Nursing Practice Environment Research Articles

Nursing practice environment in intensive care unit and professional burnout.

To evaluate and compare the nursing practice environments in Intensive Care Units of a public and private hospital and the prevalence of burnout among nursing professionals. Cross-sectional, descriptive study with a quantitative approach to the data. The data collection took place between October 2018 and March 2019, and it was carried out through a questionnaire with socio-occupational variables and with metrics of intensity. The practice environment was assessed through the Nursing Work Index Revised (NWI-R); and the burnout was assessed by the Maslach Burnout Inventory (IBM). We included professionals with, at least, six months of employment, and those who were on leave or on a fixed-term employment contract were excluded. The sample consisted of 296 professionals. We found Favorable environments in both institutions, however, low results in the subscales autonomy, control and organizational support in the private hospital. The prevalence of burnout among nurses was 2.5% in the public hospital and 9.1% in the private hospital, and among nursing technicians, it was 9.5% and 8.5%, respectively. The control of the environment, autonomy and support were considered critical points, referring to the importance of assessing institutions factors, that can improve the working conditions for the nursing team.

Impact of Nurse Practice Environment, Coworker Support, and Work-Life Balance on Job Satisfaction for Newly Graduated Nurses

Impact of Nurse Practice Environment, Coworker Support, and Work-Life Balance on Job Satisfaction for Newly Graduated Nurses

The Effect of the Nurses Practice Environment and Organizational Justice on Organizational Silence Perceived by Nurses

The Effect of the Nurses Practice Environment and Organizational Justice on Organizational Silence Perceived by Nurses

Quality improvement programs and the professional nursing practice environment: an integrative review.

to analyze the knowledge produced regarding the practice environment in hospitals with quality improvement programs. integrative literature review performed in the Latin American and Caribbean Literature in Health Sciences databases, US National Library of Medicine/National Institutes of Health, Web of Science, Scopus and CINAHL, consisting in 10 articles. data were presented and discussed using categories: Measures for the professional nursing practice environment; Hospital accreditation as an improvement program; Nursing autonomy, interpersonal relationship between nurse and doctor and the nurse as a manager and leader. it was possible to analyze that the influence of quality improvement programs can be considered as favorable in the professional nursing practice environment. The survey also brings contributions to administration in implementing strategies aiming at continuous improvement in the environment characteristics.

The Effect of Sexual Harassment Experience on Self-esteem and Clinical Competence among Nursing Students in Clinical Practice

This study aims to identify the effect of sexual harassment experiences of nursing students in clinical practice on their self-esteem and clinical competence. The survey data were collected from 319 nursing students in grade 3 and 4 enrolled in three universities located in G province of South Korea, and analyzed by descriptive statistical analysis, t-test and correlation analysis. The results show that 72.7% of nursing students experienced sexual harassment mostly from patients (74.9%) at general ward (64.9%). It is also found that, when experiencing harassment, they sought help from a nurse or head nurse and wanted the hospital to get involved to resolve the issue. A positive correlation was found between their experience with sexual harassment and their self-esteem and clinical competence. This study has contribution on providing basic information that can be used to create a safe nursing practice environment through prevention and protection measures against sexual harassment during clinical practice.

The Mediating Effect of Resilience on the Relationship between Nurse Practice Environment and Organizational Commitment in Clinical Nurses

The Mediating Effect of Resilience on the Relationship between Nurse Practice Environment and Organizational Commitment in Clinical Nurses

Relationship between burnout and nursing practice environment in pediatric cardiology: a cross-sectional study

Abstract Introduction The relationship between burnout and patient safety is widely demonstrated in the literature. Recent studies have shown that in pediatrics the burnout rates are even higher, thus increasing young patients' exposure to risks. Pediatric cardiology is often characterized by acute onset in the pre-natal period and requires long periods of hospitalization. Strategies to reduce burnout and its impact on patient safety is a priority. Purpose To test the relationship between nursing work environment and emotional exhaustion in nurses in pediatric cardiology. Methods Data were drawn from the database of a larger study, RN4CAST@IT-Ped, a cross-sectional study in which 13 Italian hospitals were involved. Convenience sampling was adopted, and inclusion criteria were nurses providing direct routine care in wards. For this study, only data relating to nurses working in Pediatric Cardiology were extracted. The data were collected through a web survey from September 2017 to January 2018. The questionnaire investigated several aspects relating to care and nursing staff including workload, skill mix, work environment measured with PES-NWI, and emotional exhaustion with the Maslach Burnout Inventory. Descriptive statistical analyses were conducted to describe the sample and variables taken into consideration; a binomial logistic regression model was built to test the relationships between the dependent variable “high Emotional Exhaustion” and the independent variables “PES-NWI composite score”, adjusted for “workload” and “skill mix”. Results The responses from eighty-five pediatric nurses from 7 units (mixed cardiology-cardiac surgery, cardiology, arrhythmology, cardiac surgery and a cardiology intensive care unit), in 5 hospitals, were analyzed. These findings show that with the same skill mix and workload, the improvement of the workplace environment conditions decreased by 81% (OR 0.192; 95% CI 0.062–0.591) the risk that nurses working in pediatric cardiology would develop a high level of Emotional Exhaustion. Conclusions Demonstrating the association between emotional exhaustion and work environment in pediatric cardiology is only a first step towards improvement. Workplace environment includes relational, logistic, and organizational aspects that require further investigation to ensure that nursing in pediatric cardiology is even safer and of better quality in all its key aspects: urgency, intensity, chronicity and complexity. Funding Acknowledgement Type of funding source: None

Principles of a Healthful Practice Environment for Nurses.

Principles of a Healthful Practice Environment for Nurses.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey.

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type. Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date. The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha. Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest. The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment. Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Ecological Predictors of Recovery-Oriented Practices Among Psychiatric Nurses in South Korea

Using hierarchical multiple regression analysis, the current study aimed to investigate ecological predictors of recovery-oriented practices among 230 psychiatric nurses in South Korea. Intrapersonal predictors associated with recovery-oriented practice were educational level, type of workplace, and attitudes regarding recovery. Extent of nursing practice environment recognized by nurses at the organizational level was also significant. Recovery-oriented practices were associated with intrapersonal and organizational factors. Therefore, it is necessary to provide multi-level considerations to improve recovery-oriented practices among psychiatric nurses. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 37-47.].

Quality and Safety in Health Care, Part LXXX: The National Database for Nursing Quality Indicators and the Practice Environment Scale of the Nursing Work Index.

The National Database for Nursing Quality Indicators is an important source of information used to benchmark nursing by unit category in multiple areas related to not only structure and process but also outcome. It also provides some information regarding best practices and the cost to achieve certain results. The Practice Environment Scale of the Nursing Work Index is a frequently used way to measure the professional practice environment of nurses and the relationship of the latter to quality, safety, and other outcomes.

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.

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care.

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.

The Moderating Effect of Nursing Practice Environment on the Relationship between Clinical Nurses' Sleep Quality and Wellness.

This study examined the moderating effect of nursing practice environment on the relationship between clinical nurses’ sleep quality and wellness. The wellness of clinical nurses is a direct outcome of individual-level health behaviors and organizational environmental factors. This study was a cross-sectional analysis. Participants were clinical nurses recruited using convenience sampling. The Nurse Practice Environment Scale, Wellness Index, and Pittsburgh Sleep Quality Index, Korean version (PSQI-K) were used. Data collected from 1874 nurses were analyzed using descriptive statistics and hierarchical multiple regression analyses. A total of 95.3% of the participants were women, and the mean age was 28.8 years. Further, 42.4% of the participants had a nursing career of 5 years or longer. The mean score for nursing practice environment was 2.24 and the mean PSQI-K score was 9.39. Nurses with less than 1 year of experience reported lower wellness scores. The wellness scores decreased with poorer sleep quality, and a more positive evaluation of the nursing practice environment predicted higher levels of wellness. Nursing practice environment had a moderating effect on the negative association of nurses’ poor sleep quality with their wellness. Regarding management, individual strategies for nurses’ well-being and organizational improvement policies may improve the nursing work environment.

An Exploratory Study of the Influence of Perceived Organizational Support, Coworker Social Support, the Nursing Practice Environment, and Nurse Demographics on Burnout in Palliative Care Nurses.

Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in health care, including nursing, medicine, and social work. The purpose of this study was to examine the relationship between perceived organizational support, coworker social support, the nursing practice environment, and nurse demographics (age, years of nursing experience, education level, marital status, and sex) on burnout in a national sample of palliative care nurses. The study aims were (1) to examine the relationship between perceived organizational support, coworker social support, and nursing practice environment on burnout in palliative care nurses; (2) to examine the relationship between age, years of nursing experience, education level, marital status, and sex on burnout in palliative care nurses; and (3) to examine potential moderators (perceived organizational support and coworker social support) on the relationship between demographic characteristics and palliative care nurse burnout. A convenience sample of 73 Hospice and Palliative Nurses Association registered nurses who were bedside caregivers was recruited from Hospice and Palliative Nurses Association's membership. Data were analyzed using Pearson correlation and regression modeling. Findings indicated palliative care nurses had moderate to high levels of burnout. There was a negative correlation between burnout and perceived organizational support, and between burnout and coworker social support. The nursing practice environment of palliative care nurses was favorable; perceived organizational support and coworker social support were not moderators for demographics of age and years of experience and their relationship to burnout.

Nursing practice environment, resilience, and intention to leave among critical care nurses.

Retaining experienced critical care nurses (CCNs) remains a challenge for health care organizations. Nursing practice environment and resilience are both seen as modifiable factors in ameliorating the impact on CCNs' intention to leave and have not yet been explored in Malaysia. To assess the association between perceived nursing practice environment, resilience, and intention to leave among CCNs and to determine the effect of resilience on intention to leave after controlling for other independent variables. This was a cross-sectional survey. The universal sampling method was used to recruit nurses from adult and paediatric (including neonatal) critical care units of a large public university hospital in Malaysia. Descriptive analysis and χ2 and hierarchical logistic regression tests were used to analyse the data. A total of 229 CCNs completed the self-administrated questionnaire. Of the nurses, 76.4% perceived their practice environment as being favourable, 54.1% were moderately resilient, and only 20% were intending to leave. The logistic regression model explained 13.1% of variance in intention to leave and suggested that being single, an unfavourable practice environment, and increasing resilience were significant predictors of nurses' intention to leave. This study found that an unfavourable practice environment is a strong predictor of intention to leave; however, further exploration is needed to explain the higher likelihood of expressing intention to leave among CCNs when their resilience level increases. Looking into staff allocation and equality of workload assignments may improve the perception of the work environment and help minimize intention to leave among nurses.

The relationships between nurses' work environments and emotional exhaustion, job satisfaction, and intent to leave among nurses in Saudi Arabia.

To examine relationships between components of nurses' work environments and emotional exhaustion, job satisfaction and intent to leave among nurses in Saudi Arabia. A descriptive correlational study with cross-sectional data. Data were collected in 2017 from 497 Registered Nurses working in a large tertiary hospital in Riyadh, Saudi Arabia. Participants completed an online survey like that used in RN4Cast studies to measure nurses' perceptions of their work environments and nurse outcomes. Hierarchical linear regression and logistic regression were conducted to examine the relationships between components of nurses' work environments and nurse outcomes after controlling for nurse and patient characteristics. Nurse participation in hospital affairs was uniquely associated with all three nurse outcomes, whereas staffing and resource adequacy was associated with emotional exhaustion and job satisfaction, but not intent to leave. These two variables were also the components of the nursing practice environment that received the lowest ratings. Nurse manager ability, leadership and support of nurses, and nurse-physician relationships were associated with job satisfaction only. A nursing foundation for quality of care was not uniquely associated with any of the three outcomes. Finally, nurse emotional exhaustion and job satisfaction fully mediated the relationship between nurse participation in hospital affairs and intent to leave. Magnet-like work environments in Saudi Arabia are critical to recruiting and retaining nurses in a country with critical nursing shortages. This study addresses a gap in the literature regarding which components of the nurses' work environment are uniquely associated with emotional exhaustion, job satisfaction and intent to leave among nurses in Saudi Arabia. Study results will assist Saudi hospital administrators and nurse leaders to develop recruitment and retention strategies by focusing on those work environment components most associated with nurse outcomes: participation in hospital affairs and staffing and resource adequacy.

Responding to the COVID-19 pandemic with the Pathway to Excellence® framework

Responding to the COVID-19 pandemic with the Pathway to Excellence® framework

Nursing Practice Environment and Its Relation to Missed Nursing Care : A Scoping Review

Objective: To examine the association between the practice environment of nursing and themissed care of nursing in a systematic way in the related literature.Methodology: An extensive search was conducted in CINAHL, ProQuest, ERIC, MEDLINE,Web of Science, PubMed, and Science Direct databases. the included studies were publishedduring time period of 2015-2020 with full text.Results: A total of 110 studies were screened, out of which 19 studies were identified to beeligible as per fulfillment of inclusion/exclusion criteria. Degraded quality of nursing,inpatient complications, and mishaps, as well as negative patient outcomes, is examined asexamples for results of missed nursing care. The nurses missed the process and task ofproviding important patient care because of the increased workload, less communication andpoor working environment. Inadequate resources and staffing were the major factors thatwere linked with the events of missed nursing care.Conclusion: It is concluded that reducing and modifying the examined factors, such as poorworking environment, inadequate staffing, less resources, poor communication amongnurses or patients etc. may decrease the missed nursing care practice. In addition, the missednursing can also be managed through the practical implementation of motivating positivework environment and safety culture of patients. These improvements and practicalimplementation will help to provide quality patient care and decrease the missed nursingcare.Keywords: Practice environment, missed nursing care, Teamwork, communication,workload, resources.

Nurse Practitioner Role and Practice Environment in Primary and in Nonprimary Care in California.

Between 2008 and 2016, there was an increase in nurse practitioners in specialty care. This study explores some differences in role and practice environment between primary care and nonprimary care nurse practitioners in the domains of time spent on activities, barriers to providing care, working to scope of practice, full skill utilization, and satisfaction. This cross-sectional quantitative study, based on data from the 2017 Survey of California Nurse Practitioners and Certified Nurse Midwives, found that nurse practitioners in nonprimary care practices have lower odds of reporting time as a barrier to practice, lower odds of reporting practice to full scope, and higher odds of reporting a hierarchical or supervisory relationship with the physician. Future exploration of these differences may shed light on ways to promote nonprimary care practice environments to foster more effective collaboration and fewer barriers to providing care.