Characteristics Of Nursing Work Research Articles

The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model.

The aim of this study was to explore the influence of nurse work characteristics, resiliency, and burnout on retention, and patient quality and safety. With an ongoing nursing shortage, maintaining qualified nursing staff is critical. We explored the direct and indirect effects of practice environment, nurse work characteristics, and burnout on retention, and perceived quality and safety. Responses from 507 RNs were collected via an anonymous online survey. Theorized relationships were explored via path analysis and invariance testing. Positive practice environment and favorable work characteristics lowered burnout and improved outcomes. The indirect effects of work characteristics and burnout were dependent upon individual level of resilience. Social capital minimized the effects of burnout for participants reporting below-average resilience. Leader support was critical in shaping positive perception of the practice environment. A nurse leader's visibility and actions impact intent to stay. Results of this study may inform healthcare systems struggling to retain a robust, engaged nursing workforce.

Work-Related Fatigue Factors among Hospital Nurses: An Integrative Literature Review

Background: Due to the demanding nature of nurses’ work and the current shortage of nurses, hospital nurses often find themselves working extra shifts, extended hours, and taking on more responsibilities. However, this added pressure on the body and mind results in fatigue which adversely affects nurses' health status as well as their ability to provide optimal health care procedures. Preventing fatigue and reducing its adverse consequences requires comprehensive awareness about its diverse contributing factors.Purpose: Examine factors that influence fatigue among nurses employed in a hospital setting.Methods: An integrative review to assess the quality of the research evidence, to find minor and major gaps in current research and the main issues in the area of the research and finally to bridge the research gaps. This integrative review identified a total of 12 relevant research studies from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, PsycINFO, and a manual search were used in this review. Data were reviewed in May 2017, using an integrative review then interpreted, analyzed and synthesized to identify key contributing factors that influence fatigue among hospital nurses.Results: The 12 studies in this review revealed that significant factors such as organizational factors, nursing work characteristics, psychosocial factors as well as individual characteristics and demand influence nurse fatigue. Work shifts, specifically night- shifts and extended work shifts without sufficient inter-shift recovery were linked to higher levels of fatigue.Conclusion: This review identified the significant associations between work schedules, work environments, demographics and fatigue among nurses in hospital settings located in various countries all around the world.Impact: Increased physical and psychological job demands combined with the lack of social support at work leads to a heightened degree of job dissatisfaction, which results in acute and chronic fatigue. Findings from this study may help healthcare organizations and policymaker to introduce strategies that mitigate fatigue among nurses in hospital settings.

The role of the personality traits and work characteristics in the prediction of the burnout syndrome among nurses-a new approach within predictive, preventive, and personalized medicine concept.

The burnout syndrome is characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. It was identified in some professional categories, the most often being affected those in public health services. This study mainly aims to identify and analyze the value of the personality traits and work characteristics as predictive factors for the occurrence of the burnout syndrome in nurses, under the new approach of predictive, preventive, and personalized medicine. A total of 192 nurses were included in the study. The NEO-Five-Factor Inventory, the Copenhagen Burnout Inventory, and the Inventory of Nursing Work Characteristics were administered to all of the participants. Some personality traits proved to be predictive factors for the occurrence of the burnout syndrome. Neuroticism, negative self-esteem, and negative emotionality predict burnout vulnerability. The negative correlations between sociability and the burnout dimensions show that the positive affectivity of the extraverted individuals and the strong positive orientation of the extraverts towards others are protective factors against burnout. There are also significant associations between certain personality traits and nursing work characteristics (work overload, the existence of problems in the department, and satisfaction in the professional and family life), which could be defined, also, as predictive factors for burnout. This study confirms the influence of the Big Five personality traits and nursing work characteristics as predictive factors of the burnout occurrence, opening real possibilities to perform a targeted prevention and provide personalized interventions as organizational services.

Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.

Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.

Promoting Work Engagement: One Medical Center’s Journey

The ability to effectively engage employees is now recognized as an important business differentiator. 1 Bersin J It's time to rethink the employee engagement issue. http://www.forbes.com/sites/joshbersin/2014/04/10/its-time-to-rethink-the-employee-engagement-issue/Date: April 10, 2014 Google Scholar In health care, it has been shown to impact quality of care, patient satisfaction, and safety. 2 Laschinger H Wilk P Cho J Greco P Empowerment, engagement, and perceived effectiveness in nursing work environments: does experience matter?. J Nurs Manag. 2009; 17: 636-646 Crossref PubMed Scopus (108) Google Scholar , 3 Bacon C Mark B Organizational effects on patient satisfaction in hospital medical-surgical units. J Nurs Adm. 2009; 39: 220-227 Crossref PubMed Scopus (58) Google Scholar , 4 Gobenbach V Drenkard K The outcomes of magnet environments and nursing staff engagement: a case study. Nurs Clin N Am. 2011; 46: 89-105 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar , 5 Bogaert PV van Heusden D Timmermans O Frank E Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors. Front Psychol. 2014; 5: 1261-1271 PubMed Google Scholar Yet, employee engagement and loyalty can be challenging in our current turbulent health care environment when the focus for most organizations has been on reducing costs, improving quality, and implementing innovative change. Recent nationwide research conducted by the Advisory Board Company indicates that only 32.8% of registered nurses (RNs) are engaged in their work, and 7.4% are actively disengaged. 6 Virkstis N The national prescription for nurse engagement: best practices for enfranchising frontline staff in organizational transformation. April 10, 2014. Advisory Board Company website. http://www.advisory.com/research/nursing-executive-center/studies/2014/national-prescription-for-nurse-engagement Google Scholar Statistically, professional nurses have lower work engagement and higher disengagement rates than other frontline staff in health care agencies. This is troubling because nurses contribute substantially to the patient care experience and are also crucial in efforts to transform health care. The 2010 Institute of Medicine Report on The Future of Nursing recommended that nurses should be prepared to lead change to address the gaps in health. 7 Institute of Medicine The Future of Nursing: Leading Change, Advancing Health. National Academies Press, Washington DC2010 Google Scholar This will not happen if nurses are disengaged in their jobs. The ability to effectively engage employees is now recognized as an important business differentiator. 1 Bersin J It's time to rethink the employee engagement issue. http://www.forbes.com/sites/joshbersin/2014/04/10/its-time-to-rethink-the-employee-engagement-issue/Date: April 10, 2014 Google Scholar In health care, it has been shown to impact quality of care, patient satisfaction, and safety. 2 Laschinger H Wilk P Cho J Greco P Empowerment, engagement, and perceived effectiveness in nursing work environments: does experience matter?. J Nurs Manag. 2009; 17: 636-646 Crossref PubMed Scopus (108) Google Scholar , 3 Bacon C Mark B Organizational effects on patient satisfaction in hospital medical-surgical units. J Nurs Adm. 2009; 39: 220-227 Crossref PubMed Scopus (58) Google Scholar , 4 Gobenbach V Drenkard K The outcomes of magnet environments and nursing staff engagement: a case study. Nurs Clin N Am. 2011; 46: 89-105 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar , 5 Bogaert PV van Heusden D Timmermans O Frank E Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors. Front Psychol. 2014; 5: 1261-1271 PubMed Google Scholar Yet, employee engagement and loyalty can be challenging in our current turbulent health care environment when the focus for most organizations has been on reducing costs, improving quality, and implementing innovative change. Recent nationwide research conducted by the Advisory Board Company indicates that only 32.8% of registered nurses (RNs) are engaged in their work, and 7.4% are actively disengaged. 6 Virkstis N The national prescription for nurse engagement: best practices for enfranchising frontline staff in organizational transformation. April 10, 2014. Advisory Board Company website. http://www.advisory.com/research/nursing-executive-center/studies/2014/national-prescription-for-nurse-engagement Google Scholar Statistically, professional nurses have lower work engagement and higher disengagement rates than other frontline staff in health care agencies. This is troubling because nurses contribute substantially to the patient care experience and are also crucial in efforts to transform health care. The 2010 Institute of Medicine Report on The Future of Nursing recommended that nurses should be prepared to lead change to address the gaps in health. 7 Institute of Medicine The Future of Nursing: Leading Change, Advancing Health. National Academies Press, Washington DC2010 Google Scholar This will not happen if nurses are disengaged in their jobs.

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

Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging.Design: Cross-sectional survey.Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium.Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care.Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.

Nurses well-being in intensive care units: study of factors promoting team commitment.

Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction. The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses. A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals. A total of 222 nurses participated and completed a self-reported questionnaire. Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction. Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs.

Practice Environment, Work Characteristics and Levels of Burnout as Predictors of Nurse Reported Job Outcomes, Quality of Care and Patient Adverse Events: A Study across Residential Aged Care Services

To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and psychiatric care hospitals. Knowing residential aged care services are challenged to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a cross-sectional survey, a sample of 709 registered nurses, licensed practical nurses and nurse aides employed in 25 residential aged care services completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality and patient adverse events. Associations between variables across residential aged care services were examined using multilevel modelling techniques. Associations were identified between practice environment factors, work characteristics, burnout dimensions, and reported outcome variables across residential aged care services. Multiple multilevel models showed independent variables (nursing management at the unit level, workload, decision latitude, social capital, emotional exhaustion and depersonalization) as important predictors of nurse reported outcome (job satisfaction, turnover intensions), quality of care (at the unit, the last shift, and in the service within the last year) and patient adverse events (patient and family complaints, patient falls, pulmonary and urinary tract infections, and medications errors). Results suggested the importance of nurse practice environment factors, nurse work characteristics and perception of burnout on nurse and patient outcomes across their nurse practice environment. Challenging the complex care of a vulnerable and frail population executives, physicians, nursing leaders as well as nurses in their nurse practice environment shared responsibility to create working conditions achieving excellent quality and patient safety.

Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events—A cross-sectional survey

AimTo investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. BackgroundNurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. DesignA cross-sectional design with a survey. MethodIn a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. ResultsVarious unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. ConclusionResults suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development.

The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: A cross-sectional survey

AimTo explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. BackgroundAcute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. DesignCross-sectional survey. MethodGrounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. ResultsNurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses’ work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. ConclusionThe study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses’ involvement in decision-making process and interdisciplinary teamwork are recommended.

Nursing practice in the wards of "Harmony mission-2011"

Objective According to the nursing work characteristics of medical services during the task of harmony mission-2011,and the hospital ship ward nursing work experience,in order to improve the level of medical services and provide reference fo hospital ship.Methods Totals of 7 nurses in the hospital ship ward,according to the characteristics of hospital ship,made nursing plan for 96 specialist surgical patients from three Latin American countries (Jamaica,Trinidad and Tobago,Costa Rica).Results Among 96 patients,no case had complications,and the cure rate was 100％.Successfully completed the foreign medical services.Conclusions Organization management and quality of care in ward care of maritime hospital are provide protection for the successful completion of medical services. Key words: Harmonious mission; Hospital ship; Nursing work; Academic exchange

Korean nurses’ attitudes towards older people with dementia in acute care settings

To identify and describe Korean nurses' attitudes towards older people with dementia in acute care settings and to examine the effect of selected socio-demographics and nursing work characteristics on attitudes. In Korea, older people receive health care services in acute care settings because long-term care settings are not the norm. Culturally, it is considered shameful to place parents or relatives in a long-term care facility. A descriptive survey design. Attitudes towards older people with dementia were measured in Korean registered nurses (n = 100) working in acute care settings of two hospitals in southern Korea in 2009. The Attitudes toward the Elderly with Dementia (AED) and the Approaches to Dementia Questionnaire (ADQ) were administered to participants. Moderately positive attitudes towards older people with dementia in the acute care setting were found. Two-thirds of the nurse participants (n = 65, 65.7%) working in medical wards demonstrated significantly more positive attitudes than those working in surgical wards (n = 34, 34.3%). Demographics including years of experience in the current unit and in the service, and nurses' position did not correlate significantly with their attitudes. The environment, work routine and technology may influence the likelihood of negative attitude towards people with dementia. IMPLICATIONS FOR PRACTICE. There may be conflict between nurses' cultural values and care practices in acute care settings. Therefore, there is a need for ongoing education of nurses in dementia care that may reduce the potential of such conflicts.

Jordanian nurses’ attitudes toward older patients in acute care settings

To identify and describe Jordanian nurses' attitudes toward older patients in acute care settings. The effects of socio-demographics and nursing work characteristics on nurses' attitudes were also examined. Descriptive correlational design was used. Kogan's (1961) Attitudes Toward Old People Scale was administered to a total population of Jordanian nurses (n = 200) working in selected units in acute care settings of three public hospitals in northern Jordan. Nurses' attitudes were described by using descriptive statistics. ANOVA and Pearson correlation were used to examine the effects of selected socio-demographic details and work characteristics on nurses' attitudes. Jordanian nurses who participated in this study had marginally positive attitudes toward older patients in acute care settings. Years of clinical experience correlated significantly with their attitudes. Male nurses had significantly more positive attitudes than their female counterparts. Surgical nurses also demonstrated significantly more positive attitudes than those working in medical units. Although positive attitudes emerged towards older people, it was also apparent that efforts should be made to enhance them further so that quality care is delivered to this population. In addition, Jordanian nurse educators should put a greater focus on issues related to the care of the older person in their nursing curriculum.