Nursing work environment and quality of care: differences between units at the same hospital

Abstract

The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub-scales from the Nursing Work Index - Revised (NWI-R) to assess the nursing work environment and the performance of these sub-scales across different units in a hospital. Data were derived from a cross-sectional survey of 243 nurses from 13 units of a 300-bed university-affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five subscales were confirmed; three of the sub-scales had greater ability to discriminate between units. Using hierarchical regression models, "resource adequacy" was the sub-scale most strongly associated with the perceived quality of care at the last shift. The NWI-R sub-scales are potentially useful for comparison of work environments of different nursing units at the same hospital.

Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

“…In contrast, greater availability of support services was associated with higher levels of work engagement and better work conditions. These findings have been similarly documented in other studies (Cimiotti et al, 2005;Choi, Bakken, Larson, Du, & Stone, 2004;Mark et al, 2003;McCusker, Dendukuri, Cardinal, Laplante, & Bambonye, 2004). Patient acuity and unit size, however, did not have a direct effect on structure because we limited the sample to medical-surgical units, and in so doing, restricted variability in patient acuity and unit size in our sample.…”

Organizational Climate and Hospital Nurses' Caring Practices: A Mixed‐Methods Study

“…Researchers repeatedly have shown a link between resource adequacy and nurses' perceptions of quality of care (Friese, 2005;Hinno et al, 2011;McCusker et al, 2004). Here we extend this work to nurse caring practices, a specific aspect of care performed by nurses.…”

“…To date, however, investigations of organizational climate's influences on nurses have focused on care outcomes rather than processes of nursing care. The organizational contextual element most consistently correlated with quality of care is the perceived adequacy of staffing (Hinno, Partanen, & Vehviläinen-Julkunen, 2011;Laschinger & Leiter, 2006;McCusker, Dendukuri, Cardinal, Laplante, & Bambonye, 2004;Rochefort & Clarke, 2010). Perceptions of nurse managers' ability and nurse-physician relationships also have surfaced as important predictors of outcomes.…”

PENGARUH LINGKUNGAN KERJA PERAWAT TERHADAP PELAKSANAAN PRAKTEK KEPERAWATAN DI RUMAH SAKIT UMUM Dr. SAIFUL ANWAR MALANG TAHUN 2006

“…Lingkungan kerja yang berkualitas tinggi sangat bermanfaat bagi perawat dan dapat meningkatkan kualitas perawatan klien (7,8). Komponen dari lingkungan kerja perawat ini antara lain meliputi komponen kepemimpinan, dan budaya; kendali terhadap praktek; kendali terhadap beban kerja; dan sumbersumber yang adekuat bagi terlaksananya pelayanan keperawatan yang berkualitas (7).…”

“…Kemampuan yang dimiliki oleh manajer dalam mengelola manajemen pelayanan, adanya pelaksanaan supervisi klinik yang dilakukan oleh pemimpin, adanya dukungan dari pemimpin dan pemberian kesempatan perawat untuk melakukan aktivitas refleksi terhadap pekerjaannya serta adanya budaya organisasi yang berlaku dalam suatu rumah sakit akan mempengaruhi kualitas kondisi lingkungan kerja perawat yang berdampak pada kualitas pemberian asuhan keperawatan yang dilakukan oleh perawat pada klien (8,10,11). Hal ini sesuai dengan temuan pada penelitian ini yang menunjukkan adanya pengaruh yang signifikan antara kepemimpinan, manajemen dan budaya dengan pelaksanaan praktek keperawatan dengan pola hubungan yang positif, artinya semakin baik kepemimpinan, manajemen dan budaya maka akan semakin baik pula pelaksanaan praktek keperawatan di institusi tersebut.…”