Nursing Work Environment Research Articles

Cultural Competence and Nursing Work Environment: Impact on Culturally Congruent Care in Portuguese Multicultural Healthcare Units

Background: Cultural competence is central to ensuring effective culturally congruent care to patients and fostering positive work environments, particularly in multicultural settings. Objective: This study aimed to analyse the relationship between cultural competence, the nursing work environment, and the delivery of culturally congruent care in multicultural units of a healthcare organisation in Portugal. Method: This was a quantitative, descriptive, and cross-sectional study, targeting nurses from multicultural units. Data were collected using both online and paper-based questionnaires, which included the Cultural Competence Questionnaire for Help Professionals, the Nursing Work Index—Revised Scale (NWI-R-PT), and a single question assessing nurses’ perceptions of the adequacy of the culturally congruent care they provide. Results: A moderate, positive correlation was identified between cultural competence and the Fundamentals for Nursing, while the nursing work environment was influenced by organisational support, professional category, and unit type. Discussion: The findings suggest that enhancing cultural knowledge and technical skills and reinforcing management support may positively impact culturally congruent care delivery in multicultural settings. Conclusion: This study contributes to nursing knowledge by highlighting the complex interactions between cultural competence and the work environment in Portuguese multicultural healthcare units. Future research should explore the impact of transcultural nursing leadership on multicultural work environments and in the delivery of culturally congruent care.

The mediating role of professional identity between work environment and caring behavior: a cross-sectional survey among hospice nurses in China

BackgroundAs core members of hospice care team, the hospice nurses’ ability to care for patients not only directly affects the standard of patient care, but also significantly impacts patient quality of life. It can be seen that it is very meaningful for patients to improve the caring behavior of hospice nurses. Therefore, it is necessary to deeply explore the influencing factors of nurses’ caring behavior and further clarify the mechanism between them.MethodsThe STROBE guideline was performed to report this study. We conducted a cross-sectional survey from December 2023 to February 2024. In this study, 392 hospice nurses were recruited from tertiary public hospitals in East China by convenient sampling method. Participants were investigated using the Practice Environment Scale, Professional Identity Scale, and Caring Behaviors Inventory. Structural equation modelling was utilized to verify the research hypotheses.ResultsThe results revealed that there were significant and positive correlations between work environment, professional identity and caring behavior. Furthermore, professional identity partially mediated the relationship between work environment and caring behavior.ConclusionWork environment is critical to improving hospice nurses’ caring behavior. Professional identity plays an intermediary role impacting how work environment promotes caring behavior among Chinese hospice nurses. Nursing managers should have a correct understanding of the relationship between them. Targeted measures and coping strategies need to be actively taken to create a better working environment for hospice nurses. This would enhance professional identity, and thereby promote caring behavior.

Insights to Advocate for Positive Work Environments for Nurses.

Insights to Advocate for Positive Work Environments for Nurses.

Making an urgent shift from oppressive to healthy work environments for nurses.

Making an urgent shift from oppressive to healthy work environments for nurses.

Influence of the Nursing Work Environment on Job Satisfaction in Male Nurses: The Mediating Effect of Social Support.

Although the proportion of male nurses in the nursing profession has risen in recent years, their turnover rate remains higher than their female counterparts. Male nurses tend to report lower levels of job satisfaction. However, there has been a dearth of research examining the relation among perceptions of work environment, social support, and job satisfaction in male nurses. The aim of this study was to investigate the associations among work environment, social support, and job satisfaction in male nurses in Korea. In addition, the potential mediating effect of social support on the relationship between work environment and job satisfaction was explored. A cross-sectional design was employed to investigate the research questions. The study was conducted in a metropolitan area in South Korea, and self-administered questionnaires were distributed to participants. Hierarchical multiple regression analysis was utilized to explore the potential associations among work environment, social support, and job satisfaction. Work environment was found to correlate positively with job satisfaction (r = .53, p < .001) and social support (r = .57, p < .001) in the participants, whereas a positive correlation was also found between social support and job satisfaction (r = .57, p < .001). Social support was shown to partly mediate the relationship between work environment and job satisfaction. The findings of this study suggest that social support partially mediates the relationship between work environment and job satisfaction in male nurses as well as confirm the importance of both work environment and social support as factors that can positively influence job satisfaction in this group.

Factors Influencing Person-Centered Care Among Psychiatric Nurses in Hospitals.

This study aimed to examine the association between psychiatric nurses' empathy, teamwork, nursing work environment, and the degree of person-centered care, as well as to identify factors influencing person-centered care (PCC). An online cross-sectional survey was conducted from 11 January to 19 January 2024, using four validated questionnaires. Participants included 167 psychiatric nurses with more than one year of clinical experience working in South Korea. Person-centered care was positively correlated (p < 0.001) with empathy, teamwork, and the nursing work environment. Hierarchical regression analysis was used to identify factors influencing person-centered care among psychiatric nurses. The analysis revealed that the nursing work environment (p < 0.001), teamwork (p < 0.001), empathy (p < 0.001), type of hospital (general hospital) (p = 0.002), and age (p = 0.037) significantly influenced person-centered care, explaining 78.7%. Enhancing PCC among psychiatric nurses requires the development of training and educational programs that bolster empathy and teamwork. Additionally, improvements and strategic enhancements to the nursing work environment are essential.

Navigating uncertainties for promoting nurse-led changes in work environments: A participatory action research

BackgroundThe nursing work environment is crucial for nurses' well-being and patients’ quality of care. Despite effective interventions to improve the nursing work environment, understanding the most effective types and integration mechanisms for nurses remain challenging. As nursing practices evolve amid complex care demands and staff shortages, understanding nurses’ challenges, support systems, and adoption mechanisms is vital to optimize the work environment and to enhance quality of care, job satisfaction, and staff retention. PurposeTo explore strategies for promoting and supporting nurse-led changes to improving their work environment. MethodsThe study employed a participatory action research design on three nursing wards in a Dutch academic hospital. Action research teams with diverse ward nurses were established on each ward. The research took place between September 2022 and October 2023. Data were collected during observations, PhotoVoice workshops, and individual interviews. Data were analyzed using the rigorous and accelerated data reduction technique. ResultsNurses and managers showed patterns of behavior that either hindered or facilitated changes, leading to the emergence of three themes: strengthening relationships, taking the lead, and being up to the task. These themes highlight the importance of fostering collaboration, encouraging proactive attitudes, and building capabilities to address challenges and drive positive changes in their work environment. Feelings of uncertainty emerged in all themes, and this uncertainty hindered nurses from taking responsibility for facilitating change. ConclusionsThis study demonstrated different mechanisms that either facilitate or hinder nurse-led changes and how feelings of uncertainty play a role. Nurses emphasized the importance of collaboration and proactive attitudes but faced challenges in recognizing responsibility and their perceived competencies. Strengthening nurses' resilience to and management of uncertainty is essential. Healthcare organizations should help nurses navigate uncertainty to foster positive changes. Tweetable abstractCollaboration, proactivity, and competency are key in nurse-led changes. Strengthening nurses' resilience and uncertainty management is crucial.

A cross-sectional study examining the relationship between nursing practice environment and nurses’ psychological empowerment

The nursing practice environment is essential for improving the quality of nursing practice and patient service. Performing secondary analysis of data from the work environment for hospital nurses in Japan (WENS-J) study, this research investigated whether an improved, healthier work environment could enhance nurses’ psychological empowerment. Self-administered questionnaire responses of 2,438 participants from 23 participating general hospitals with over 200 beds in municipalities with a population of 200,000 or more were analyzed. The questionnaire recorded participating nurses’ demographic characteristics and utilized two scales: the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Psychological Empowerment Instrument (PEI), which identified adequate work environments and measured the internalization of organizational goals and objectives, respectively. Most participants (93.7%) were female nurses with a mean age of 33.7 years. Multilevel analysis (hierarchical linear models) revealed that the total PEI score was significantly related to the PES-NWI composite score and all subscales after adjusting for nurses’ demographic characteristics, such as age (coefficient 0.33–0.72, all p < .001). The results suggest that a work environment such as that presented in the PES-NWI may contribute to nurses’ psychological empowerment. These findings could provide insight for creating healthier work environments.

Differentiating Occupational Burnout Among Chinese Nurses: Moderating Roles in Nursing Work Environment and Perceived Care Quality.

Objective: To investigate and identify different profiles of occupational burnout among Chinese nurses and explore how these burnout profiles moderate the relationship between the nursing work environment and perceived care quality. Methods: Cross-sectional data retrieved from the Chinese Nursing Work Environment Survey (C-NWES) were used for analysis. Variables of interest included occupational burnout, the nursing work environment, nurses' perceived care quality, and demographic characteristics. Latent profile analysis was employed to identify potential profiles of occupational burnout, which were subsequently used as moderating variables to explore the relationship between the nursing work environment and perceived care quality. Results: Four profiles of occupational burnout were identified among Chinese nurses: Self-Fulfillment profile (38.3%), Emotional Exhaustion profile (37.7%), Lack of Accomplishment profile (16.6%), and Self-Isolation profile (7.4%). Among these, nurses in the Self-Fulfillment profile showed the greatest responsiveness to changes in the work environment, followed by those in the Self-Isolation profile, with the Emotional Exhaustion profile being the least responsive. Conclusions: The findings highlight the need for tailored interventions to address the specific needs of distinct nurse groups experiencing burnout, enabling organizations to improve nurses' well-being, work performance, and patient care quality.

Organizational Rigidity and Demands: A Qualitative Study on Nursing Work in Complex Organizations.

The nursing work environment is a critical element in healthcare delivery and a strong predictor of both patient and nurse outcomes. Understanding the complexity and multifaceted nature of this environment is essential for improving nursing practices and optimizing healthcare systems. This study aimed to gain insights into the perceived characteristics of the nursing work environment, considering it as a complex and multifaceted system. A qualitative research approach was employed, involving 42 semi-structured interviews with 43 nurses and managers from academic, teaching, and general hospitals in The Netherlands. Data were collected between July 2020 and August 2021 through convenience sampling. Thematic coding was conducted to identify key patterns and themes. The findings revealed that nurses demonstrated flexibility and a strong commitment to high-quality care, despite grappling with rigorous organizational tasks and processes. Four key themes emerged: (1) direct patient care as a standard feature of nursing work; (2) nurses' flexibility for hospital productivity; (3) interdependencies, which decrease autonomous nursing practices; and (4) organizational structures that determine how nurses can shape their work. Nurses found it difficult to balance direct care with broader tasks due to organizational rigidity, revealing a gap between ideal nursing practices and daily reality. This study highlighted the challenges within the nursing work environment, particularly in balancing direct care with organizational demands. Addressing this gap between ideal nursing practice and reality requires a systems approach. This includes autonomous practices, supportive management, and flexible structures, allowing nurses to shape their work and enhance job satisfaction and care quality.

Exploring the influence of nurses’ demographics and hospital work environment on medical error reporting practices in Jordan: a cross-sectional study

ObjectiveNurses have a significant role in maintaining patient and healthcare safety. Thus, healthcare administrators should focus on nurse performance and create a friendly hospital work environment to ensure patient safety...

Variation in organisational factors across high- and low-performing hospitals with regard to spontaneous vaginal birth for Black women in four states: a cross-sectional descriptive study

ObjectiveTo describe variation in hospital organisational factors across high- and low-performing hospitals with regard to spontaneous vaginal birth (SVB) for Black women.DesignCross-sectional descriptive.SettingWe conducted a cross-sectional study using three datasets...

A Guide for Nurse-Led Advocacy for Safe Staffing and the Quality of Nursing Work Life.

Nursing advocacy is a critical component of nursing practice. An exemplar of how nurses can advocate for an enhanced quality of nursing work environment and safe staffing is provided. Garnering state and national resources can assist in impacting statewide change. [J Contin Educ Nurs. 2024;55(11):520-522.].

Work Environment and Socio-Demographic Factors of Psychiatric Nurses: A Cross-Sectional Study in Hospitals of Eastern Saudi Arabia.

The work environment in healthcare institutions, especially in psychiatric hospitals, plays a crucial role in shaping the experiences and efficacy of nurses' performance. This environment is influenced by various factors such as facility design, resource availability, workplace culture, support systems, and interpersonal dynamics. Understanding the intricate dynamics of the work environment in psychiatric hospitals is essential for ensuring the provision of high-quality mental healthcare services and enhancing the overall quality of life for both patients and healthcare providers, including nurses. However, the work environment of psychiatric nurses in the eastern region of Saudi Arabia is still inadequately understood. Objective: This study aimed to examine the work environment of nurses working in psychiatric hospitals in the eastern region of Saudi Arabia. Method: A cross-sectional research design was employed on a sample of 346 nurses using a non-probability convenience sampling technique. The survey method was adopted with the Practice Environment Scale of the Nursing Work Index (revised, Arabic version). Results: The study found a significant association between psychiatric nurses' work environment and their socio-demographic characteristics. Demographic factors, such as age and years of experience, were identified as influencing factors of nurses' perceptions of their work environment. Younger nurses and those with fewer years of experience reported greater job satisfaction when their work environment was positive. Conclusions: This study underscores the critical importance of maintaining a supportive work environment for psychiatric nurses due to its possible direct influence on their job satisfaction, work performance, quality of life, and overall well-being. Tailoring interventions to address demographic variations in perceptions of the work environment can enhance the well-being of nurses and improve the quality of care provided to psychiatric patients. These findings contribute to the body of knowledge on psychiatric nursing and have clinical implications for healthcare institutions that aim to optimize their work environments and retain a skilled and satisfied nursing workforce.

Enhancing training transfer among stroke specialist nurses: Insights from latent profile analysis

AimUsing Latent Profile Analysis (LPA) to identify distinct categories within stroke specialist nurses training transfer and to explore the factors influencing these categories. BackgroundStroke represents a significant worldwide health challenge. During the treatment and rehabilitation of stroke, stroke specialist nurses play an essential role. However, despite significant resources devoted in the training of stroke specialist nurses, the effectiveness of training transfer is still at a moderate or low level. Therefore, there is an urgent need to identify the factors affecting the training transfer of stroke specialist nurses and to formulate effective strategies for improvement based on these findings. DesignThis is a cross-sectional study. MethodFrom August to September 2023, demographic questionnaires, stroke specialist nurses training transfer scales, nursing work environment scales, and job crafting questionnaire were used to survey 413 stroke specialist nurses in 5 tertiary hospitals in Henan Province, China. LPA was used to analyze the latent characteristics of nurse training transfer and to explore the predictive factors of different categories using univariate analysis and logistic regression. ResultsA total of 397 stroke specialist nurses were included, identifying three categories of training transfer: "low training transfer group" (20.40 %), "medium training transfer group" (31.74 %), and "high training transfer group" (47.86 %). Work experience, employment type, training duration, nursing work environment, and job crafting significantly influence the training transfer categories. ConclusionThe majority of stroke specialist nurses fall into medium and low training transfer group. Contract employment and less work experience are the main reasons for medium and low levels of training transfer. Enhancing work experience, designing effective training courses, ensuring equal pay, improving the nursing environment, and implementing job crafting strategies could effectively improve training transfer for various types of stroke specialist nurses.

Relationship of the Perioperative Nurse Work Environment With a Culture of Safety and High Reliability

PurposeThe purpose of this study was to examine dimensions of the perioperative work environment and their associations with the operating room (OR) culture of safety and high-reliability characteristics. DesignA predictive correlational design using a cross-sectional survey was used. MethodsA convenience sample of perioperative nurses (N = 96) was used to evaluate strength of associations of their work environment with OR safety culture and high-reliability organizational culture. In addition, the best predictive models for OR culture of safety and high-reliability characteristics were used. FindingsFindings indicated that the five dimensions of the work environment are significant predictors of a safety culture; however, only Collegial Relationships and Nursing Foundations for Quality of Care significantly predict high reliability. ConclusionsDue to the extraordinary responsibility perioperative nurses hold to maintain safety standards for surgical patients, it is critical to fortify elements of the nurse work environment.

The Effect of Perceptions of Evidence-Based Practice on Endotracheal Cuff Pressure Management in Critical Care Nurses: A Correlational Cross-Sectional Multicentre Study.

This correlational cross-sectional multicentre study aims to achieve two objectives. Firstly, to assess nurses' knowledge and practice of endotracheal cuff pressure management. Secondly, to examine the relationship between endotracheal cuff pressure management knowledge and evidence-based practice leadership and work environment. A correlational cross-sectional multicentre study design. This study was conducted among 144 intensive care nurses in Turkey. Data collection included descriptive characteristics and cuff pressure management of nurses, the Evidence-Based Practice Leadership Scale and Evidence-Based Practice Work Environment Scale. Descriptive statistics, chi-square test, Pearson correlation and receiver operating characteristics analysis were conducted. A STROBE checklist was the reporting guide for this study. The success status of nurses in terms of knowledge related to cuff pressure was found significantly different according to the type of intensive care unit working in and the status of receiving training on evidence-based practice. A positive, strong relationship was found between nurses' mean scores on the Evidence-Based Practice Leadership Scale and the Work Environment Scale. There was a very weak positive correlation between the mean scores of the Evidence-Based Practice Leadership Scale and the cuff pressure management. Adherence by nurses to current evidence-based practice for cuff pressure monitoring is essential for safe patient care and improved quality of care. It is recommended to provide both a supportive working environment and training programmes for intensive care nurses to perform cuff pressure management in line with evidence-based practice. Providing educational programs, an appropriate clinical environment, support from health managers and access to appropriate tools are important considerations in increasing the knowledge and skills of intensive care nurses to effectively monitor and manage cuff pressure. Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross-sectional studies. No patient or public contribution.

Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals.

Addressing patient experience is a priority in the health care system. Hospital Consumer Assessment of Providers and Systems (HCAHPS) survey results incentivize hospitals to elevate patient experience, a factor in patient-centered care. Although hospital nursing resources have been positively associated with better HCAHPS ratings, it is unknown how changes in nursing resources are associated with changes in HCAHPS ratings over time. This two-period longitudinal study ranked the associations between changes in nurse staffing, skill mix, nurse education, and work environment on HCAHPS ratings and found that changes in the work environment had the strongest associations (β = 2.29; p < .001) with improved HCAHPS ratings. Our findings provide hospital administrators with empirical evidence that may help make informed decisions on how to best invest limited resources to improve HCAHPS ratings, including the potential utility of improving the work environment through enhancing Nursing Quality of Care and Nurse Participation in Hospital Affairs.

Validity and Reliability of the Korean Version of the Trauma-Informed Climate Scale-10

PurposeThe Trauma-Informed Climate Scale-10 is a short form developed to efficiently measure staff perceptions of the values of trauma-informed care within the service environment. This study aimed to evaluate the reliability and validity of the Korean version of the Trauma-Informed Climate Scale-10 (K-TICS-10) among Korean nurses. MethodsThe K-TICS-10 underwent a linguistic validation process, including translation, back-translation, and expert committee review. Data were collected from 218 nurses in tertiary general hospital in South Korea. Internal consistency reliability was assessed using Cronbach’s α. Structural validity was tested through confirmatory factor analysis. Convergent validity was examined using Pearson’s correlation with affective commitment and burnout. Item-convergent validity was evaluated to examine the internal structure of the scale. ResultsThe Korean version of the TICS-10 demonstrated reliable internal consistency, with Cronbach’s α of .82. The fitness of the modified model was acceptable (χ2/Df = 2.85, goodness-of-fit index = .92, root mean square error of approximation = .09, standardized root mean square residual = .08, Normed fit index = .88, Tucker–Lewis index = .88, and comparative fit index = .91). Convergent validity of the K-TICS-10 was confirmed by significant correlation with affective commitment (r = .56, p <.001) and burnout (r = -.53, p <.001), respectively. The average extracted variances (.34) and composite reliability (.81) indicated adequate convergent validity of the items. ConclusionThe findings of this study support the satisfactory psychometric properties of the K-TICS-10, indicating its utility for evaluating the trauma-informed climate among nursing work environment in Korea.

Nursing Work Environment, Teamwork, and Job Stress-related Presenteeism in Comprehensive Nursing Care Service Units

Nursing Work Environment, Teamwork, and Job Stress-related Presenteeism in Comprehensive Nursing Care Service Units