Practice Environment Scale Of The Nursing Work Index Research Articles

Validation of a short form of the practice environment scale of the nursing work index: The PES-5.

The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5. We conducted a cross-sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item-to-subscale R2 from the original PES-NWI publication. Five psychometric properties of the PES-5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES-5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28-item and 5-item versions was 0.94. The Cronbach's alpha reliability of the PES-5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES-5 mean value across responses to a single-item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES-5. The classification accuracy of the PES-5 was high, with 88% of hospitals classified identically by both versions. The PES-5 shows promise for measurement of nurses' work environments while maximizing response rate by reducing participant burden.

Cross-Cultural Adaptation of the Scale of the Nursing Work Index With Nurses From Seven Countries

Background and Purpose:The aims of this study are as follows: to adapt and validate the psychometric properties of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) adapted to the nursing home environment across seven Spanish-speaking countries and to cross-culturally adapt the Scale of the Nursing Work Index with nurses from seven countries.Methods:Adaptation process and psychometric validation of the instrument included translation and back-translation, content validity, test–retest reliability, internal consistency, and construct validity.Results:A total of 134 nursing homes belonging to the same religious order were randomly selected from seven Spanish-speaking countries with a sample of 378 nurses. The exploratory factor analysis explained a five-factor structure (56% of the explained variance) with adequate goodness-of-fit indices in the final factor solution.Conclusions:The validation process indicates that the Spanish language version of the PES-NWI with five factors and 31 items, for long-term care facilities for the elderly, is valid and reliable in its current version and can be used to measure the environment of nurses working in clinical practice in Spanish-speaking nursing homes.

Self-assessment of the characteristics of nurses' work environment and psychometric analysis of the Slovene-language version of the Practice Environment Scale of the Nursing Work Index (PES-NWI)

Introduction: Measures to improve nurses' work environments include ensuring adequate staffing levels, recognising the importance of nursing work, involving nurses in decision-making processes, and improving interprofessional communication. The aim of this study was to analyse the job characteristics reported by nurses and their association with the dimensions of clinical practice environments in hospitals.Methods: A cross-sectional explorative research design was employed. The Slovene-language version of the Practice Environment Scale of the Nursing Work Index (PES-NWI(SI)) and data on nurses' job characteristics were used. A total of 1,010 nurses (403 general care nurses and 605 healthcare assistants) from ten Slovenian general hospitals participated in the study. Permission to conduct the research was granted by the Commission of the Republic of Slovenia for Medical Ethics.Results: The mean score of the PES-NWI(SI) was low (2.64), and the scale reliability was 0.937. The original theoretical five-factor structure was confirmed. The regression model explained the five factors in 26–47% of cases. The explanatory variables included opportunities for advancement, educational opportunities, professional status, satisfaction with current job and work environment, independence at work, and study leave.Discussion and conclusion: The study revealed managers' inadequate ability to ensure sufficient staffing, insufficient involvement of both respondents and managers in hospital affairs, and the lack of promotion opportunities. Creating an optimal work environment for nurses is an important task for managers and leaders. National healthcare policy must consider nurses as equal healthcare professionals and nursing as both a professional and scientific discipline.

Nurses' intention to leave their jobs in relation to work environment factors in Polish hospitals: Cross-sectional study.

The lack of nursing staff is a current problem not only in Poland, but also in the world. The decision of nurses to leave the workplace, apart from the financial aspect, often results from unfavourable working conditions related to the work environment. The study was multicentre, cross-sectional. The study was conducted among a group of 1509 nurses employed in surgical and internal medicine wards in 21 hospitals in Poland. The key variables of the study were: the intention of the nurses to leave their jobs, the nurses' working environment, the level of satisfaction, the level of occupational burnout and the number of patients cared for on the last shift, the number of nurses on the last shift. The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI) questionnaire were used in the research. Almost half of the surveyed nurses (48.84%) declared their willingness to leave their current workplace. The statistical analysis showed that nurses declaring their willingness to quit their job in the hospital where they were employed were significantly younger (42.88 vs. 45.04, p = 0.000), had shorter total length of service overall (19.96 vs. 23.20), and also in the hospital where they were employed (15.86 vs. 18.50, p = 0.000). The increase in the number of patients by one was significantly associated with a 1% increase in the risk of leaving work (OR = 1.01, 95% CI 1.00-1.02). An increase in emotional exhaustion significantly increased the risk of leaving work by 2% (OR = 1.02, 95% CI 0.99-1.03). Younger age of nurses, greater workload resulting from more patients and occupational burnout - emotional exhaustion is correlated with the risk of leaving work in the hospital. A lower risk of leaving the job is associated with a higher level of job satisfaction in the hospital, salary and promotion opportunities. Med Pr Work Health Saf. 2023;74(5):377-87.

Modernizing Measure of the Nurse Work Environment.

Research has established a relationship between favorable nurse work environments and better nurse, patient, and organizational outcomes. However, the instrument most frequently used to measure the nurse work environment, the Practice Environment Scale of the Nursing Work Index (PES-NWI), has not had its items significantly re-evaluated since the 1980s. We sought to examine the psychometric properties of an updated PES-NWI and create an instrument suitable for further testing and refinement to measure the present-day nurse work environment. Specifically, we sought to establish construct, structural, discriminative, and concurrent validity. For reliability, we desired to establish interrater reliability and internal consistency reliability. We administered a modified PES-NWI to a national sample of direct-care hospital nurses (n = 818) in the United States. We then assessed the psychometric properties of the instrument. While the modified PES-NWI displayed adequate validity and reliability properties, further testing and refinement of the instrument is necessary. With this updated measure of the nurse work environment, researchers and hospital leaders can identify modifiable opportunities for improvement in contemporary hospital nurse work environments which may enhance nurse and patient outcomes.

Work Environment-Mediated Job Burnout and Intention-to-Stay in Registered Nurses

Nurse engagement and retention are critical issues affecting the quality of healthcare. Although the work environment is known to affect nursing performance and patient outcomes, little is known regarding the impact of this environment on nurse burnout and future work intention, especially in non-Western settings. This study explored the extent to which Taiwanese nurses' perceptions of their practice environment mediates burnout levels and intention-to-stay. This descriptive, correlational study, conducted between September and December 2020, recruited nurses employed at a regional teaching hospital located in a relatively rural region in Taiwan. The participants completed standardized questionnaires, including a demographic information form, the 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI), the 22-item Maslach Burnout Inventory (MBI-HSS), and the 6-item Intention-to-stay (ITS) scale. The mediating effect among the variables related to intention-to-stay was examined using Model 4 of the PROCESS macro and tested using the bootstrapping method (repeated 5,000 times) with a p value < .05. The mean age of the 376 participants was 34.3 years (SD = 8.1). Nearly one-third (30.3%) scored > 27 on the emotional exhaustion subscale of the MBI-HSS, indicating they were "highly burned-out". Also, nearly one-third (30.6%) were uncertain about their intention to stay with their current employer. Burnout was associated with intention-to-stay (β = -.088, p < .001), and holding a positive perception toward their practice environment was shown to mediate the relationship between burnout and intention-to-stay (β = -.015; p < .001). Targeted interventions and technical support that promote a collaborative climate and psychological empowerment in clinical practice may alleviate burnout and intention-to-leave in nurses and improve workplace quality.

Using item response theory to develop a shortened practice environment scale of the nursing work index.

The 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI) has been frequently used globally to measure the nurse work environment. However, due to its length and subsequent respondent burden, a more parsimonious version of the PES-NWI may be desirable. Item response theory (IRT) is a statistical technique that assists in decreasing the number of items in an instrument without sacrificing reliability and validity. Two separate samples of nurses in the United States (one called the "internal data source"and the other called "external data source"; sample sizes = 843 and 722, respectively) were analyzed. The internal data source was randomly split into training (n = 531) and validating data sets (n = 312), while a separate whole external data source was used as the final validating data set. Using IRT with training data, we removed nine items; two additional items were removed based on recommendations from a previous study. Confirmatory factor analyses supported the validity of the measurement model with the 20-item of PES-NWI in both internal and external validation data sources. The correlations among subscales between 31- and 20-item versions were high magnitude for five subscales in both validation data sets (τ = 0.84-0.89). Ultimately, we identified a 20-item version of the PES-NWI which demonstrated adequate validity and reliability properties while decreasing data collection burden yet maintaining a similar factor structure to the original instrument. Additional research may be necessary to update the items themselves on the PES-NWI.

Measuring the Work Environment: The Voice of the Staff Nurse.

The aims of this study were to obtain direct care hospital nurse input on the relevance of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and to determine whether additional items are needed to measure the contemporary nursing work environment (NWE). Instruments accurately measuring the NWE are essential due to the NWE's association with nurse, patient, and organizational outcomes. However, the most frequently used instrument for measuring the NWE has not been scrutinized by today's practicing direct care nurses to ensure its current relevancy. Researchers administered a survey with a modified PES-NWI and open-ended questions to a national sample of direct care hospital nurses. Three items from the PES-NWI may be suitable for removal, and additional items may be added to accurately measure the current NWE. Most PES-NWI items remain relevant for modern nursing practice. However, some revisions could enable greater precision in measuring the current NWE.

How nurses’ job characteristics affect their self-assessed work environment in hospitals— Slovenian use of the practice environment scale of the nursing work index

BackgroundNurses’ work environment influences nursing practice. Inappropriate working conditions are the result of underdeveloped workplace infrastructure, poor work organisation, inadequate education, and inappropriate staffing norms. The aim of this study was to describe and examine the predictors that affect nurses’ work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI).MethodsThe validation of the PES-NWI was made. Nurse-reported job characteristics were used as independent variables. The sample included 1,010 nurses from adult surgical and medical units at 10 Slovenian hospitals. The Nurse Forecasting (RN4CAST) protocol was used. Permission to conduct the study was obtained from the National Medical Ethics Committee.ResultsThe PES-NWI mean (2.64) was low, as were job and career satisfaction at 2.96 and 2.89, respectively. The PES-NWI can be explained in 48% with ‘Opportunities for advancement’, ‘Educational opportunities’, ‘Satisfaction with current job’, ‘Professional status’, ‘Study leave’, and ‘Level of education’. A three-factor solution of PES-NWI yielded eight distinct variables.ConclusionsThe obtained average on the Nursing Work Index was one of the lowest among previously conducted surveys. Nurses should be recognized as equals in the healthcare workforce who need to be empowered to develop the profession and have career development opportunities. Inter-professional relations and equal involvement of nurses in hospital affairs are also very important.Trial registrationThis is a non-intervention study – retrospectively registered.

Working Condition and Job Satisfaction of Nurses as Predicting Factors of the Prevalence of Health care-associated Infections among Elderly Inpatients.

Health care-Associated Infections (HCAIs) are among the most common adverse events (AEs) that can negatively affect both patients and health systems. The elderly is among patients at high risk for infections. Some controllable risk factors have received less attention in research. Therefore, this study aims to investigate the relationship between prevalence of HCAIs among elderly inpatients, job satisfaction of nurses, and working condition. This cross-sectional study was conducted on 211 nurses working in hospitals affiliated with Iran University of Medical Sciences, Tehran, in 2021. The data were collected from HCAIs reports by the Nosocomial Infection Control Committee, a demographic questionnaire, the Practice Environment Scale of the Nursing Work Index (PES-NWI), and the Minnesota Satisfaction Questionnaire (MSQ). The data were statistically analyzed using Pearson correlation coefficient, ANOVA, t-test, and multiple linear regression (MLR) in SPSS 26. The results showed that there was a significant relationship between the PES-NWI and MSQ (r = 0.68, p < 0.00). The MLR results indicated that staffing and resource adequacy, nurse participation in hospital affairs, job satisfaction, nursing manager's leadership, and nursing foundations for quality of care are predictive factors that these could explain 78% of the changes in the prevalence of HCAIs and the goodness of fit of the regression model was acceptable [F6.210 = 129.47, p < 0.001]. Since job satisfaction and the work condition could predict HCAIs among the elderly patients, healthcare administers are recommended to consider these two variables in the development of HCAIs prevention and control programs.

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

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

Measures of Nursing Environment Multidimensionality and Patient Centricity Using Importance-Performance Map Analysis

Background: The nursing environment has become a consideration for an organization in improving service quality, especially in the implementation of patient-centred care. The various dimensions make it necessary to know which sectors need to be prioritized. However, there is still limited research that is more specific in linking the dimensions to become more operational. Purpose: This study aimed to analyze the relationship between nursing environment dimensions and patient centricity through the Importance-Performance Map Analysis (IPMA).Methods: A quantitative survey with a cross-sectional approach was conducted in June 2022 to test the conceptual framework on the population obtained from non-managerial inpatient nurses who worked for above two years in a general hospital in East Java, Indonesia. The constructs were measured using a set of indicators in The Practice Environment Scale of the Nursing Work Index (PES-NWI) and Patient Centricity. During the data collection, a total sampling technique was performed, resulting in 89 respondents being acquired. The data were analyzed through partial least squared structural equation modelling (PLS-SEM).Results: At the construct level, the mean total effect and performance were 0.192 and 56.302, respectively. From the IPMA chart, it was found that the construct in the right lower quadrant with the largest total effect value but not having adequate performance was nursing manager ability (total effect: 0.294, performance: 34.563), making it a construct with the highest importance and requiring priority for improvement among all dimensions.Conclusion: The nursing environment dimensions have to get attention to achieve patient centricity in inpatient ward nurses, where nursing manager ability is the dimension that has the most vulnerable performance. Leadership development is needed for the head nurse of the inpatient unit to strengthen the ability to lead and change the culture in nurturing subordinates so that kinship between nursing professionals can be established.

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.

Association of burnout and intention-to-leave the profession with work environment: A nationwide cross-sectional study among Belgian intensive care nurses after two years of pandemic

BackgroundIntensive care unit (ICU) nurses are at an increased risk of burnout and may have an intention-to-leave their jobs. The COVID-19 pandemic may increase this risk. ObjectiveThe objective of this study was to describe the prevalence of burnout risk and intention-to-leave the job and nursing profession among ICU nurses and to analyse the relationships between these variables and the work environment after two years of the COVID-19 pandemic. DesignA national cross-sectional survey of all nurses working in Belgian ICUs was conducted between December 2021 and January 2022 during the 4th and 5th waves of the COVID-19 pandemic in Belgium. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to measure the work environment, intention-to-leave the hospital and/or the profession was assessed. The risk of burnout was assessed using the Maslach Burnout Inventory scale including emotional exhaustion, depersonalisation, and reduced personal accomplishment. SettingNurses in 78 out of 123 Belgian hospital sites with an ICU participated in the survey. Participants2321 out of 4851 nurses (47.8%) completed the entire online survey. ResultsThe median overall risk of burnout per hospital site (high risk in all three subdimensions) was 17.6% [P25: 10.0 - P75: 28.8] and the median proportion of nurses with a high risk in at least one subdimension of burnout in Belgian ICUs was 71.6% [56.7–82.7]. A median of 42.9% [32.1–57.1] of ICU nurses stated that they intended-to-leave the job and 23.8% [15.4–36.8] stated an intent-to-leave the profession. The median overall score of agreement with the presence of positive aspects in the work environment was 49.0% [44.8–55.8]. Overall, nurses working in the top 25% of best-performing hospital sites with regard to work environment had a statistically significant lower risk of burnout and intention-to-leave the job and profession compared to those in the lowest performing 25% of hospital sites. Patient-to-nurse ratio in the worst performing quartile was associated with a higher risk for emotional exhaustion (OR = 1.53, 95% CI:1.04–2.26) and depersonalisation (OR = 1.48, 95% CI:1.03–2.13) and intention-to-leave the job (OR = 1.46, 95% CI:1.03–2.05). ConclusionsIn this study, a high prevalence of burnout risk and intention-to-leave the job and nursing profession was observed after two years of the COVID-19 pandemic. Nevertheless, there was substantial variation across hospital sites which was associated with the quality of the work environment. Tweetable abstract“Burnout & intention to leave was high for Belgian ICU nurses after 2 years of COVID, but wellbeing was better with high quality work environments and more favourable patient to nurse ratios”.

The structure of the Italian version of the Practice Environment Scale of the Nursing Work Index.

To investigate the factor structure of an Italian translation of the Practice Environment Scale of the Nursing Work Index (PES-NWI). Italy suffers from high turnover rates, yet validated tools in Italian to study and manage the problem are lacking. The PES-NWI measures aspects of nurses' working environment. This study reports on the translation and investigation of the structure of the translated PES-NWI scale. A survey was conducted with 3667 nurses from 182 hospitals across 13 Italian regions using the PES-NWI. The structure of this scale was investigated using principal components analysis and other properties, including internal consistency (Cronbach's alpha). Construct validity was investigated using logistic regression. The Italian translation of the PES-NWI showed a five-factor structure, and Cronbach's alpha of the factors ranged between 0.80 and 0.92. Logistic regression showed that the PES-NWI was positively related to job satisfaction (odds ratio = 10.3; CI 8.62-12.35) and negatively related to intention to leave (odds ratio = 0.14; CI 0.12-0.16). The original five-factor structure of the PES-NWI was evident in the present study, albeit with some different factor loadings. The Italian version of the PES-NWI can be used by nurse managers to tackle the workforce issues related to nurses' work environments in a major European country.

A Conceptual Model of Nurses' Turnover Intention.

The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses’ turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.

An Exploratory Study of the Associations Between the Hospital Work Environment and Implementation of Baby-Friendly Hospital Policy.

A descriptive, cross-sectional study design was used to explore the relationships between the hospital work environment and implementation of the Baby-Friendly USA Ten Steps Policy in an urban hospital. Nurses reported the degree to which the Ten Steps policy was implemented, perceptions of the unit work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI), and self-efficacy related to the implementation of the policy. Results suggest that the work environment and the implementation of breastfeeding policy have separate and independent effects on nurse self-efficacy. Robust nursing leadership focused on education and skill development for clinicians, and focused on post-hospital care for patients and families are important contributory factors to successful breastfeeding policy implementation.

Comparing the Nurse Work Environment, Job Satisfaction, and Intent to Leave Among Military, Magnet®, Magnet-Aspiring, and Non-Magnet Civilian Hospitals.

This study aimed to compare the nurse work environment, job satisfaction, and intent to leave (ITL) among military, Magnet®, Magnet-aspiring, and non-Magnet civilian hospitals. The professional nurse work environment is an important, modifiable, organizational trait associated with positive nurse and patient outcomes; creating and maintaining a favorable work environment should be imperative for nursing leaders. Secondary data from the Army Nurse Corps and the National Database of Nursing Quality Indicators included the Practice Environment Scale of the Nursing Work Index (PES-NWI) and single-item measures of job satisfaction and ITL. Magnet and military hospitals had identical PES-NWI composite scores; however, statistically significant differences existed among the subscales. Military nurses were the most satisfied among all groups, although this difference was not statistically significant, yet their ITL was highest. Favorable work environments may exist in other organizational forms besides Magnet; however, the specific components must be considered.

Exploring the relationship between midwives’ work environment, women's safety culture, and intent to stay

BackgroundThe shortage of midwives is a concern for healthcare systems as it compromises the quality maternity care. Various studies argue that a favorable work environment increases nurses’ job satisfaction and intention to continue working at their current workplace. AimTo analyze the work environment and its relationship with women’s clinical safety culture and midwives’ intention to stay in their current job and the midwifery profession. MethodsA cross-sectional, correlational study was performed on N = 218 midwives working in Spain. Standardized instruments were used, including The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive and bivariable statistics were used. The study followed the STROBE guidelines. ResultsThe work environment in the labor wards was mixed, according to the PES-NWI classification. The mean total score of the PES-NWI significantly and positively correlated with the mean total score of the HSOPSC (rs = 0.498, p < 0.001), indicating that as the quality of midwives’ work environment increased, women’s clinical safety increased. Significant correlations were observed between the midwives’ intent to stay in the hospital where they work and features of women’s safety culture. ConclusionThe results of this study showed significant relationships between the work environment, women’s safety culture, and midwives’ intentions to leave their job/profession. Creating a favorable working environment could be a potentially effective strategy that encourages improvement in the women’s safety culture in healthcare organizations and greater intention of midwives to stay at their current job.

The Impact of Work Environment on Nurses' Compassion: A Multicenter Cross-Sectional Study.

IntroductionCompassionate care is considered as the main part of the nurses’ identity and a core component of nursing care. One clinical environment where patients experience a lot of pain and nurses play a vital role in delivering care is the intensive care unit (ICU).ObjectiveConsidering the importance of compassionate care in intensive care units, this study aimed to assess the relationship between the work environment and nurses’ compassion in intensive care units.MethodsIn this cross-sectional survey, a total of 235 nurses were randomly selected from the intensive care units of four educational hospitals of Tabriz University of Medical Sciences from January to March 2021. Data were collected by demographic questionnaire, the Sussex-Oxford Compassion for Others Scale (SOCS-O) and the Practice Environment Scale of the Nursing Work Index (PES-NWI).ResultsThe results showed that there was a significant and inverse relationship between the patient per nurse ratio and the mean score of nurses’ compassion (P < .05). Moreover, Pearson correlation coefficient showed that the mean total score of the nursing work index had a significant positive relationship with the mean score of the compassion for others (r = 0.16, P = .016).ConclusionHealth care managers and leaders should pay more attention to the promotion of nurses’ working environments and they should remove the organizational barriers of compassionate care delivery.