Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. A survey of Icelandic hospital nurses
Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. A survey of Icelandic hospital nurses
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DOI：
10.1016/j.ijnurstu.2006.11.007
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发表时间：
2009-07-01
影响因子：
8.1
通讯作者：
Nutbeam, Don
中科院分区：
文献类型：
--
作者：
Gunnarsdottir, Sigrun;Clarke, Sean P.;Nutbeam, Don
目的：调查冰岛一家医院护士工作环境与工作成果和护理质量评估相关的各个方面。背景：先前的研究表明，医院恶劣的工作环境严重阻碍了护士的保留和高质量的患者护理。另一方面，保留率高的医院（如 Magnet 医院）表现出支持性管理、专业自主权、良好的专业间关系和护士工作满意度，减少了护士倦怠并提高了患者护理质量。 方法：对雷克雅未克 Landspitali 大学医院的 695 名护士进行横断面调查。使用修订后的护理工作指数 (NWI-R) 来测量护士的工作环境，并使用线性和逻辑回归方法将其作为工作满意度、Maslach 职业倦怠量表 (MBI) 和护士评估的患者护理质量的预测因素进行检查。结果：NWI-R 的冰岛版本显示出与 Lake (2002) 类似的五因素结构。在控制了护士的个人特征后，发现工作满意度、情绪疲惫和护士对护理质量的评价与单位级别管理人员的支持感、人员配备充足性以及护士与医生的关系独立相关。结论：NWI-R 衡量医院护士工作环境的要素，这些要素可预测冰岛的工作成果和护士对患者护理质量的评级。努力改善和维持护士与护士经理和医生的关系，以及他们对人员配备充足性的看法，可能会提高护士的工作满意度和员工保留率，并可能提高患者护理的质量。 (C) 2006 Elsevier Ltd. 保留所有权利。
Objective: To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital.Background: Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care.Methods: Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavik. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches.Results: An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations.Conclusions: The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care. (C) 2006 Elsevier Ltd. All rights reserved.