Nursing Practice Environment Research Articles

The Relationship Between Nursing Practice Environment and Innovative Behavior in the Al-Madinah Region, Saudi Arabia: A Descriptive Study.

Background and objective A positive and supportive practice environment is essential for inspiring innovation in nursing. Innovative behaviors (IBs) could motivate nurses to devise solutions in several domains, such as identifying and solving workplace problems, building new work methods, delivering their services efficiently and effectively, adopting new medical technology advancements, and leading the change process to face current challenges in healthcare. In this study, we aimed to investigate the relationship between the nursing practice environment (NPE) and IB in the Al-Madinah region of Saudi Arabia. Methods A quantitative, descriptive, cross-sectional correlational design was employed for the study. The convenience sample consisted of 330 bedside nurses working in five general hospitals in the Al-Madinah region who voluntarily completed a self-report questionnaire consisting of queries related to demographic and professional characteristics, the Practice Environment Scale of the Nursing Work Index (PES-NWI), and the Innovative Behavior Inventory (IBI). The collected data were analyzed using descriptive statistics and Pearson's correlation. Results Based on the study findings, the NPE was favorable. The overall PES-NWI mean score was 2.62 ± 0.50, and the mean scores of four of the five subscaleswere >2.50. The collegial nurse-physician relations subscale was perceived as the most favorable (2.87 ± 0.59), while staffing and resource adequacy was perceived as unfavorable (2.35 ± 0.65). The overallIBI mean score was 3.53 ± 0.56, indicating that nurses had a moderate level of agreement on IB. The highest mean score in IB was in the idea search domain (3.72 ± 0.77), while it was lowest in the implementation of starting activities domain (3.11 ± 0.86). Conclusions The correlation between the NPE and IB was positive and statistically significant. However, the correlation of the staffing and resources adequacy subscale in relation to subscales of idea search, overcoming obstacles, and innovation output did not reach statistical significance. Healthcare organizations should incorporate the principles of work innovation and healthy nursing work environments into their core values and enhance and nurture them through strategic management.

Work-Related Stress and Turnover Intention during Covid-19 among Nurses in Hospital Universiti Sains Malaysia

The outbreak of COVID-19 had significantly impacted the healthcare system, placing it under tremendous strain. Nurses were shown to have suffered the impact of the pandemic, suggested traumatization and estimated a mass turnover intention among nurses globally due to the pandemic [1]. The objective of this cross-sectional study is to assess the prevalence of work-related stress and turnover intention among nurses in the Hospital Universiti Sains Malaysia (Hospital USM). This hospital is a teaching hospital with 830 beds that offers various specialties recognized as Hybrid COVID Hospital in managing patients.
 
 This study utilized multi-stage sampling. The population was stratified into three strata which were, Medical-Surgical wards, Specialty wards (Pediatric, Obstetrics and Gynecology), and Critical Care wards. Next, the wards were selected through a simple random method. The nurses from the selected wards who follow inclusion criteria; nurses with grade U29 or U32 (KUP) with at least one year of working experience [2] were invited to join the study. A total of 365 nurses participated in this study by answering a self-administered questionnaire through Google Forms sent to them. The questionnaire included three parts; Part A sociodemographic data, Part B Nurse Stress Index (NSI) with scoring ranging from 30-150 and Part C Turnover Intention Scale (TIS-6) with a scoring of 9-18[3]. The NSI is categorized into four categories: 30-60= no pressure, 61-90= very little pressure, 91-120= moderate pressure and 121-150=extreme pressure[3]. As for TIS-6, a score <18 indicates a desire to stay whereas ≥18 indicates a desire to leave [3].
 
 The collected data were analyzed using SPSS version 26.0. Sociodemographic characteristics, the prevalence of work-related stress and turnover intention were analyzed descriptively. Pearson correlation test was used to analyze the correlation between work-related stress and turnover intention. Nearly half of the nurses experienced little (40.8%) to moderate (42.5%) level of work-related stress however 73.3% of the nurses reported that they did not have the intention to leave (Table 1 and Table 2). The mean score of work-related stress and turnover intention showed that the nurses were in a moderate level of stress (90.78), with low turnover intention (16.42). Next, the findings showed a significant and positive correlation between work-related stress and turnover intention (r= 0.559, p< 0.001) (Table 3).
 This study found that work-related stress was significant among nurses although the data were collected towards the end of the pandemic approaching endemic phase. This could be explained by the uncertainty of the disease which was among the factors that could contribute to stress among frontliners [4]. Although the stress level is significant, the nurses in this study have low intention to leave. This could be possibly due to the job security working in government sector as this study was done in a semi-government hospital where the nurses receives benefits and securities such as salary remuneration and pension scheme[5]. Findings of the study shows a positive correlation between work-related stress and turnover intention. It is known that prolonged stress causes negative impact towards the physical and mental health of nurses, subsequently being the contributing factor towards turnover intention[6].
 
 Nevertheless, this study implies that healthcare personnel should be alert regarding the issues and consequences related to work-related stress and turnover intention. Appropriate strategies or recommendations should be done to improve nurses’ satisfaction and addressing issues related that surround the nursing practice environment to improve the quality of work life among nurses and thus, improve the quality of care delivered and patient safety, thus retaining highly skilled nurses.

A Nursing Approach to Improving Critical Care Compliance With Vital Signs and Neurological Assessments in Post-IV-Alteplase Stroke Patients

Ischemic stroke represents 87% of all strokes. As global initiatives move forward with stroke care, health care providers and institutions will be called on to deliver the most current evidence-based care. The American Heart Association/American Stroke Association (AHA/ASA) estimates that 795 000 strokes occur each year; 610 000 are new strokes, and 185 000 are recurrent strokes. Eighty-seven percent are ischemic strokes; the overall mortality rate from stroke was 273 000, which makes stroke the fifth leading cause of death and the leading cause of disability in the United States. Stroke costs the United States an estimated $34 billion each year. This article outlines a nursing intervention regarding the use of intravenous thrombolytic therapy for treating acute ischemic stroke, the risk factors related to IV-alteplase, best-practice protocols, and the nursing role in efforts to deliver safe care. The conclusion reveals the need for health care organizations to explore opportunities, continually inspire innovation at the bedside, highlight nursing's essential contribution to acute stroke care, and encourage publishing improvements in patient care and the nurse practice environment.

Developing and Evaluating the Effectiveness of a Leadership Integrated Educational Program for Master's Nursing Students in Taiwan

Nursing students with master degrees have the strong potential to serve as future leaders in medical teams. Implementing a well-developed and integrated educational program for nursing leadership at the master's level can strengthen the leadership of advanced practice nurses and promote a positive nursing practice environment. To develop a leadership integrated educational program for master's nursing students and conduct a preliminary evaluation of the effectiveness of this program in cultivating leadership competencies in these students. Phase 1: A modified Delphi survey conducted on 14 experts with clinical or academic backgrounds was used to identify the teaching objectives and strategies of the leadership integrated educational program. Phase 2: These teaching objectives and strategies were embedded into nine compulsory courses within a current training program for master's nursing students at a national university. The core elements of the leadership integrated educational program were incorporated into each compulsory course. The objectives of each compulsory course directly reflected the objectives of the integrated program. The leadership integrated educational program was implemented for one academic year, and its effectiveness was evaluated using a quasi-experimental test with a single group pre- and post-test design. A self-developed, 10-item "Master Nursing Student's Leadership Competence Scale" covering four core elements was applied to measure the self-reported leadership competencies of the participants. A paired sample t-test was applied to analyze the differences in leadership competencies between pre- and post-intervention. A consensus on the teaching objectives and strategies of the leadership integrated educational program was achieved in the first round of the Delphi survey. The overarching teaching objective of the leadership integrated educational program was to "lead the healthcare team with the leadership and competencies, and demonstrate the advanced nursing practice skills for improving quality of care." In addition, the four core elements under the overarching goal, i.e., personal characteristics, leading people, business management, and vision building, were proposed. Forty-eight master's nursing students participated in this study. The results showed the average total score of leadership competency was 42.33 ± 12.16 (potential range: 10 - 70), indicating that the participants had a middle level of leadership competency prior to program participation. After participating in the Leadership Integrated Educational Program for one academic year, the average total score for leadership competency increased to 51.27 ± 9.74, indicating that the participants still had a middle level of leadership competency. Nevertheless, the 8.94 increase in the post-intervention score was statistically significant (p < .01). Moreover, the scores for each subscale (personal characteristics, leading people, business management, and vision building) had all increased significantly increased from 13.52 to 15.71, 12.65 to 15.35, 8.15 to 10.31, and 8.02 to 9.90, respectively (p < .01). This study offers proactive recommendations for reforming master's degree programs in nursing. The proposed multidisciplinary-expert-informed leadership integrated educational program may be used to strengthen leadership competencies in this student population. Furthermore, the findings provide a benchmark for developing an effective nursing leadership integrated educational program that may be incorporated into domestic master's degree programs.

The influence of the nursing practice environment on missed care and individualized care

Enquadramento: O ambiente de prática de enfermagem (APE) influencia a qualidade dos cuidados de saúde, a prática de cuidados centrados na pessoa e a segurança dos doentes. Concretamente, prestar cuidados seguros engloba não deixar cuidados omissos. Objetivo: Analisar a influência do APE nos cuidados omissos e na individualização dos cuidados. Metodologia: Estudo quantitativo, descritivo e correlacional, desenvolvido em três serviços de internamento de um hospital de oncologia em Portugal. A perceção dos enfermeiros acerca do APE foi avaliada pela Practice Environment Scale of the Nurse Work Index, sendo-lhes também solicitado que identificassem os cuidados omissos do último turno por falta de tempo. A perceção das pessoas internadas acerca da individualização dos cuidados prestados foi avaliada recorrendo à Individualized Care Scale Patient. Resultados: Participaram 66 enfermeiros e 40 pessoas internadas. O APE global foi avaliado como desfavorável. O serviço com ambiente no limiar favorável reportou menos cuidados omissos. As pessoas internadas perceberam os cuidados como sendo individualizados. Conclusão: O APE identificado pode colocar em causa a qualidade dos cuidados prestados.

Analysis of the Work Environment and Burnout among Nurses, Technicians and Nursing Assistants in Brazilian Institutions

In addition to causing damage to the health of patients, the Covid 19 pandemic has brought a greater burden to health systems directly affecting professionals, leading many to physical and emotional exhaustion. The present study aims to demonstrate the perceptions of the professional practice environment of nurses, technicians and nursing assistants through the use of the Environment of Professional Practice research (Practice Environment Scale of the Nursing Work Index – PES/NWI) and the Maslach Burnout Inventory (MBI), in addition to comparing them. The researches were applied in private and public administrative institutions in four Brazilian states, these being Amazonas (AM), Minas Gerais (MG), Mato Grosso do Sul (MS) and Rio de Janeiro (RJ) that are part of the IQG Nursing Certification, from December 2020 to June 2021, with the participation of 1484 professionals from the six invited institutions. The nursing team-physician relationships are identified as the most favorable characteristics of the work environment in the PES/NWI, and the foundations for nursing practice, however, identified as unfavorable to the participation of nursing in hospital affairs and adequacy of personnel and resources. Regarding the dimensions of the MBI research the best results are related to emotional exhaustion. However, the rates of low professional fulfillment were 69.1%. There are impacts on burnout related to emotional exhaustion and professional fulfillment related to the work environment, more frequently in the group of nurses. The analysis showed differences in the perceptions of nurses when compared to nursing assistants and technicians, with attention to inter-professional working relationships and the availability of resources. Therefore, the importance of guiding actions aimed at the management of these health resources is portrayed, with attention to the risk to the quality and safety of care, but also to the health of these professionals. The role of the leader, represented by the nurse, needs more attention and preparation, given its potential in guiding the best practices, professional engagement and promoting changes in the environment of professional practice.

The Influence of Moral Distress, Empowerment and Nursing Practice Environment on Nurses’ Person-centered Care in Long-term Care Hospitals: A Cross-Sectional Study

Purpose: The purpose of this study was to identify the influence of moral distress, empowerment, and nursing practice environment on nurses’ person-centered care in long-term care hospitals.Methods: A cross-sectional descriptive study was conducted using self-report questionnaires. Participants included 128 nurses working in eight long-term care hospitals. Data were collected from July 24 to August 31, 2018 and analyzed using the independent t-test, one-way ANOVA, Pearson correlation, and multiple linear regression using the SPSS/WIN 26.0 program.Results: Person-centered care showed significantly negative correlations with moral distress (r=-.18, p=.048) and positive correlations with empowerment (r=.52, p&lt;.001) and nursing practice environment (r=.46, p&lt;.001). Person-centered care was significantly affected by empowerment (β=.42, p&lt;.001) and nursing practice environment (β=.26, p=.002), and the explanatory power of these variables was 34% (F=22.29, p&lt;.001).Conclusion: Research results suggest it is necessary to develop a program to improve the empowerment of nurses for person-centered care and nursing practice environment in long-term care hospitals.

Association between nursing practice environment and sense of coherence among staff nurses: A cross-sectional study in Japan.

This study aimed to investigate the association between work environment and sense of coherence among staff nurses. In Antonovsky's salutogenetic theory, factors that causes stress are not always harmful when people's sense of coherence is high. Although the effects of sense of coherence have repeatedly been confirmed, few studies have examined factors that increase sense of coherence. We used cross-sectional data (N = 6172) surveyed in 2017 from a 2-year longitudinal study in 2016 and 2017. Multiple group structural equation modelling was conducted for years of nurse experience of different groups. Work environment subscale scores for nurses with less than 5 years of experience ranged from 2.3 to 2.9 and for those with more than 5 years, from 2.1 to 2.7. The averages of sense of coherence for the groups were 36.9 and 39.7, respectively. For both groups, there was a statistically significant association between work environment and sense of coherence. Improvement of nurses' work environment may increase sense of coherence, leading to improvements in health. The study suggests that nurse managers should improve the work environment to increase sense of coherence of staff nurses, leading to improved health for any length of a nurse's experience.

Dissonance Between Human Nurses And Technology: Understanding Nurses’ Experience Using Technology Beds With Monitoring Functions Within Clinical Nursing Practice

Aims: Are nurses adapting to the mechanized nursing practice environment? Is it possible for nurses to collaborate with technology to provide care to patients? The aim of the study is to investigate what nurses feel about using technology in nursing practice. Background: Preventing patients from falling is one of the nursing tasks that can be helped by using technology, such as sensors. However, little is known about how nurses experience and feel the use of technological beds for monitoring functionality within clinical nursing practice. Especially it is indicated that alarm fatigue makes nurses and patients fatigued and induces a dissonance between nurses and technology. Objective: To clarify the experiences of nurses in clinical practice following the introduction of a bed with monitoring and fall prevention technology (technology bed). Methods: We interviewed 12 nurses working at a hospital about their nursing practice experiences with the technology bed. Results: The content of the interview was classified into three categories: ‘providing a safe environment’, ‘limitation of entry into machine care scenes’, and ‘nurses’ dilemmas’; with eight themes describing nursing practice: (1) strategies of fall prevention, (2) decrease in nurses’ burden, (3) not good at using technology (all tools must be easy to use), (4) inefficiency such as over-engineering, (5) patients feel annoyed by frequent visits from nurses, (6) limitations of utilization from a nursing perspective, (7) nurse resistance to equipment introduction and (8) ethical issues. Conclusion: Although technology beds could effectively prevent falls, many nurses face an ethical dilemma in using these beds. It would be important for nurses to recognize the role of technology, embrace it, and raise awareness of collaborating with technology to eliminate a dissonance between technology and nurses.

Evidence-based nursing practice and prevention of falls in hospitalized patients

Background: the risk of falls in hospitalized adult patients is a very important topic to develop and investigate since a fall can produce irreparable harm. Every hospitalized patient can suffer a fall which can produce an adverse event. Aim: to analyze the relationship between the evidence-based nursing practice environment and its relationship with knowledge about fall prevention in hospitalized patients. Methods: an observational, descriptive, cross-sectional study was conducted. The sample consisted of 73 nurses. Results: the sample consisted of 80,8 % female nurses. The average age was 37,7 ± 8,4. The average age was 37,7 ± 8,4. 50,7 % of the sample had a Professional Nursing degree. The mean score of the health personnel knowledge survey on fall prevention was 15,1 ± 7,8 points (95 % CI: 13,2444 to 16,8926). No relationship was found between evidence-based nursing practice setting and health care staff knowledge of falls prevention (P=0,2742). Conclusions: adequate levels of both evidence-based nursing practice setting and health care staff knowledge of falls prevention were found. Both indicators were independent and no relationship was found between them or with sociodemographic variables. Therefore, it cannot be affirmed that the level of knowledge regarding falls is a factor that affects the intention to behave in accordance with the implementation of evidence-based practice

Effect of work environment on the job performance among nurses at Makkah City, Saudi Arabia

Background: Nurses represent the most significant proportion of health care professionals. Nurses work in different healthcare organisations and play a vital role in improving healthcare quality. The healthy nursing practice environments are significant to recruiting and retaining nursing professionals in in Saudi Arabia, because the country facing a critical nursing shortage. Nurses are generally eager to have a healthy work environment that provides them with a sense of worth, and a favourable work environment means better hospital performance. In this regard, it is essential to study the factors influencing nurses’ job performance. Aim: To determine the effect of the work environment on the job performance of nurses working in selected hospitals in Makkah, Saudi Arabia. Design: This study employed a quantitative, descriptive, cross-sectional research design to assess the effect of the work environment on nurses’ job performance. Sample: The convenience sampling method was chosen to collect and analyse the data from professional nurses who have worked for at least six months in the selected hospitals, from King Faisal Hospital and King Abdulaziz Hospital in the Makkah region of Saudi Arabia.

Essential core competencies for scope of practice of paediatric oncology nurses in Latin America: a scoping review protocol

IntroductionNurses comprise the largest group of health workers globally and are essential to the provision of care necessary for delivering curative therapy to children with cancer. In high-income countries, previous...

Nursing Practice Environment and Counterproductive Work Behavior among Staff Nurses at Gastroenterology Center-Mansoura University

Nursing Practice Environment and Counterproductive Work Behavior among Staff Nurses at Gastroenterology Center-Mansoura University

The impact of nurse practice environment on patient outcomes and mediation effects of registered nurse outcomes in Middle Eastern acute care hospitals: A cross-sectional study

AimsExamining associations between unit nurse practice environment and four patient outcomes (catheter-associated urinary tract infections [CAUTIs], central line-associated bloodstream infections [CLABSIs], falls, and pressure injuries) and mediation effects of three RN unit workgroup outcomes (job enjoyment, psychological safety, and intent to stay at 1 and 3 years) on these relationships. MethodsA cross-sectional correlational design, using the National Database of Nursing Quality Indicators® (NDNQI®) unit-level data from 2018 on inpatient units from seven Middle Eastern hospitals. Ninety units were included, where the sample of units for each patient outcome varied (n = 73–90) based on outcome data availability. ResultsHigher unit nurse practice environment scores were significantly associated with higher CLABSIs (exp(b) = 8.181, 95 % CI = [2.204, 30.371], p = .002) and lower pressure injuries (exp(b) = 0.153, 95 % CI = [0.032, 0.730], p = .018). However, mediation analysis showed no significant direct effects of unit nurse practice environment on patient outcomes. Mediation analysis showed that nurses' psychological safety-respect significantly mediated the relationship between unit nurse practice environment and CAUTIs (β = 2.620, p = .013, 95 % bcb CI = [0.837, 5.070]). Nurses' intent to stay at 1-year and psychological safety-respect had significant direct effects (β = −4.784, p = .017 and β = 3.073, p = .012, respectively) on CAUTIs. ConclusionsNurse practice environment was significantly associated with two patient outcomes and a mediation role of RN outcomes was supported when examining one patient outcome. Future research should examine these relationships in a larger sample for replication. Tweetable abstractAlthough nurse practice environment can impact patient outcomes directly, nurse outcomes play a crucial role in mediating this relationship.

The changes in the nursing practice environment brought by COVID-19 and improvement recommendations from the nurses’ perspective: a cross-sectional study

BackgroundThe COVID-19 pandemic has brought an opportunity to increase investment in the nursing practice environment, which has greatly impacted patients, nurses, and organizations. However, there were limited studies concerning the changes in the practice environment since the COVID-19 pandemic and the way to improve it from nurses’ perspectives.MethodsA cross-sectional study was conducted among 460 nurses from seven hospitals in Sichuan, China. Both the quantitative and qualitative data were collected from an online questionnaire. The quantitative data were collected using the Chinese version of the Practice Environment Scale-Nursing Work Index and compared with available norms in 2010. The qualitative data were collected through an open question following the scale and analyzed by content analysis.ResultsThe mean of the score of the practice environment scale was 3.44 (SD = 0.56) out of 4.00. The score of the total scale and the dimensions were significantly higher than the norms, apart from nurse-physician relations and nurse participation in hospital affairs. The qualitative findings revealed positive changes in nursing foundations for quality of care, nurse participation in hospital affairs and nurse-physician relations, and poor staffing and resource adequacy. The improvement in the working model and ward environment is the primary concern of nurses.ConclusionsThe COVID-19 pandemic brought some positive changes in the nursing practice environment, but more efforts are needed to solve those nagging and important problems, such as staff shortages and low participation. Nursing managers and hospital leaders were encouraged to listen to nurses’ concerns and value this suitable opportunity for changing and improving to achieve better health services and coping ability to deal with emergency events going forward. Improving the ward environment and taking a professional model instead of sticking to the tedious process might be worthwhile.

A Study on the Relationship Among Nurses’ Practice Environment, Safety Attitude, and Occupational Wellbeing

Objective: To investigate the status quo of nursing practice environment, nurses’ safety attitude, and occupational well-being, as well as to explore the relationship among the three, so as to provide reference for formulating and implementing corresponding measures. Methods: A cross-sectional survey was conducted from October 2021 to December 2021. A total of 1,939 nurses from five tertiary hospitals in a city were surveyed using the Nurses’ Practice Environment Assessment Scale, Safety Attitudes Questionnaire, and Medical Workers’ Occupational Wellbeing Scale. The data were analyzed using SPSS 22.0. Results: The total score of nurses’ practice environment was 68.81 ± 27.79 points, which is at a relatively general level; the total score of nurses’ safety attitude was 111.28 ± 14.38 points, which is at a moderate level; and the total score of occupational well-being was 62.43 ± 28.17 points, which is relatively high. There was a significant positive correlation between nurses’ practice environment and their safety attitudes and occupational well-being (p &lt; 0.05). Conclusion: Nurses are the main human resources in hospitals, and their practice environment is closely related to patient safety and their work enthusiasm. An unhealthy practice environment not only affects the quality of care, which leads to patient safety issues, but also their job satisfaction. Nurse managers are encouraged to implement targeted interventions in advance to improve nurses’ practice environment, strengthen safety attitudes, and enhance the professional wellbeing of nurses.

종합병원 간호⋅간병통합서비스병동 간호사와 일반병동 간호사의 직무만족 관련 요인

Purpose: This study aimed to analyze and compare job satisfaction and its related factors of nursing care integrated service and general unit nurses. Methods: The participants were 345 nurses from 8 general hospitals working in the Kyungsang area. Data were collected from August through September 2018, by a structured self-administered questionnaire measuring general characteristics, nursing practice environment, emotional labor, nursing professionalism, and job satisfaction. The data were analyzed with IBM SPSS Statistics 25 program. Results: The participants were 170 nurses working in the nursing care integrated service unit and 175 nurses working in the general unit. The factors associated with job satisfaction in integrated service unit nurses were total years of clinical experience (β = -.11, p = .047), nursing practice environment (β = .52, p < .001), and nursing professionalism (β = .22, p = .009), which explained 51.0% of the variance. The factors of job satisfaction in general unit nurses were nursing practice environment (β = .55, p < .001) and emotional modulation efforts (β = .18, p = .006), explaining 51.0% of the variance. Conclusion: In order to increase the job satisfaction of nurses, a good work environment should be created through the efforts of associated units.

Effects of an Intranet-Based Call-for-Help System on Teamwork, Work Efficiency, Job Satisfaction, and Job Stress in Nurses.

In the medical environment, teamwork among medical care personnel is closely related to patient safety and care quality. This research has developed an Intranet-based call-for-help system to establish an emergency support system. Few studies have explored the effects of the timely call-for-help system on teamwork. This study explored the effects of the timely call-for-help system intervention. This study was designed by 2 groups of pretest and posttest. This research was conducted at a medical center in Taiwan. The subjects of the study were nurses in inpatient wards. The newly established call-for-help system was used in the 4 experimental wards, enabling nurses to immediately seek help from each other when faced with challenges and difficulties. This study was blind with the outcome evaluator and data analyst blinded to the group of participants. A total of 165 nurses were included in the study, 84 in the intervention group and 81 in the control group. After the intervention of the call-for-help system, the experimental group had significantly better teamwork, work efficiency, job satisfaction, and lower job stress than the control group ( P &lt; 0.01). The generalized estimating equation showed that the progress scores of the experimental group on the 4 scales were significantly higher than those of the control group ( P &lt; 0.01). The implementation of timely call-for-help system can enable nursing staff to get immediate support, strengthen teamwork, create a positive nursing practice environment, and improve patient safety and quality of care. These improvements in teamwork and support are very important and worthy of promotion.

Impact of COVID-19 on professional nursing practice environments and patient safety culture.

AimTo analyse the impact of COVID‐19 on professional nursing practice environments and patient safety culture.BackgroundThe relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown.MethodThis is a quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self‐completion questionnaire was used.ResultsThe impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favourable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; ‘teamwork within units’ was the only dimension that maintained a positive culture.ConclusionPositive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. The need to invest in all dimensions of safety culture emerges to promote positive professional environments.Implications for nursing managementImproving professional nursing practice environments can be achieved through managers' investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair and participatory safety culture that encourages reporting events and provides adequate support for professionals.

Status and associations of nursing practice environments in intensive care units: A cross-sectional study in China.

The objective of this study is to investigate the status and associations of nursing practice environments in intensive care units of tertiary hospitals and provide suggestions for improvement. Nursing shortage is an urgent global problem and a concern in China. Intensive care unit nurses have been reported to have one of the highest rates of burnout; however, their comprehensive perceptions of nursing practice environments have not yet been examined. The Nursing Practice Environment Scale was used to conduct a questionnaire-based survey of 1,523 intensive care unit nurses from 22 tertiary hospitals in China. The data collection was conducted in 2020. The overall score for the nursing practice environment was 77.042 ± 19.682 (where 100 was the highest possible score). The three highest scoring dimensions were quality management, clinical nursing professionalism and professional improvement, whereas the three lowest-scoring dimensions were hospital management participation, remuneration package and social status. Educational background, position, gender and hospital type were significantly associated with nurses' satisfaction with the working environment. Chinese nurses in the intensive care units of tertiary hospitals reported relatively satisfactory nursing practice environments, but the scale scores in dimensions such as hospital management participation, remuneration package and social status remained low. Understanding the status and associations of the nursing practice environment in intensive care units provides evidence that new policies are needed. Furthermore, managers are responsible for supervising and ensuring that nursing practice environments meet the criteria necessary to improve job satisfaction.