Validation and Psychometric Assessment of the Practice Environment Scale of the Nursing Work Index in the Portuguese Hospital Context.

BACKGROUND: The nursing work environment has an impact on patient safety outcomes and its measurement should be a regular practice. PURPOSE: To assess the reliability and construct validity of the Practice Environment Scale of the Nursing Work Index in the Portuguese context. METHODS: An exploratory factor analysis followed by a confirmatory factor analysis to assess model adjustment quality was performed with a sample of 3,686 nurses. RESULTS: The final solution for the exploratory factor analysis comprised 26 items and five factors (56.6% of the total variance). The confirmatory factor analysis, after refinement, showed a stable factor structure. CONCLUSIONS: The final model showed good construct validity and high reliability, which supports the decision to exclude the items that are not essential to the construct being measured.

Work environment issues and intention-to-leave in Portuguese nurses: A cross-sectional study.

This study extends the Registered Nurses Forecasting (RN4CAST) study evidence base with newly collected data from Portuguese nurses working in acute care hospitals, in which the measurement of the quality of work environment, workload and its association with intention-to-leave emerge as of key importance. Data included surveys of 2235 nurses in 144 nursing units in 31 hospitals via stratified random sampling. Multilevel multivariate regression analysis shows that intention-to-leave is higher among nurses with a specialty degree, nurses aged 35-39, and in nursing units where nurses are less satisfied with opportunities for career advancement, staffing levels and participation in hospital affairs. Analysis with moderation effects showed the observed effect of age and of having a specialty degree on intention-to-leave during the regression analysis is reduced in nursing units where nurses are more satisfied with opportunities for career advancement. The most important finding from the study suggests that promoting retention strategies that increase satisfaction with opportunities for career advancement among Portuguese nurses has the potential to override individual characteristics associated with increased turnover intentions.

Cognitive ability patterns and nurses' clinical decision making.

The present study concerns the clinical decision-making process in a naturalistic context and its relationship to the nurses' abilities of critical thinking, creative thinking and emotional intelligence. Apart from describing a model of the clinical decision-making process in nursing, the results showed its continuous and interactive nature as well as that different patterns of decisions correspond to distinct patterns of those cognitive abilities. Despite some limitations, we consider that this study has implications in the caring, administration, education and nursing informatics areas.

Cognitive abilities and clinical decision making in nursing.

This investigation focused the clinical decision-making process in a naturalistic context and its relationship to the nurses' abilities of critical thinking, creative thinking and emotional intelligence. Apart from describing a model of the clinical decision-making process in nursing, the results showed its continuous and interactive nature as well as that different patterns of decisions correspond to distinct patterns of those cognitive abilities. Despite some limitations, we consider that this study has implications in the caring, administration, education and nursing informatics areas.