Organizational configuration of hospitals succeeding in attracting and retaining nurses.
Organizational configuration of hospitals succeeding in attracting and retaining nurses.
复制标题
成功吸引和留住护士的医院的组织结构。
DOI：
10.1111/j.1365-2648.2006.04095.x
复制
发表时间：
2007
影响因子：
3.8
通讯作者：
W. D'Hoore
中科院分区：
文献类型：
--
作者：
S. Stordeur;W. D'Hoore
目的
本文对比了低流动率医院和高流动率医院的结构和管理特征，并描述了有吸引力的医院的组织配置。
背景
在面临护士短缺和流动的国家，一些医院成功地招聘和留住了护士。在磁力医院中，管理实践和环境特征提高了护士的工作满意度和对组织的承诺，从而减少了护士流动率。这种方法表明，最好将组织理解为相互关联的结构和实践的集群，即组织配置，而不是可以单独理解其组成部分的实体。
方法
对 12 家医院的护士流动率进行了为期一年的研究，比较了第一和第四四分位的医院的结构和组织特征，即有吸引力的（流动率<3.1%）与传统的（流动率>11.8%）。调查问卷包括对健康相关因素、工作要求、压力源、工作安排、组织氛围以及离职前的工作调整的看法，调查对象是在有吸引力的医院工作的 401 名护士（答复率 = 53.8%）和传统医院的 774 名护士（答复率 = 54.5%）。
研究结果
结构特征并不能区分有吸引力的医院和传统医院，但员工对组织的看法却截然不同。在风险暴露、情感需求、角色模糊和冲突、工作与家庭冲突、努力与回报失衡以及工作意义方面观察到差异，所有这些都倾向于有吸引力的医院（P < 0.001）。有吸引力的医院与护理管理、工作能力以及对工作时间、交接班次和时间表的满意度的关系也更好（P < 0.001）。有吸引力的医院的工作满意度和投入度较高，而职业倦怠和离职意愿较低（P < 0.001）。
结论
组织特征是吸引和保留护士的关键因素。护士在工作中面临困难，但一些医院被认为是健康的组织。有吸引力的机构的概念可以成为改善欧洲护士工作环境的催化剂。
AIM
This paper contrasts structural and managerial characteristics of low- and high-turnover hospitals, and describes the organizational configuration of attractive hospitals.
BACKGROUND
In countries facing nurse shortages and turnover, some hospitals succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial practices and environmental characteristics increase nurses' job satisfaction and their commitment to the organization, which in turn decreases nurse turnover. Such an approach suggests that organizations are best understood as clusters of interconnected structures and practices, i.e. organizational configurations rather than entities whose components can be understood in isolation.
METHOD
From a sample of 12 hospitals whose nurse turnover was studied for 1 year, structural and organizational features of hospitals in the first and fourth quartiles, i.e. attractive (turnover <3.1%) vs. conventional (turnover >11.8%) were contrasted. A questionnaire, including perceptions of health-related factors, job demands, stressors, work schedules, organizational climate, and work adjustments antecedent to turnover, was received from 401 nurses working in attractive hospitals (response rate = 53.8%) and 774 nurses in conventional hospitals (response rate = 54.5%).
FINDINGS
Structural characteristics did not differentiate attractive and conventional hospitals, but employee perceptions towards the organization differed strikingly. Differences were observed for risk exposure, emotional demands, role ambiguity and conflicts, work-family conflicts, effort-reward imbalance and the meaning of work, all in favour of attractive hospitals (P < 0.001). Relationships with nursing management, work ability and satisfaction with working time, handover shifts and schedules were also better in attractive hospitals (P < 0.001). Job satisfaction and commitment were higher in attractive hospitals, whereas burnout and intention to leave were lower (P < 0.001).
CONCLUSION
Organizational characteristics are key factors in nurse attraction and retention. Nurses face difficulties in their work situations, but some hospitals are perceived as healthy organizations. The concept of attractive institutions could serve as a catalyst for improvement in nurses' work environments in Europe.