurses and 110 questionnaires were used for the data analysis in Statistical Package for Social Sciences. Frequency, descriptive statistics, reliability, and validity analyses were performed. As per the results of the study, the questionnaire used in the study was reliable and valid. Additionally, the results of the study established that the nursing practice environment is poor asking for concrete steps to make it better for improved patient care delivery. Nurse leaders can dedicate their efforts to the improvement of the nursing practice environment to improve the nurse job outcomes. Further, they can also arrange the trainings for the professional development of the nurses to ensure the better healthcare services delivery. The perceptions of the good nursing practice environment can be fostered among the nurses by having their active participation in the hospital matters and decision making because they are also the key staff in the hospital environment.

A Cross-sectional Study Evaluating the Association Between the Nursing Practice Environment and Missed Nursing Care in Medical and Surgical Wards in Jordan.

Missed nursing care can jeopardize the safety of patients. The practice environment contains various elements that may impact nursing staff's capability to provide appropriate care. To examine the association between the practice environment and missed nursing care in Jordanian hospitals. A cross-sectional design, including the MISSCARE survey and the Practice Environment Scale of the Nursing Work Index, was used for this study. Data were gathered from 672 nurses working in 10 hospitals between March and July 2021. Findings revealed significant negative correlations between nurses' participation in hospital affairs ( r = -0.077, P = .046), nursing foundations for quality of care ( r = -0.139, P < .001), and missed nursing care. Information from this study can help nursing leaders modify practice environment elements that impact missed nursing care occurrences, which will help improve the quality of care provided to patients.

Antecedents and Outcomes of Work Engagement among Psychiatric Nurses in Japan.

While previous studies have examined antecedents and outcomes of work engagement among general nurses, studies among psychiatric nurses remain limited. This study aimed to explore the antecedents (i.e., job crafting and nursing practice environment) and outcomes (i.e., strength-oriented care attitudes, mental health, and turnover intention) of work engagement among psychiatric nurses in Japan. This cross-sectional study included 309 nurses from three psychiatric hospitals in Japan (valid response rate: 60.4%). Data collection using the self-administered questionnaire took place from July to August 2021. We performed Structural Equation Modeling to examine the directional relationships among variables. Job crafting (β = 0.57, p < 0.01) and nursing practice environment (β = 0.23, p = 0.01) exhibited positive effects on work engagement. Work engagement had positive effects on strength-oriented care attitudes (β = 0.15, p = 0.04) and mental health (β = 0.37, p < 0.01) as well as negative effects on intention to resign from their profession as a nurse (β = -0.17, p = 0.01). Job crafting and a healthier nursing practice environment could help enhance work engagement. Higher work engagement could contribute to improving strength-oriented care attitudes, mental health, and intention to resign from their profession as a nurse.

Missed Nursing Care and its relationship with Nurses’ Perceptions of Professional Practice Environment during Hajj Season

Context: An important factor that significantly affects missed nursing care is the nursing work environment. Additionally, it significantly impacts the recruitment and retention of healthcare professionals and indirectly affects the standard of nursing care.&#x0D; Aim: To identify nurses' perception of the professional practice environment, identify types and reasons for missed nursing care, and find the relationship between nurses' perceptions of the professional practice environment and missed nursing care during the Hajj season.&#x0D; Methods: A descriptive correlational design was carried out at seven hospitals in Makkah region. A convenience sample of 463 registered nurse who has at least one year of nursing experience and working in inpatient units was included in this study. Data was collected through an online questionnaire. It included patients' demographic data, the revised professional practice environment scale, and missed nursing care assessment questionnaire.&#x0D; Results: The result of this study reveal that the mean scores of the professional practice environment and its subscales were 3.56±0.46, indicating a favorable environment. Furthermore, it was found that the overall missed nursing care among the studied nurses was 1.56±0.65, which indicates low missed nursing care. The highest reason for missed nursing care was the inadequate staff (2.85±1.12), supplies/equipment not functioning properly when needed (2.74±1.07), and not being available when needed (2.70±1.10). The professional practice environment statistically significantly negatively correlated with missed nursing care (r=-0.32, p=0.000).&#x0D; Conclusion: Missed nursing care in hospitals can be reduced by improving the professional practice environment. The study recommends that the hospital and nursing administrators consider keeping good practice environments for nurses to prevent missed care activities and potentially enhance patient outcomes in nursing units.

Investigation on Nurses' Willingness to "Internet + Nursing Service" and Analysis of Influencing Factors.

To investigate the willingness of nurses in Yichang to participate in "Internet plus nursing services" and analyze the influencing factors in order to provide reference for the implementation of "Internet plus nursing services". Using the "Internet plus Nursing Service" questionnaire, a cross-sectional survey was conducted among 1447 nurses in Yichang by convenience sampling from July to September in 2022, and the related influencing factors were analyzed. The questionnaire was composed of two parts: the demographic characteristics and the questionnaire of nurses' willingness to participate in "Internet plus nursing service", including 4 dimensions: awareness, promoting factors, concern factors and training needs. Likert 5-point scoring method was used for scoring. Binary logistic regression was used to screen the variables, and the ROC curve and Nomogram risk prediction model were drawn. A total of 1233 valid questionnaires were collected. It shows that 76.07% of nurses in Yichang are willing to participate in "Internet plus nursing services". Among them, education background, specialist nurses, awareness, promotion factors, concerns and training needs are the independent influencing factors (all P < 0.05). The area under the ROC curve (AUC) of the prediction model is 0.802, and the consistency index (c-index) of nomogram is 0.800. The average absolute error of internal calibration is 0.014, and the model has good accuracy and discrimination. Nurses in Yichang have a high willingness to participate in "Internet plus nursing services", a low awareness of the program and a high demand for relevant professional training. It is suggested that the government and hospitals should strengthen the publicity of "Internet plus nursing services", improve relevant laws and regulations and strengthen the construction of specialist nurses' team, so as to provide a good practice environment for nurses' door-to-door service.

Impact of Nursing Organizational Culture and Nursing Practice Environment on Generational Conflict in Organization among Hospital Nurses

Impact of Nursing Organizational Culture and Nursing Practice Environment on Generational Conflict in Organization among Hospital Nurses

Working Conditions Among Chinese Nurses Employed in Japan: A Cross-Sectional Survey-Based Study.

Although the number of Chinese nurses employed in Japan is increasing, the situation regarding their work conditions has not been clarified. It is necessary to understand such conditions to consider support for Chinese nurses in Japan. This study examined the professional nursing practice environment, occupational career, and work engagement of Chinese nurses in Japan. Using a cross-sectional study design, 640 paper questionnaires were mailed to 58 Japanese hospitals that employed Chinese nurses and included a QR code for online responses. A survey request form and URL were sent to the Wechat app, where Chinese nurses in Japan communicate. The contents include attribute-related questions, the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Career Scale, and Utrecht Work Engagement Scale. Either Wilcoxon's rank-sum or the Kruskal-Wallis test was performed to compare scores of the study variables between subgroups. A total of 199 valid responses were obtained, of which 92.5% were female, and 69.3% had a university degree or higher. The PES-NWI score was 2.74, and the work engagement score was 3.10. The group with a university degree or higher had significantly lower scores on PES-NWI and work engagement than those with diplomas. Regarding the subscale of occupational career, scores of forming and coordinating interpersonal relationships, self-development, and accumulating a variety of experience were 3.80, 2.58, and 2.71, respectively. The scores were significantly higher with more than 6 years of nursing experience in Japan than those with 0-3 years or 3-6 years. Most participants had university degrees or higher, and their scores of PES-NWI and work engagement tended to be lower than those with diploma degrees. Participants showed low self-ratings in self-development and lacked a variety of experience. Understanding Chinese nurses' work conditions in Japan enables hospital administrators to develop measures for continuing education and support.

Midwives' attitudes toward safety: A qualitative study

In order to understand the cognitive and subjective perceptions of midwives' attitudes towards patient safety within the current nurse practice environment, in addition to providing new insights and guiding methods for patient safety. In this study, 10 midwives were selected using a purposive sampling method, who working in the obstetrics department of a Grade III A hospital, located in Baoding, from January to May 2018. Data were collected using semi-structured interviews, face-to-face nonverbal behavior observation, and analyzed using the Colaizzi 7-step analysis method. There were three themes: (1) Patient safety issues are important and when they occur make midwives feel very frustrated or even lose confidence in their work; (2) there are numerous safety hazards in obstetrics and delivery room work; and (3) when safety problems occur, senior medical or nursing staff or leaders are most desired to be present. Hospitals should pay attention to midwives' safety attitudes, establish a safety support system, do a good job of psychological counseling after safety problems occur, systematically assess existing safety problems in departments, eliminate safety hazards in a timely manner, formulate detailed emergency plans and improve coping mechanisms.

Ambiente de prática de enfermagem em contexto hospitalar

Ambiente de prática de enfermagem em contexto hospitalar

Impact of COVID-19 on the Environments of Professional Nursing Practice and Nurses' Job Satisfaction.

(1) Background: The repercussions of work environments were widely studied before the pandemic. However, there are still many difficulties to be discovered considering the impact generated by it. Thus, this study aimed to analyse the impact of COVID-19 on nursing practice environments and nurses' job satisfaction. (2) Methods: A correlational study was conducted in a hospital in northern Portugal, with the participation of 416 registered nurses. Data were collected in June 2021 through questionnaires. The study was approved by the Institutional Ethics Committee. (3) Results: COVID-19 had a favourable impact on the structure component of the practice environments; the process component decreased compared to the pre-pandemic period; the outcome component remained moderately favourable to the quality of care. Nurses were not very satisfied or not at all satisfied with their valuation and remuneration; moderately satisfied with the leadership and staffing; and satisfied with the organisation and resources, co-workers and valuation by patients and families. In more favourable environments, nurses' job satisfactions were higher. (4) Conclusions: Identifying the dimensions with the best and worst scores allowed the institution's managers to concentrate efforts on where improvements were needed, thus preparing professional contexts for the recovery of care activities.

The effects of tertiary hospital nurses' ageism and nursing practice environment on geriatric nursing performance

Purpose: This study aimed to examine tertiary hospital nurses’ ageism, nursing practice environment and geriatric nursing performance and discover factors influencing geriatric nursing performance. Methods: The research was conducted for 117 nurses working at tertiary hospitals located at Seoul, and data were collected from March 14 to March 31, 2022. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression using the IBM SPSS 26.0 program. Results: Nursing practice environment was positively correlated with geriatric nursing performance (r=.25, &lt;i&gt;p&lt;/i&gt;=.007). The factors influencing geriatric nursing performance were nursing practice environment (β=.25, &lt;i&gt;p&lt;/i&gt;=.009) and experience living with the elderly (β=.23, &lt;i&gt;p&lt;/i&gt;=.013), and as for the present units, internal medicine (β=.27, &lt;i&gt;p&lt;/i&gt;=.009) and integrated nursing·care service (β=.21, &lt;i&gt;p&lt;/i&gt;=.042) wards compared with a surgery ward showed an explanatory power of 19.0%. Conclusion: Factors affecting geriatric nursing performance include the current unit where nurses work, nursing practice environment, and experience living with older adults. Based on the research findings, preparing measures for enhancing the quality of geriatric nursing performance is necessary.

간호사의 비판적 사고성향과 간호근무환경이 투약안전 역량에 미치는 영향

Purpose: The purpose of this study was to examine the impact of nurses’ critical thinking disposition and nursing practice environment on medication safety competency. Methods: A total of 189 nurses who directly performed medication administration at a tertiary referral hospital in Seoul volunteered to participate in this study. Data collection was conducted using online surveys and was analyzed through technical statistics, t-test, one-way ANOVA, Scheffē test, Pearson’s correlation coefficient, and multiple linear regression. Results: The results revealed that both critical thinking disposition (β=0.498, p<.001) and nursing practice environment (β=0.212, p=.001) were significant predictive factors of medication safety competency. Conclusion: Critical thinking disposition and nursing practice environment were important factors affecting medication safety competency. Therefore, in order to increase critical thinking disposition, it is necessary to develop various teaching methods and apply them in nurse education programs as a way to indirectly improve medication safety competency. In addition, in terms of nursing practice environment, hospitals will need to improve working conditions and provide sufficient material support to maintain nursing workforce. Likewise, it is necessary to prepare and implement a nursing policy to increase the nursing workforce.