Nursing professional practice environment and its relationship with nursing outcomes in intensive care units: a test of the structural equation model

Abstract

Introduction Burnout, intention to leave and ultimately shortage of skilled nurses are associated with poor practice environments; however, in Iran comprehensive data are unavailable. The aim of this study was to investigate the relationships between the nursing professional practice environment with nurses’ burnout and intention to leave in intensive care units, using structural equation modelling analysis. Methods This cross‐sectional, multi‐centred study was conducted among 320 nurses in twenty ICUs of five teaching hospitals affiliated with Shiraz University of Medical Sciences from September 2018 to June 2019. Valid measurement instruments including Nursing Professional Practice Environment Questionnaire (NPPEQ), Maslach Burnout Inventory (MBI) and Anticipated Turnover Scale (ATS) were used for data collection. Results Goodness‐of‐fit statistics confirmed a model with burnout dimensions in mediating positions between nursing professional practice environment dimensions and intention to leave, explaining 86.4% of the variation. Conclusion The results confirmed a theoretical model with structural the relationships among the nursing professional practice environment, burnout and intention to leave in nurses working in ICUs. In this model, burnout had a strong direct positive effect on intention to leave. The results can provide guidance for various stakeholders, such as health policymakers and nurse managers attempting to improve the quality of nurses’ workplace, by drawing their attention to various factors influencing the retention of technically trained nurses in the critical care units.

Assessment of the Relationship between Nurses’ Perception of Ethical Climate and Job Burnout in Intensive Care Units

“…The result confirmed adequate construct validity of the MBI. (7) Ethical considerations. The study was approved by the Research Ethics Committee of Shiraz University of Medical Sciences (No: IR.SUMS.…”

“…( 4 ) Nursing practice environment characteristics including resource inadequacy, poor inter-professional collaboration, and lack of supportive management are associated with nurses’ job burnout. ( 7 ) The prevalence of burnout is estimated to range from 10%-70% among nurses and 64% of Chinese nurses experienced job burnout. ( 4 ) In Iran, the overall prevalence of nursing burnout has been reported to be 25%.…”

Experiences of intensive care unit nurses with COVID-19 patients

“…This finding was corroborated by a study with 320 ICU nurses in Iran that reported high levels of burnout in the participants, with a rate of emotional wearing of 70% and a rate of only 49% of personal fulfillment. Professional wearing showed a directly significant relationship with intention of leaving nursing (25) .…”

Status and associations of nursing practice environments in intensive care units: A cross‐sectional study in China

“…Intensive care units (ICUs) are facing increasing work pressure due to their high workload, high number of patients per nurse, increased recording and the care of critically ill and unstable patients (Adams et al, 2019;Rivaz et al, 2021). Numerous international studies have reported high numbers of ICU nurses expressing their intention to leave, including 24% in Canada (Sawatzky et al, 2015), 30% in the Netherlands (van Dam et al, 2013), 41.1% in the USA (Fitzpatrick et al, 2010) and 48.9% in China (Lai et al, 2008).…”