Nurse work environment: comparison between private and public hospitals

Abstract

Objective To compare the characteristics of the work environment that enable the professional practice of nurses in private and public organizations.Methods A quantitative, exploratory, cross-section study, carried out in four health organizations - one public and three private, with 188 registered nurses. Participants answered the Brazilian version of the Nursing Work Index − Revised, which aims to evaluate the presence of characteristics that favor the development of nursing activities through 15 items distributed into three subscales: autonomy, control over the practice setting and relationships with physicians. The measurement scale used is Likert, and lower scores represent better evaluation of the environment, i.e. , more favorable characteristics are present to assist the development of nursing activities.Results The means of the responses of participants of private hospitals were smaller in all subscales of the instrument, as compared to those from public hospitals.Conclusion The environment of private hospitals showed more favorable characteristics to the professional practice of registered nurses than the public hospital environment.

Quality improvement programs and the professional nursing practice environment: an integrative review

“…In all surveys, the practice environment was evaluated using scale-based instruments (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) , such as NWI-R, PES and HWEA. We will address each one below.…”

Instruments for assessing professional nursing practice environments: An integrative review

“…Values below 2.5 represent favorable environments for the professional nursing practice and, above 2.5, unfavorable environments. In this instrument, the lower the score, the greater the presence of attributes favorable for the professional practice (18,23) . At the international level, the NWI-R, already adapted and validated in several countries, has been applied in several contexts (19,23) .…”

“…In addition, according to some authors, the measures most frequently used to assess work environments were developed more than 20 years ago and, in addition to the lack of robust psychometric tests, there is a limited theoretical component that boosted their development (57) . Consequently, the validity of these instruments can be questioned in terms of their relevance to the current environment of the professional nursing practice (18,57) .…”

Avaliação do ambiente da prática profissional da enfermagem em instituições de saúde

“…However, when using another instrument that evaluates the characteristics of the environment of the professional practice, authors also found more favorable results in private hospitals, when compared to the public ones. (21) With regard to subscales, the Participation of nurses in hospital obtained the most unfavorable evaluation in the perception of the participants and in the evaluation of countries such as the United States of America, China, Thailand, Japan, New Zealand, Germany (22) and Turkey (23) it was possible to perceive that the hospitals surveyed have much to invest in the inclusion of members of the nursing staff in political decisions, commissions and committees, as well as in offering opportunities for professional growth and in a more accessible communication with the managers. (10) In resource adequacy, the second subscale with the most unfavorable evaluation, it was noted that only China and Thailand achieved more favorable results, (22,23) which shows that the feeling of work overload is not present only in the participating professionals of this research.…”