Challenging and redesigning a new model to explain intention to leave nursing.

BACKGROUND: It is important to have a full and detailed understanding of the factors that influence intention to leave nursing. It has been shown to be the best predictor of actual turnover, and turnover has a significant financial impact and also on the provision of care. AIMS: The aim is to examine the impact of predictive work environment factors on nurses' intention to leave their position and to explore contributing factors. METHODS: Cross-sectional survey using a convenience sample (n = 605) of Finnish nurses drawn from five clinical settings. The Nursing Context Index, an internationally used and psychometrically validated tool, was used to measure workplace practice environment, work stress, job satisfaction and intention to leave. A response rate of 29.4% was achieved, exceeding power calculation estimates. RESULTS: Personal satisfaction and satisfaction with profession and resources, and organisational commitment were significantly related to intention to leave. Younger nurses reported higher levels of intention to leave and there was variability among clinical specialties. Measures of stress and practice environment had no significant relationship with intention to leave. DISCUSSION: This study provides a new theoretical model for understanding intention to leave. Having a better understanding of the factors that may help reduce intention to leave allows for targeted interventions to be developed and implemented. This would help reduce the personal and financial implications associated with turnover. IMPLICATIONS FOR PRACTICE, POLICY, MANAGEMENT AND EDUCATION: The findings have significant implications for all aspects of nursing. Educators need to prepare new nursing staff for the working environment; policymakers must ensure that nursing satisfaction is promoted to strengthen organisational commitment and nurse managers and leaders respond accordingly in implementing effective interventions.

Structure and Content of a New Entrance Exam to Select Undergraduate Nursing Students.

Aim The aim of this study was to develop an evidence-based structure and content for the new nursing entrance examination. Background The purpose of the student selection process is to ensure that those admitted have the required aptitude, motivation and potential to successfully complete studies. Methods The literature reviews were collected using systematic searches in five electronic databases on the assessment of learning skills, social skills/ emotional intelligence and certainty of career choice of nursing applicants. Three focus group interviews (n = 26) were conducted. Data were analysed inductively. The structure and content of the entrance examination was formed by two data sets synthesis. Findings Nursing student selection should involve the assessment of five categories in learning skills, three in social skills and four categories in certainty of career choice. Conclusion Comprehensive assessment can ensure that those admitted are suitable for the profession and have the capability to succeed in their studies.

Workplace culture among operating room nurses.

AIMS: To investigate the workplace culture in the Operating Room (OR) environment and the factors associated with it. BACKGROUND: In health care, the workplace culture affects the delivery and experience of care. The OR can be a stressful practice environment, where nurses might have occasionally either job stress or job satisfaction based on their competence. METHOD: A quantitative cross-sectional approach was used. The study consisted of 96 Finnish OR nurses. A Nursing Context Index instrument was used to obtain data by way of an electronic questionnaire. RESULTS: The primary role and working unit of respondents were the main components relating to workplace culture, and especially to job stress. Nurse anaesthetists were found to be slightly more stressed than scrub nurses. In local hospitals, job stress related to workload was perceived less than in university hospitals (P = 0.001). In addition, OR nurses in local hospitals were more satisfied with their profession (P = 0.007), particularly around issues concerning adequate staffing and resources (P = 0.001). CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: It is essential that nurse managers learn to recognise the different expressions of workplace culture. In particular, this study raises a need to recognise the factors that cause job stress to nurse anaesthetists.

The Relationship of Workplace Culture With Nursing-Sensitive Organizational Factors.

OBJECTIVE: The aim of this study is to explore the relations of workplace culture on nursing-sensitive organizational factors. BACKGROUND: The need for standardized and valid measures for nursing-sensitive organizational outcomes has already been recognized in the literature. METHODS: A cross-sectional questionnaire survey of 21 inpatient acute care units in 9 organizations at the municipal primary healthcare level was conducted. Participants included licensed practical nurses, registered nurses, and nurse managers. RESULTS: Workplace culture, especially the overarching factor of stress, correlated with the use of supplemental nursing staff and patients' length of stay. CONCLUSION: It is essential to find and test workplace-sensitive indicators so that managers will have a wider range of methods to plan and evaluate nursing outcomes.

Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care.

AIM: To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. BACKGROUND: The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. METHODS: A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. RESULTS: Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. CONCLUSION AND IMPLICATIONS FOR NURSING MANAGEMENT: To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave.