Nursing Work Environment Research Articles

Association between the nurse work environment and patient experience in Chilean hospitals: A multi-hospital cross-sectional study.

International evidence shows that nurses' work environments affect patient outcomes, including their care experiences. In Chile, several factors negatively affect the work environment, but they have not been addressed in prior research. The aim of this study was to measure the quality of the nurse work environment in Chilean hospitals and its association with patient experience. A cross-sectional study of 40 adult general high-complexity hospitals across Chile. Participants included bedside nurses (n=1632) and patients (n=2017) in medical or surgical wards, who responded to a survey. The work environment was measured through the Practice Environment Scale of the Nursing Work Index. Hospitals were categorized as having a good or poor work environment. A set of patient experience outcomes were measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Adjusted logistic regression models were used to test associations between the environment and patient experiences. For all outcomes, the percentage of patients satisfied was higher in hospitals with good as compared to poor work environments. In good environment hospitals patients had significantly higher odds of being satisfied with communication with nurses (OR 1.46, 95% CI: 1.10-1.94, p=0.010), with pain control (OR 1.52, 95% CI: 1.14-2.02, p=0.004), and with nurses' timely responses in helping them to go to the bathroom (OR 2.17, 95% CI: 1.49-3.16, p < 0.0001). Hospitals with good environments outperform hospitals with poor environments in most patient care experience indicators. Efforts to improve nurses' work environment hold promise for improving patient experiences in Chilean hospitals. Hospital administrators and nurse managers should value, especially in the context of financial constraints and understaffing, the implementation of strategies to improve the quality of nurses´ work environments so that they can provide patients with a better care experience.

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.

A cross-sectional study on burnout and its individual and environmental correlates among hepatological surgery nurses in Hunan Province, China.

Burnout is a widespread occupational phenomenon among nurses with significant adverse outcomes for nurses, patients, and society. It is thus important and urgent to understand burnout and its risk factors to guide interventions. This study aimed to examine the level of burnout and explore its individual and environmental correlates. This cross-sectional study was conducted in Hunan, China. A total of 623 hepatological surgery nurses completed an online survey (response rate: 72.78%). Burnout was measured using the standard Maslach Burnout Inventory (MBI). Information on individual factors and environmental factors was collected by self-designed questionnaires. The scores of emotional exhaustion, depersonalization, and personal achievement in nurse burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The prevalence of high burnout ranged from 52.81% for emotional exhaustion to 90.37% for decreased personal achievement. The three dimensions of burnout shared common correlates such as self-rated physical health and working environment, while also having additional unique correlates such as overwork, satisfaction with income, and age. Hepatological surgery nurses in Hunan Province are suffering from high levels of burnout, which requires public attention and urgent interventions. Improvement of the physical health and working environment of nurses may be the most beneficial intervention measures to tackle various dimensions of burnout, while other targeted measures are also needed for each specific dimension.

Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

BackgroundA high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development.MethodThis was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%.ResultsFive domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021).ConclusionsQuality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

Effects of registered nurses' staffing levels, work environment and education levels on nursing home residents' quality of life and nurse outcomes.

To examine the effects of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurses' job dissatisfaction, burnout and turnover intention. Registered nurse staffing status and work environment are suboptimal in nursing homes worldwide. Nursing home care aims to maximise residents' quality of life. However, evidence on the impact of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurse outcomes in nursing homes is limited. This is a cross-sectional observational study. A total of 513 residents and 117 registered nurses from 39 nursing homes in South Korea participated in surveys. The main measures included registered nurses' staffing levels, work environment, education levels, residents' quality of life, registered nurses' job dissatisfaction, burnout and turnover intention. We analysed data using the generalised estimating equations and reported the study using the STROBE checklist. Overall, the residents' quality-of-life score was 13.7 ± 2.6 (out of 17). Residents in nursing homes with a higher number of registered nurses or with work environment evaluated as 'mixed' or 'better' (compared with 'poor') had a higher quality of life. Regarding nurse outcomes, 74.4% of the registered nurses were dissatisfied with their current jobs, 12.0% had burnout and 18.8% had a turnover intention. Registered nurses working in 'mixed' or 'better' work environment were less likely to have job dissatisfaction. Registered nurses' education levels did not have a statistically significant effect on the resident and nurse outcomes. Registered nurse staffing levels and work environment should be considered important for improving residents' quality of life and nurses' job satisfaction. Regulation and policy reforms are needed to increase the registered nurse staffing levels and to create a good work environment in nursing homes. Nursing home residents and registered nurses participated in the surveys of this study. Registered nurses facilitated resident recruitment by identifying and introducing the study to residents who were eligible for study participation. Not applicable.

Pathways to Quality: Nurse Work Environment, Unfinished Nursing Care, Job Satisfaction, and The Electronic Health Record

Better nurse work environments are associated with patient and nurse outcomes reflecting nursing care quality. Mechanisms through which the work environment influences nursing care quality are not well documented. Unfinished nursing care, electronic health records, and job satisfaction may be involved. Clear mechanistic pathways that explain how these variables might interact to influence care quality are lacking. This study examined how satisfaction with the electronic health record, unfinished care, the work environment, and job satisfaction collectively affect nursing care quality. A secondary analysis of cross-sectional data was performed using survey data collected from inpatient hospital staff nurses in a single U.S. state. Survey responses (n=916) were analyzed using bivariate correlations and path analysis. Moderate bivariate correlations were documented among all study variables. However, smaller effects were identified in the full path analysis model. The nurse work environment had direct and indirect effects (through unfinished nursing care and job satisfaction) on nursing care quality. Satisfaction with the electronic health records affected nursing care quality indirectly through an inverse relationship with unfinished nursing care. More research is needed to better understand the mechanisms through which the electronic health record influences the nurse work environment and nursing care quality are needed.

Relationship Between Nurses’ Ethical Sensitivity and Work Environment Index

Providing nursing care based on ethical values ​​requires nurses to have ethical sensitivity. Determining the factors related to moral sensitivity can help to identify strategies to promote this ability. The aim of this study was to investigate the relationship between nurses' ethical sensitivity and work environment index. This descriptive-correlational study was performed in the presence of 135 nurses of Vali-e-Asr Hospital in Shahr-e-Babak (Kerman province) in 2021. Samples were selected by consensus method. Lutzen Ethical Sensitivity Questionnaire and Work Environment Index Questionnaire were used to data collection. Data analysis was performed by determining the Pearson correlation coefficient and regression test using SPSS26. T-test and ANOVA were also used to examine the difference in mean scores based on demographic and occupational variables. Findings showed that the status of ethical sensitivity and work environment index of nurses participating in this study is at a moderate level and there is a significant correlation between nurses' ethical sensitivity and work environment index (P=0/049 R=0/212). Also, the mean score of work environment index showed a significant difference based on the variables of position (P=0/008) and shift work (P = 0/012). The existence of a significant relationship between nurses' ethical sensitivity and their work environment index confirms the importance of the work environment and its related consequences. According to the results of the present study, by optimizing the working environment of nurses, we can expect their ethical sensitivity to improve.

Coping with the Burden of Care through Effective Management of Stress: A Study among Nurses in Selected COVID-19 Isolation Hospitals in the United Arab Emirates

The burden of providing care to patients during the COVID-19 pandemic escalated stress among nurses, which affected their mental health, and called for effective coping. The goal of this study was to correlate the burden of caregiving with the management of stress by nurses during the COVID-19 pandemic in the United Arab Emirates. We conducted this cross-sectional correlational study among the nurses in two hospitals in the United Arab Emirates. A non-probability voluntary sample (n = 64) was taken of nurses working in the intensive care unit (n = 41) and isolation wards (n = 24). The respondents completed two questionnaires via Google Forms, namely, the Professional Care Team Burden Scale and the 15-item Stress Management Inventory. The findings indicate that the nurses reported moderate (37.5%) to low (62.5%) levels of the burden associated with caregiving. There was a significant inverse correlation between the burden of care and three elements of the stress management inventory, namely developing resiliency (r = −.284, p = .023), short-term coping (r = −313, p = .012), and effective delegation (r = −.395, p = .001). However, there was no correlation between the burden of care and eliminating stressor elements. The findings suggest that when nurses increased their resilience, short-term coping strategies and effective delegation they tended to experience less burden of caregiving during the COVID-19 pandemic. We therefore recommend that health policymakers focus on supporting resilience, short-term coping strategies and effective delegation in the nursing work environment to reduce the burden of caregiving.

Nurse Leadership Development: A Qualitative Study of the Dutch Excellent Care Program

Aims. To understand how nurses perceived the contributions of the Dutch Excellent Care Program, the development of nurses’ leadership, and their ability to positively influence their work environment. Background. Research shows that the nursing work environment influences job satisfaction, retention, and quality of care. Many countries have created programs such as the Excellent Care Program to improve nurses’ leadership and facilitate a positive work environment. Methods. A descriptive qualitative study based on 17 semistructured group interviews (participants N = 52) and directed content analysis using thematic coding. Results. Four program processes contribute to leadership development: (1) nurses taking responsibility for their knowledge and skills development; (2) strengthening organizational structures to improve nursing governance; (3) challenging the status quo with quality-enhancing projects; and (4) enhancing awareness of the supportive role of the nurse manager. Conclusions. The program supported nurses’ leadership development for a positive work environment. The interrelatedness of the four processes enhanced the nurses’ ability to solve day-to-day problems and challenge the status quo that influenced working practices. Implications for Nursing Management. The findings support making improvements to healthcare organizational strategies to encourage nurses to show leadership in their work environment.

Effects of External Employment Opportunities, Nursing Professionalism, and Nursing Work Environments on Korean Hospital Nurses' Intent to Stay or Leave.

This study aims to explore Korean Hospital nurses' intent to stay or leave their working environment, and to identify the difference between the intent to stay and the intent to leave by identifying the relationship between external employment opportunities, professionalism, and work environment. Data were collected via an online survey and analyzed using stepwise multiple regression analysis. As a result of the analysis, the intent to stay among Korean hospital nurses was influenced by the work environment, external employment opportunities, education level, and marital status, whereas the intent to leave was influenced by the nursing work environment, marital status, and total clinical experience. As a result, the reflected variables differed. Thus, it can be concluded that hospital nurses' intent to either stay or leave are not concepts that simply contradict each other in the same context but are, in fact, influenced differently by various factors. Nevertheless, it can also be concluded that nursing managers should make efforts to improve the nursing work environment to lower nurses' intent to leave and increase their intent to stay by improving only the nursing work environment.

Factors associated with the extent of nurses’ involvement in promotion of the nursing profession: a cross-sectional study among nurses working in diverse healthcare settings

Aims and objectivesTo examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings.BackgroundLittle is known about the factors that contribute to nurses’ involvement in the promotion of the nursing profession.MethodsThis cross-sectional study comprises a convenience sample of registered nurses (n = 526) with ≥ 3 months’ experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses’ involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson’s correlation analysis, and multivariate linear regression were performed.ResultsNurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses’ involvement in promotion of the nursing profession. In contrast, holding a master’s degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession.ConclusionThe extent of nurses’ involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment.Clinical relevanceHealthcare managers may advance nurses’ involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse’s role.

Extreme work environment and career commitment of nurses: empirical evidence from Egypt and Peru

PurposeThis paper aim to analyse the motives behind the commitment of nurses to their profession despite their intense job duties during the COVID-19 pandemic.Design/methodology/approachThe empirical sample comprises of 35 semi-structured interviews with public sector hospital nurses in under-researched contexts of Egypt and Peru.FindingsThree types of motives were found to play a critical role in nurses’ commitment to their profession despite the difficulties associated with extreme work conditions. These factors include cultural (religious values, governmental coercion), contextual (limited education, organisational support) and personal (good nurse identity, submissive nature) dimensions.Originality/valueThis paper is one of the pioneering works to link existing literature streams on career commitment, extreme jobs, extreme context and management under disruptions (particularly COVID-19) by analysing these aspects in the under-researched Peruvian and Egyptian contexts.

Reengaging in Nursing

Q I love nursing, but I am thinking about giving it up. How can I reengage in my profession?A Sarah K. Wells, MSN, RN, CEN, CNL, and Sarah A. Delgado, MSN, RN, ACNP, reply:Nursing, in its most basic form, is the act of caring for someone who is sick.1 Nurses join the profession expecting to provide skilled and informed care for others when they need it most. When care delivery does not meet our expectations, job dissatisfaction, burnout, and moral distress threaten our emotional well-being and our ability to feel psychologically safe. In addition, nurses are reporting increased violence and abuse in the workplace, which threaten physical safety.2 These experiences generate an intent to change roles and even change professions. There are many tools and strategies that can support reengaging with nursing and reigniting your nursing passion.First, nurses need to know that they are not alone in wanting to leave nursing. In its latest survey on the work environment of critical care nurses, conducted in October 2021, the American Association of Critical-Care Nurses (AACN) received more than 9000 responses.3 The results showed that 67% of the respondents planned to leave their current position within the next 3 years. Reported contributing factors to this intention included poor staffing, increasing moral distress, and feeling like the quality of patient care was worsening. We face immense challenges in health care, and often they feel insurmountable.To address moral distress, AACN recommends the following steps4: There are many ways to reconnect with our nursing identity to find increased joy and satisfaction in our profession.The final decision is up to you, but the good news is that you have so many options. Nursing is a diverse and dynamic profession with many opportunities for change and growth. Whatever your interests, there is a space for you in our field.Remember, you are never alone in your journey. Whether you need time to self-reflect, recharge, or reconnect with your nurse self, AACN and the rest of your nursing community will be there when you are ready to reengage.

한국 간호사의 윤리적 이슈 경험 정도와 간호윤리교육 요구도 : 서술적 조

Nursing ethics, which is an ethical norm of nursing practice, is basic to the professionalism of nurses, and ethical education is important in building the professional virtues. The study aimed to identify the needs of nursing ethics education targeting a group of nursing professionals in South Korea. This study adopted descriptive survey design via online survey. The questionnaire items consisted of the experience of ethical issues and the needs related to the subject of ethics education in nursing. 53 questionnaires were finally analyzed by descriptive statistics and correlation coefficients. The results showed that 40 of the study participants had more than 5 years of total clinical experience(69.8%). 48 of them previously participated in nursing ethics education(90.6%). The most frequently experienced ethical issues were ‘conflicts between colleagues’, ‘protecting of patient rights’ and ‘informed consent’. In relation to nursing ethics education, ‘ethical decision making and moral distress’, ‘shared decision making’ and ‘end-of-life care’ showed high needs for education. Overall, the higher the level of experience on ethical issues, the more educational needs for nursing ethics education(r=.360, p<.01). In addition, satisfaction with previous nursing ethics education was statistically significant positive correlation with the needs for the overall nursing ethics education topic(p.<01). In conclusion, the high level of experience on ethical issues shows the demands for continuity of ethical education and systematic improvement to improve the working environment of clinical nurses, and to meet the needs of nursing ethics education, a venue for discussion and education using case-based method should be provided.

Nurses’ roles, knowledge and experience in national disaster pre-paredness and emergency response: A literature review

Aim: Nurses play a central role in disaster preparedness and management, as well as in emergency response, in many countries over the world. Care in a disaster environment is different from day-to-day nursing care and nurses have special needs during a disaster. However, disaster nursing education is seldom provided and a lack of curricula exists in many countries around the world. The aim of this literature review is to provide an overview of nurses’ roles, knowledge and experience in national disaster preparedness and emergency response. Methods: An electronic search was conducted using multiple literature databases. All items were included, regardless of the publication year. All abstracts were screened for relevance and a synthesis of evidence of relevant articles was undertaken. Relevant information was extracted, summarized and categorized. Out of 432 reviewed references, information of 68 articles was included in this review. Results: The sub-themes of the first main theme (a) roles of nurses during emergency response include the expectations of the hospital and the public, general and special roles of nurses, assignments of medical tasks, special role during a pandemic influenza, role conflicts during a disaster, willingness to respond to a disaster. For (b) disaster preparedness knowledge of nurses, the corresponding sub-themes include the definition of a disaster, core competencies and curriculum, undergraduate nursing education and continuing education programs, disaster drills, training and exercises, preparedness. The sub-themes for the last theme (c) disaster experiences of nurses include the work environment, nursing care, feelings, stressors, willingness to respond as well as lessons learned and impacts. Conclusion: There is consensus in the literature that nurses are key players in emergency response. However, no clear mandate for nurses exists concerning their tasks during a disaster. For a nurse, to be able to respond to a disaster, personal and professional preparedness, in terms of education and training, are central. The Framework of Disaster Nursing Competencies of the WHO and ICN, broken down into national core competencies, will serve as a sufficient complement to the knowledge and skills of nurses already acquired through basic nursing curricula. During and after a disaster, attention should be applied to the work environment, feelings and stressors of nurses, not only to raise the willingness to respond to a disaster. Where non-existent, national directives and concepts for disaster nursing should be developed and nurses should be aware of their duties. Nursing educators should prepare nurses for disasters, by adjusting the curricula and by meeting the increased need for education and training in disaster nursing for all groups of nurses. The appropriateness of theoretical and practical preparation of disaster nursing competencies in undergraduate nursing courses and continuing education programmes should be evaluated.

Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review.

The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment. To determine whether measures designed to improve the work environment for nursing professionals are effective. Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool. A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement. Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy. This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis.

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

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.

Analisis Faktor Yang Memengaruhi Kepuasan Kerja Perawat Di RSUD dr. Pirngadi Medan

The establishment of the ASEAN Economic Community (AEC) in 2015 allows a country to sell health services including nurses to ASEAN countries, this is a threat for nurses in Indonesia because they have to be able to compete with nurses from other countries. Indonesian nurses still have to make improvements both in terms of competence and quality of service where to be able to improve the quality of service, nurses in carrying out their duties must get job satisfaction. Job satisfaction is a positive attitude towards work in a person which is individual. Each individual has a different level of job satisfaction in accordance with the value system that applies to the person where many factors can affect job satisfaction. This study aims to analyze the factors that affect job satisfaction (compensation, promotion opportunities, supervision, coworkers, job characteristics, work environment) of nurses at RSUD Dr. Pirngadi Medan. The research design was observational study with cross-sectional approach and using questionnaires as a research instrument. The sample was 79 State Civil Apparatus Nurses. The statistical test used is the chi-square test and logistic regression. The result shown that 57% of nurses who were satisfied with their jobs as many as 40.5% stated that compensation was in the unfavorable category, 45.6% stated that promotion opportunities were in the sufficient category, 34.2% stated that supervision in the favorable category, as many as 35.5% stated that coworkers were in the unfavorable category, as many as 37.1% stated that the characteristics of work in the appropriate category and as many as 30.5% stated the work environment was in the good category. Multivariate test analysis results using logistic regression showed that compensation, promotion opportunities, supervision, coworkers, job characteristics, and work environment has a value of p&lt;0,05 which means significantly influence job satisfaction. The conclusions was obtained that compensation is the most dominant factor affecting job satisfaction of nurses in RSUD Dr. Pirngadi Medan. The hospital management is expected to pay more attention to the factors of job satisfaction of nurses in order to improve the quality of service at the hospital.

The Impact of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care at Medical and Surgical Departments

The Impact of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care at Medical and Surgical Departments