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PURPOSE: This study was done to investigate the relationships between nursing work environment, leader-member exchange(LMX), peer support, and organizational commitment in one city with a severe nurse shortage. METHODS: Participants were 198 nurses who had worked for more than 6 months with the same head nurse. They worked in five general hospitals located in one city. In April 2016 participants completed a survey questionnaire about their nursing work environment, LMX, peer support, and organizational commitment. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS: There was a significant difference in nursing work environment by experience of turnover (t=−2.58, p=.010). LMX showed significant difference by department (F=3.81, p=.011). Factors influencing nurses' organizational commitment were nurse participation in hospital affairs (β=.23, p=.028) and nurse manager ability, leadership and support (β=.18, p=.022). Explanatory power was 18.2% in the regression model. CONCLUSION: The results suggest that it is necessary to improve the nursing work environment in order to increase organizational commitment. Improvement of the nursing system should be considered along with supplementation of nurses particularly during a severe nurse shortage.
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Humans , Hospitals, General , Leadership , Nurse Administrators , Nursing , Nursing, Supervisory , Peer InfluenceABSTRACT
Objective@#To describe job satisfaction of paediatric intensive care units in China, and analyze the relationship of nursing work environment between job satisfaction.@*Methods@#From November 2017 to May 2018, a total of 1 414 nurses of paediatric intensive care units from 25 hospitals of 16 provinces and cities nationwide in China were selected using convenient sampling, and surveyed by Nurses Job Satisfaction Scale and Practice Environment Scale. Descriptive statistics and Hierarchical multiple regression analysis were performed by SPSS 20.0.@*Results@#The average score of nurse job satisfaction of paediatric nurses was 3.29 ± 0.49, which was in the middle level in China. Hierarchical regression results showed that the area where the hospital was located, monthly income could affect the nurse job satisfaction, and nursing work environment played an important role for nurses job satisfaction, the model explained 73.1% amount of variance (R2=0.731, P<0.01).@*Conclusions@#The nursing work environment is the important factor influencing the nurses job satisfaction of paediatric intensive care unit, how to balance the domestic resources and reduce the regional differences, we work together to create a healthy environment in paediatric intensive care unit, further improving the nurses job satisfaction will be the important issues in the future.
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Objective To describe job satisfaction of paediatric intensive care units in China, and analyze the relationship of nursing work environment between job satisfaction. Methods From November 2017 to May 2018, a total of 1414 nurses of paediatric intensive care units from 25 hospitals of 16 provinces and cities nationwide in China were selected using convenient sampling, and surveyed by Nurses Job Satisfaction Scale and Practice Environment Scale. Descriptive statistics and Hierarchical multiple regression analysis were performed by SPSS 20.0. Results The average score of nurse job satisfaction of paediatric nurses was 3.29 ± 0.49, which was in the middle level in China. Hierarchical regression results showed that the area where the hospital was located, monthly income could affect the nurse job satisfaction, and nursing work environment played an important role for nurses job satisfaction, the model explained 73.1％ amount of variance (R2=0.731, P<0.01). Conclusions The nursing work environment is the important factor influencing the nurses job satisfaction of paediatric intensive care unit, how to balance the domestic resources and reduce the regional differences, we work together to create a healthy environment in paediatric intensive care unit, further improving the nurses job satisfaction will be the important issues in the future.
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PURPOSE: The purpose of this study was to investigate whether the effects of emotional intelligence and working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.METHODS: The data was collected between Aug. 1 and Aug. 30, 2018 from 240 nurses caring for cancer patients from 11 small and medium hospitals in B city. Variables included in this study were the Wong and Law Emotional Intelligence Scale (WLEIS), the Practice Environment Scale of Nursing Work Index (PES-NWI), the Global Interpersonal Communication Competence (GICC), and nursing performance. The collected data were analyzed by t-tests, ANOVA and Scheffe's test, Pearson's correlation coefficients, and 3 step multiple regression using SPSS/WIN 24.0 and the Sobel test.RESULTS: Communication competence, in the relationship between emotional intelligence and nursing working environment on nursing performance in nurses caring for cancer patients in small and medium hospitals, showed a partial mediating effect (Z=5.24, p < .001; Z=2.44, p=.001 respectively).CONCLUSION: The results of this study showed the effects of emotional intelligence and nursing working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.
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Humans , Emotional Intelligence , Jurisprudence , Mental Competency , Negotiating , NursingABSTRACT
A health nursing work environment can improve nurses' working satisfaction and job retention, which is an important indicator reflecting the quality of nursing care and patient safety. This article expounds the connotation of nursing working environment,reviews the research status and extracts the improvement strategies for the future.
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PURPOSE: The purpose of this study is to provide preliminary data for alleviating nurses' job stress and support health promotion behaviors. Further, the study reviews the mediating effects of positive psychological capital and nursing work environment in relation to job stress and health promotion behaviors among nurses in a regional general hospital. METHODS: A study survey was conducted from June 9 to 16, 2017. The subjects were current nurses working at a regional general hospital in D city. Analysis of a survey questionnaire from 147 participants was conducted. RESULTS: Upon reviewing the mediating effects of positive psychological capital and nursing work environment in relation with health promotion behaviors and job stress, it was found that positive psychological capital (Z=−4.78, p < .001) and nursing work environment (Z=−4.17, p < .001) were significant mediators. CONCLUSION: As demonstrated through the results of this research, it is necessary to build programs to strengthen individual positive psychological capital and increase the practice of health promotion behaviors among nurses. It is also evident that a systematic approach is needed to improve the nursing work environment.
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Health Promotion , Hospitals, General , Negotiating , NursingABSTRACT
PURPOSE: The study was undertaken to investigate influence of nurses' work environment, organizational commitment, and nursing professionalism on turnover intention of nurses working in long term care hospitals. METHODS: The study was cross-sectional study. Participants were 199 nurses working in one of 7 long term care hospitals. Data were collected from May 1 to June 30, 2016 and analysed using two stage hierarchial regression analysis with SPSS 22.0. RESULTS: There was a statistically significant difference in turnover intention according to age (F=6.23, p < .001), present work career (t=−2.11, p=.036), frequency of night duty (t=−3.53, p=.001), and present position (t=−4.07, p < .001). The significant predictors of turnover intention were attachment (β=−0.29, p=.005), nursing professionalism (β=−.21, p=.030), identification (β=−.21, p=.014), continuance (β=−.19, p=.008), collegial nurse-physician relations (β=−.16, p=.039), and originality of nursing (β=.16, p=.014). These factors explained 50.4% of the variance. CONCLUSION: The results suggest that several points need to be considered in order to reduce turnover intention in long term care hospital nurses. These points include building work environments to improve collegial nurse-physician relations, promoting recognition of nurses' organizational commitment, nursing professionalism and the political efforts of organizations supporting nursing originality.
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Cross-Sectional Studies , Intention , Long-Term Care , Nursing , Physician-Nurse Relations , ProfessionalismABSTRACT
Objective To investigate the status quo of junior nurses' nursing work environment and clinical decision making perception,and to analyze the influence of nursing work environment on clinical decision making perception.Methods The general data questionnaire,nursing work environment scale and clinical decision making perception scale was used to investigate 633 Junior nurses in hospitals.Results The overall mean score of nursing work environment was (2.99±0.37) points,the dimensions score from high to low were:medical cooperation (3.12 ± 0.47) points,nursing management and leadership style (3.06 ± 0.47) points,nurse participation in hospital affairs (2.91 ±0.48) points,high quality nursing service (2.78 ± 0.48) points,sufficient manpower and material resources (2.75 ± 0.52) points,;clinical decision—making perception of Junior nurses was (143.36 ± 14.01) points,the dimensions score from high to low were:the decision—evaluative feedback (37.31 ± 4.53) points,determine the goal of solving the problem (36.16 ± 4.39) points,find the information again (35.04 ± 3.76) points,gather information ability (30.98 ± 3.80) points.The Total score of nursing work environment were positively correlated with the clinical decision making perception of junior nurses(r =0.08-0.28,P＜ 0.01).Conclusions Junior nurse's nursing work environment remains to be improved,nursing work environment has a good effect on clinical decision making perception,therefore,nursing managers should create a positive working atmosphere.It is beneficial to improve the awareness of nursing clinical decision-making by giving specific support to the needs of junior nurses.
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Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.
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Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.
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Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.
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Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.
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Nursing work environment impacts patient outcomes. This article summarized the concept and connotation of nursing work environment, related theories of how nursing work environment impacts patient safety outcomes and related researches conducted by foreign scholars. The effort of this review article aims to put forward new research direction.
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Objective To analyze the relationship between nursing work environment and nurses′work values of tertiary public hospitals in Tianjin ,and provide a scientific basis for the development of nurses′work values. Methods The sample was 1 875 clinical nurses from 7 tertiary public hospitals in Tianjin, and investigated with Practice Environment Scale (PES) and Work Values Scale. Results The score of nurses′ work values and each dimension(material work values, affective work values,cognitive work values) were different in different level of work environment,betterwork environments>mixedwork environments>poorwork environments(F=121.528, 38.555, 86.834, 136.816,P<0.01). The nursing work environment was positively correlated with work values(r=0.127-0.423, P<0.01). Foundation for quality of care and leadership of the head nurse could predict the nurse work values, and could explain 16.9%of the nurse work values(F=191.315,P<0.01). Conclusions By improving nursing work environment, especially in foundation for quality of care and leadership of the head nurse,can promote the development of nurses′work values.
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Objetivo: O estudo objetivou identificar o conhecimento dos enfermeiros acerca da abordagem ecossistêmica em Unidade de Terapia Intensiva (UTI). Métodos: Caracterizou-se como pesquisa de caráter descritivo-exploratório de abordagem qualitativa. Os sujeitos foram três enfermeiros que atuavam a mais de um ano nesse espaço em Santa Maria, RS. A coleta ocorreu em agosto e setembro de 2011. Utilizou-se a análise temática para examinar os achados da pesquisa. Resultados: Na categorização emergiram duas temáticas: Abordagem Ecossistêmica em Unidade de Terapia Intensiva e Unidade de Terapia Intensiva como ambiente saudável e sustentável. Destacou-se que o conhecimento com base no paradigma ecossistêmico possibilita a compreensão das complexas atividades do espaço da UTI por meio das interações dos seus elementos constituintes. Conclusão: Assim, a visão sistêmica, ao considerar as múltiplas dimensões dos elementos integrantes desse espaço/ambiente e suas interações, é apropriada para potencializar a dinamicidade das constantes mudanças nesse espaço de trabalho.
Objective: This study aimed to identify the nurses' knowledge about the ecosystem approach in the Intensive Therapy Unit (ITU). Method: Characterized as a descriptive-exploratory research, with a qualitative approach. The subjects were three nurses who worked more than one year in this space in Santa Maria, RS. The data was collected in August and September 2011. We used thematic analysis to examine the research findings. Results: In the categorization two themes emerged: Ecosystem Approach in the Intensive Therapy Unit and Intensive Therapy Unit as a healthy and sustainable environment. It was emphasized that the knowledge-based ecosystem paradigm enables the understanding of complex space activities of the ITU through the interactions of its constituents. Conclusion: Thus, a systemic view, when considering the multiple dimensions of the integral elements of that space / environment and their interactions, it is appropriate to enhance the dynamics of the constant changes in this workspace.
Objetivo: El estudio tuvo por objetivo identificar el conocimiento de los enfermeros acerca del abordaje ecosistémico en la Unidad de Terapia Intensiva (UTI). Método: Se efectuó como investigación de carácter descriptivo-exploratorio de abordaje cualitativo. Los sujetos fueron tres enfermeros que actuaban más de un año en ese espacio en Santa Maria, RS. La recolección ocurrió en agosto y septiembre del 2011. Se utilizó el análisis temático para examinar las informaciones de la investigación. Resultados: En la categorización emergieron dos temáticas: Abordaje Ecosistémico en Unidad de Terapia Intensiva y Unidad de Terapia Intensiva como espacio saludable y sustentable. Se destacó que el conocimiento con base en el molde ecosistémico posibilita la comprensión de las complejas actividades del espacio de la UTI por medio de las interacciones de sus elementos constituyentes. Conclusión: Así, la visión sistémica, al considerar las múltiples dimensiones de los elementos integrantes de ese espacio/ambiente y sus interacciones, es apropiada para potencializar la dinamicidad de las constantes mudanzas en ese espacio de trabajo.
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Humans , Male , Female , Adult , Working Conditions , Ecosystem , Intensive Care Units , BrazilABSTRACT
PURPOSE: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. METHODS: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. RESULTS: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. CONCLUSION: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.
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Humans , Decision Making , Delivery of Health Care , Marital Status , Nursing , Professional AutonomyABSTRACT
PURPOSE: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. METHODS: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. RESULTS: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. CONCLUSION: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.