Defining an evidence-based work environment for nursing in the USA
Defining an evidence-based work environment for nursing in the USA
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DOI：
10.1111/j.1365-2702.2007.02148.x
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发表时间：
2008-06-01
影响因子：
4.2
通讯作者：
Arellana, Kerry
中科院分区：
文献类型：
--
作者：
Kotzer, Anne Marie;Arellana, Kerry
瞄准。描述和比较专职护士对三级儿科机构真实和理想工作环境的看法；为管理者提供研究证据，以确定需要改进的地方。医院护士的劳动力短缺是一个全球性问题，对一个组织的财政资源和有效运作以及向病人提供的护理质量都有影响。护士的工作满意度、留职率、离职率与护士的工作环境因素之间存在直接的关系。研究确定当前工作环境中与护士对其首选实践环境的看法相冲突的特定元素，有助于为护理设计和方法定义以证据为基础的工作环境。采用描述性调查设计，对5个住院病房的385名护士和浮游组的385名护士进行问卷调查，完成了真实和理想两种形式的工作环境量表。工作环境量表由人际关系、个人成长和系统维护与变更三个维度的10个子量表组成。所有单位都出现了一致的模式，据报告，他们的参与度、同伴凝聚力、任务导向和管理控制水平都很高。工作压力和自主性得分为中-高，身体舒适度、主管支持、清晰度和创新力为中等。总体而言，据报道，参与得分最高，身体舒适度得分最低。真实和理想的分量表得分之间存在显著差异，这表明工作人员能够确定需要改进的地方。尽管工作压力适中，但工作人员对所在单位高度积极的工作环境表示肯定。确定他们当前工作环境中与他们喜欢的工作环境不一致的特定领域，并针对这些领域进行更改。与临床实践相关。了解护士工作环境需要改善的各个方面，并让工作人员参与进行和评估变化，有助于建立一个以证据为基础的环境，以吸引和留住合格的工作人员。
Aim. To describe and compare staff nurses' perceptions of their real and ideal work environment in a tertiary paediatric facility; to provide administrators with research evidence for identifying areas for improvement.Background. The workforce shortage of hospital nurses is a global problem having an impact on the financial resources and efficient operations of an organisation and the quality of care delivered to patients. A direct relationship exists between job satisfaction, retention, turnover and elements of the nurses' work environment. Research identifying specific elements of the current work setting that are in conflict with nurses' views of their preferred practice milieu can help define an evidence-based work environment for nursing.Design and methods. Using a descriptive survey design, a convenience sample of 385 nurses on five inpatient units and the float team completed two forms (real and ideal) of the work environment scale. The work environment scale consists of 10 subscales within three dimensions: relationship, personal growth and system maintenance and change.Results. A consistent pattern was seen across all units with reported high levels of involvement, peer cohesion, task orientation and managerial control. Scores for work pressure and autonomy were moderate-high and physical comfort, supervisor support, clarity and innovation were moderate. Overall, highest scores were reported for involvement and lowest for physical comfort. Significant differences were found between real and ideal subscale scores suggesting that staff were able to identify areas for improvement.Conclusions. Despite moderate work pressure, staff affirmed a highly positive work environment on their units. Specific areas in their current work setting that were not congruent with their preferred work environment were identified and targeted for change.Relevance to clinical practice. Understanding dimensions of the nurses' work environment needing improvement and involving staff in making and evaluating change supports an evidence-based environment to attract and retain qualified staff.