Practice Environment Quality Research Articles

Quality and safety of the nurse practice environment: Implications for management commitment to a culture of safety.

The Philippines experiences several challenges pertaining to the quality of the practice environment (PE) and nursing quality safety (NQS) among nurses. Although there is already considerable empirical data on PE effects on NQS, there is still little overall information on the association between these variables. This survey study examined the contribution of nurses' perceptions of their PE on their perception of their PE's quality of safety among hospital nurses in the Philippines. This survey was conducted in two government hospitals and two private hospitals in the Philippines. A total of 374 nurses selected from two selected government hospitals and two private hospitals in the Philippines using a convenience sample technique. Data were collected using a self-administered questionnaire focusing on the PE and NQS among nurses. The overall PE mean score of nurses is 3.07 (SD = 0.159) while the overall mean score of their NQS is 3.97 (SD = 0.702). NQS was higher in female nurses compared with male nurses (M = 2404 vs 4.16). Nurses assigned to emergency departments (F = 1.04, [df = 11], and P = .025) presented higher perceived NQS compared with those in other departments. Nurses report moderate PE and higher NQS. Sex and emergency room department are significantly associated with NQS. Health care services have an obligation to ensure strong PE, as an important factor in regard to nursing management and affecting the QNS.

The Influence of Appropriate Staffing and Healthy Work Environments on Patient and Nurse Outcomes.

The Influence of Appropriate Staffing and Healthy Work Environments on Patient and Nurse Outcomes.

Impact of Coping Strategies on Nurses' Well-Being and Practice.

To examine the mechanisms of coping strategies on nurses' psychological well-being, practice environments and safety attitudes. A cross-sectional study design was used. Structural equation modeling was performed to analyze the results. Five hundred clinical nurses were randomly selected from a large group of 1,500 from a medical center with 1,350 beds in Taipei, Taiwan, from July to October 2015. Self-report questionnaires were administered to measure coping strategies (Brief COPE), psychological well-being (Ryff's Psychological Well-being Scale), nurses' practice environments (Practice Environment Scale of the Nursing Work Index), and safety attitudes (Safety Attitudes Questionnaire). Of the 500 participants who gave written consent, 474 (94.8%) filled out the questionnaire. Results showed that using more approach-oriented coping strategies and fewer avoidant coping strategies was associated with greater psychological well-being. Psychological well-being was directly associated with quality of nurses' practice environments and safety attitudes. The impact of psychological well-being on safety attitudes was mediated significantly by the quality of the practice environment. The use of approach-oriented coping strategies was significantly predictive of positive psychological well-being, a good practice environment, and good safety attitudes. This study found a distinct pathway for the relationships between clinical nurses' psychological well-being, practice environment, and safety attitudes. Psychological well-being in clinical nurses was higher for those with more approach-oriented coping strategies. Psychological well-being directly impacted safety attitudes, which mediated nurses' practice environments. The practical implications of the results suggest that interventions designed to promote positive psychological well-being may help improve nurses' practice environments, which, in turn, may result in better safety attitudes and nursing care outcomes.

The relationship between individualized care and the practice environment: An international study

BackgroundPrevious research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses’ ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies. ObjectivesThe aim of this study was to determine whether nurses’ views of their professional practice environment associate with their views of the level of care individualization in seven countries. DesignThis study had an international, multisite, prospective, cross-sectional, exploratory survey design. SettingsThe study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey. ParticipantsNurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study. MethodsSelf-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model. ResultsTwo regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care. ConclusionsThe results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse–patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes.