Best practice recommendations for healthy work environments for nurses: An integrative literature review

Healthy work environments that maximise the health and well-being of nurses are essential in achieving good patient and societal outcomes, as well as optimal organisational performance. While studies have been conducted on healthy work environments, there is no available evidence that an integrative literature review summarising best-practice recommendations related to healthy work environments has been conducted before. This review aimed to summarise existing best-practice recommendations related to a healthy work environment for nurses. An integrative literature review following the approach adapted from Whittemore and Knafl was used. Existing guidelines related to healthy work environments for nurses were searched. EBSCOhost (CINAHL, Medline), Biomed Central, Science Direct, PubMed and Google Scholar and organisational websites via Google were searched, followed by a citation search. Twelve guidelines were identified for data extraction and synthesis, and themes were subsequently formulated. Four themes emerged from the integrative literature review regarding a healthy work environment for nurses: (1) the need for effective nursing leadership, (2) effective communication as central to enhancement of a healthy environment, (3) effective teamwork as an integral part of a healthy work environment and (4) the need for professional autonomy. In summary, a healthy work environment for nurses requires leadership, effective communication, teamwork and professional autonomy.

Desarrollo y validación del instrumento ENLASA-Enfermería para la evaluación de un entorno laboral saludable en el ámbito hospitalario / Development and validation of the ENLASA-Nursing instrument for the assessment of a healthy work environment in the hospital setting

El entorno laboral de los profesionales de enfermería es un área temática de gran interés para organizaciones internacionales en salud, organizaciones profesionales internacionales y locales, académicos, investigadores y directores o gerentes de enfermería, por la mediación o el impacto que estos entornos pueden tener en los resultados personales y profesionales de los enfermeros, en la calidad de la atención que se brinda a los pacientes y en los resultados de las organizaciones proveedoras de servicios de salud. Por lo anterior, existe el gran desafío de establecer entornos laborales saludables para mejorar la práctica de los enfermeros. Para promover la investigación empírica de los entornos laborales saludables de los enfermeros de práctica asistencial en el ámbito hospitalario, se desarrolló el instrumento ENLASA-Enfermería empleando un diseño de métodos mixtos secuencial exploratorio de tres fases. En la primera fase se adelantó la definición del concepto y la identificación de sus características, iniciando con una sub-fase de revisión teórica, continuando con una subfase de abordaje cualitativo con enfermeros y finalmente una sub-fase analítica para interconectar los hallazgos teóricos y cualitativos. En la segunda fase se generó un banco de ítems organizado en dos dimensiones (parte A: componentes estructurales organizacionales y parte B: dimensión de procesos organizacionales) que fue sometido a una revisión por expertos para estimar la validez facial y de contenido, y posteriormente se realizó una prueba piloto con una muestra de 22 enfermeros. Finalmente, en la tercera fase se aplicó el instrumento a una muestra de 307 enfermeros clínicos del ámbito hospitalario de diferentes municipios y ciudades de Colombia, con lo cual se realizó una evaluación de las propiedades métricas en términos de validez de constructo y confiabilidad. Los resultados obtenidos permitieron clasificar cada una de las partes de ENLASAEnfermería como satisfactorias en términos de validez facial y de contenido con índices globales superiores a 0,80 en las variables evaluadas por cada parte; con consistencia interna satisfactoria (Alfa de Cronbach parte A: 0,930 y parte B: 0,944) y con una estructura interna que permitió reconocer los elementos conceptuales de un entorno laboral saludable que respaldan su contenido. Se concluyó que ENLASA-Enfermería es un instrumento válido y confiable, prometedor para la investigación y la evaluación de los entornos laborales saludables de enfermeros clínicos en el ámbito hospitalario en Colombia.

The work environment of nursing professionals is a subject area of great interest to international health organizations, international and local professional organizations, academics, researchers and nursing directors or managers due to the mediation or the impact that these environments may have in the results of the professionals nursing, in the quality of care provided to patients and in the results of health service provider organizations. Therefore, there is the great challenge of establishing healthy work environments to improve the practice of professionals nursing. To promote empirical research on healthy work environments for nurses in care practice in the hospital setting, the ENLASA-Nursing instrument was developed using a three-phase exploratory sequential mixed methods design. In the first phase, the definition of the concept and the identification of its characteristics were advanced, starting with a sub-phase of theoretical review, continuing with a subphase of qualitative approach with nurses and finally an analytical sub-phase to interconnect the theoretical findings and qualitative. In the second phase, a bank of items organized in two dimensions (part A: organizational structural components and part B: organizational processes dimension) was generated, which was subjected to a review by experts to estimate facial and content validity and subsequently carried out a pilot test with a sample of 22 nurses. Finally, in the third phase, the instrument was applied to a sample of 307 clinical nurses from the hospital environment of different municipalities and cities in Colombia, with which an evaluation of the metric properties in terms of construct validity and reliability was carried out. The results obtained allowed classifying each of the parts of ENLASA-Nursing as satisfactory in terms of facial validity and content with indices global above 0.80 in the variables evaluated; with satisfactory internal consistency (Cronbach's Alpha part A: 0,930 and part B: 0,944) and with an internal structure that demonstrated relationships between items, subdimensions and dimensions, confirming the existence of the healthy work environment construct measured by the instrument. It was concluded that ENLASA-Nursing is a valid and reliable instrument, promising for the research, establishment and evaluation of healthy work environments of clinical nurses in the hospital setting in Colombia.

The investigation of the healthy work environment in emergency departments in tertiary hospitals of Guangdong province / 重庆医学

Objective To investigate the health status of nurses in emergency departments in tertiary hospitals of Guangdong province.Methods Fourteen tertiary hospitals were selected by using convenience sampling method,and 382 emergency nurses were chose by cluster sampling and their healthy work environment was evaluated by using Essentials of Magnetism Ⅱ scale(EOM Ⅱ).All the participants were asked to finished the Essentials of Magnetism Ⅱ scale.Results The healthy work environment in the tertiary hospitals' emergency departments in Guangdong had higher score than the magnet hospitals in America,but lower job satisfaction and nursing quality.There were significant differences in different shift and education of the emergency nurses.The job satisfaction and nursing quality could influence the healthy work environment.Conclusion The healthy work environment in tertiary hospitals' emergency departments of Guangdong province is good,but the job satisfaction and nursing quality is low.