Effects of work practice environment, work engagement and work pressure on turnover intention among community health nurses: Mediated moderation model

Abstract

Aim To test the relationship between work practice environment and turnover intention, considering the mediation of work engagement and the moderation of work pressure among community health nurses. Design and Samples A cross‐sectional survey design. Methods A total of 410 nurses were recruited from 32 community health centres between September 2016–January 2017 with survey on work practice environment, work engagement, work pressure and turnover intention. Structural equation modelling was used to test a mediated moderation model. Results Work practice environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work practice environment and turnover intention. In addition, work pressure moderated the relationship between work practice environment and work engagement. Conclusion The improvement of work practice environment including the physical and humanitarian environment could enhance nurse engagement and reduce turnover intention in community, which was more pronounced among high‐pressure nurses. Impact In front of the nursing shortage, especially in communities, the strategies on how to retain and motivate nurses have become the focus of concern. Based on the job demands‐resources model and the conservation of resources theory, this study examined the effect of work practice environment on turnover intention with the mediation role of work engagement and the moderation role of work pressure among community health nurses. The nurse managers of communities should pay attention to the role of work practice environment in stimulating nurses’ engagement and decreasing turnover intention, especially when nurses are under high work pressure.

Classification and evaluation of the environment of the professional nursing practice in a teaching hospital

“…The instrument's mean score showed to be lower than that of studies that evaluated the practice in countries like the United States, China, and Turkey (14)(15)(16) .…”

“…On the other hand, a national research study carried out in hospitals similar to the one in this study, that is, a public and teaching one, has revealed similar results to the ones presented here (20) . We highlight with regret that, in the Brazilian scenario, although we have only one research study published until now considering the whole hospital, the environment's characteristics of the hospitals funded by the Unified Health System (Sistema Único de Saúde, SUS) are more precarious when compared to those of the private hospitals (20) and, also, to the international literature (14)(15)21) .…”

“…It is worth noting that, even before the realities experienced by different health institutions in Brazil and in the world, it is important that the managers commit themselves to keep a work environment that is favorable for the nursing practice, since improvements in the environment collaborate for positive results both in the patients (safety improves), and in the professionals (reduced burnout and intention to leave the job) (14)(15)(16)22) .…”

“…In Other hospitals in the national (20) and international (23) contexts also had their environments classified as mixed and it is interesting to highlight that, even in favorable environments, the "Staffing and Resource Adequacy" subscale always received the lowest score (14)(15)21) .…”

Structure Please; Continuous Improvement and Employee Consequences in a Dynamic Task Environment

“…Such positive effects can also be expected when CI is implemented with the explicit aim to improve employees' working conditions [34,37]. Lower job demands, and in this dynamic task environment, lower stress, as well as related higher work engagement, are of particular importance given the contemporary concerns about the consequences of nurses' high workloads [38][39][40][41][42][43][44].…”