“鲶鱼效应”管理对降低护士职业倦怠的效果研究

[目的]将＂鲶鱼效应＂管理理论引入护理管理,旨在树立＂鲶鱼＂护士的榜样作用,正面影响其他护士的思想和行为,降低护士职业倦怠。[方法]对护士进行职业倦怠调查,运用＂鲶鱼效应＂管理,正面影响护士的思想和行为,激发护士的潜能,观察实施后的效果。[结果]通过＂鲶鱼效应＂的实施,护士职业倦怠各维度得分降低（P〈0.01）,医院护理质量提高（P〈0.01）。[结论]在护理管理中运用＂鲶鱼效应＂理论,实现了护理人员的自我价值、提高了护理质量、降低了职业倦怠,达到护理管理的最佳效果。     

"鲶鱼效应"管理对降低护士职业倦怠的效果研究

[目的]将"鲶鱼效应"管理理论引入护理管理,旨在树立"鲶鱼"护士的榜样作用,正面影响其他护士的思想和行为,降低护士职业倦怠.[方法]对护士进行职业倦怠调查,运用"鲶鱼效应"管理,正面影响护士的思想和行为,激发护士的潜能,观察实施后的效果.[结果]通过"鲶鱼效应"的实施,护士职业倦怠各维度得分降低(P<0.01),医院护理质量提高(P<0.01).[结论]在护理管理中运用"鲶鱼效应"理论,实现了护理人员的自我价值、提高了护理质量、降低了职业倦怠,达到护理管理的最佳效果.     

“鲶鱼效应”对护理质量的影响效果研究

[目的]探讨"鲶鱼效应"对护理质量的影响。[方法]将"鲶鱼效应"运用于护理质量管理,制定"鲶鱼护士"的选拔、培养、管理方法,建立科学有效的激励机制。比较实施"鲶鱼效应"前后各项护理质量标准的得分及护士对护理管理满意度得分。[结果]实施"鲶鱼效应",提高了护理质量和护士对护理管理的满意度(P<0.01)。[结论]"鲶鱼效应"运用于护理质量管理,激发了护士的潜能,提高了护理质量。     

“鲶鱼效应”管理在优质护理服务示范工程中的应用

[目的]探讨＂鲶鱼效应＂理论在优质护理服务示范工程中的应用效果。[方法]＂鲶鱼效应＂理论应用于优质护理服务示范工程,比较实施＂鲶鱼效应＂前后病人、护士满意度及临床护理质量改善情况。[结果]实施＂鲶鱼效应＂后,临床护理质量评分、护士及病人满意度均高于实施前（P均〈0.05）。[结论]＂鲶鱼效应＂理论应用于优质护理服务示范工程,通过建立健全的激励机制,激发护士潜能,使护士在良性竞争中,实现自身价值,打造高效护理团队,提升优质护理服务内涵。     

"鲶鱼效应"管理在神经内科护理质量管理中的应用效果

[目的]观察"鲶鱼效应"管理对神经内科护理质量的影响.[方法]将实施"鲶鱼效应"管理前后各病区的基础护理、危重护理、专科护理、护理安全、护理文书、病房管理、患者满意度等方面的护理质量进行比较,评价"鲶鱼效应"管理在护理质量管理中运用的效果.[结果]实施"鲶鱼效应"管理后科室各方面的护理质量较实施前均有明显提高,且在危重护理、专科护理、护理安全、患者满意度等方面优于传统护理.[结论]"鲶鱼效应"管理方法可有效提高神经内科护理质量,且优于传统管理方法,管理方法易于量化,值得推广应用.     

“鲶鱼效应”管理在优质护理服务示范工程中的应用

[目的]探讨"鲶鱼效应"理论在优质护理服务示范工程中的应用效果。[方法]"鲶鱼效应"理论应用于优质护理服务示范工程,比较实施"鲶鱼效应"前后病人、护士满意度及临床护理质量改善情况。[结果]实施"鲶鱼效应"后,临床护理质量评分、护士及病人满意度均高于实施前(P均<0.05)。[结论]"鲶鱼效应"理论应用于优质护理服务示范工程,通过建立健全的激励机制,激发护士潜能,使护士在良性竞争中,实现自身价值,打造高效护理团队,提升优质护理服务内涵。     

“鲶鱼效应”管理在神经内科护理质量管理中应用

[目的]观察神经内科实施"鲶鱼效应"管理对护理质量的影响。[方法]将神经内科4个病区分为观察组和对照组,对照组采取传统的护理管理模式,观察组采取"鲶鱼效应"管理,对各病区的基础护理、危重病人护理、护理安全、护理文书、病房管理、病人满意度进行比较。[结果]实施"鲶鱼效应"管理的两个病区各方面的护理质量较实施前均有明显提高,且在危重病人护理、护理安全、病人满意度等方面优于传统护理管理法。[结论]"鲶鱼效应"管理方法可显著提高神经内科护理质量,且优于传统管理方法。     

“鲶鱼效应”管理在神经内科护理质量管理中应用

[目的]观察神经内科实施“鲶鱼效应”管理对护理质量的影响。[方法]将神经内科4个病区分为观察组和对照组,对照组采取传统的护理管理模式,观察组采取“鲶鱼效应”管理,对各病区的基础护理、危重病人护理、护理安全、护理文书、病房管理、病人满意度进行比较。[结果]实施“鲶鱼效应”管理的两个病区各方面的护理质量较实施前均有明显提高,且在危重病人护理、护理安全、病人满意度等方面优于传统护理管理法。[结论]‘．鲶鱼效应”管理方法可显著提高神经内科护理质量,且优于传统管理方法。     

连续排班联合层级管理对心内科护士护理质量及职业倦怠感的影响研究

目的探究对心内科护士实施层级管理和连续排班对其职业倦怠感和护理质量产生的影响。方法选取2016年4月—2018年10月本院心内科病房的42名护士为研究对象,比较实施层级管理和连续排班制度前后护理质量和职业倦怠感的差异。结果干预后,护士的消毒隔离、基础护理、文书书写等质量评分明显提高,出现护理缺陷次数明显减少,差异有统计学意义(P0.001);干预后护士的MBI-GS评分明显低于干预前,职业倦怠感显著降低(P0.001)。结论连续排班联合层级管理有助于提高心内科护士的护理质量,缓解其职业倦怠感,促进护理人员工作积极性的提高。     

以安全文化理念为基础的柔性管理对夜班值班护士护理质量的影响

目的 探究以安全文化理念为基础的柔性管理对夜班值班护士护理质量的影响。方法 按照内科、外科分层抽样法选取2020年5月—2021年5月本院90名夜班值班护士作为研究对象，将2020年5月—11月45名护士作为对照组，将2020年12月—2021年5月45名护士作为观察组。对照组采用常规培训管理，观察组实施以安全文化理念为基础的柔性管理，观察并比较两组夜班值班护士的护理质量、职业倦怠感及应对方式情况。结果 干预后，观察组护士的护理质量高于对照组(P<0.05);观察组护士的职业倦怠感优于对照组(P<0.05);观察组护士的应对方式优于对照组(P<0.05)。结论 对夜班值班护士实施以安全文化理念为基础的柔性管理，可有效提升夜班值班护士的临床护理质量，一定程度上降低护士职业倦怠感，改善其应对方式，具有较好应用前景。     

Hospital staffing,organization, and quality of care: Cross-national findings

OBJECTIVE: To examine the effects of nurse staffing and organizational support for nursing care on nurses' dissatisfaction with their jobs, nurse burnout, and nurse reports of quality of patient care in an international sample of hospitals. DESIGN: Multisite cross-sectional survey SETTING: Adult acute-care hospitals in the U.S. (Pennsylvania), Canada (Ontario and British Columbia), England and Scotland. Study Participants: 10319 nurses working on medical and surgical units in 303 hospitals across the five jurisdictions. INTERVENTIONS: None Main outcome measures: Nurse job dissatisfaction, burnout, and nurse-rated quality of care. RESULTS: Dissatisfaction, burnout and concerns about quality of care were common among hospital nurses in all five sites. Organizational/managerial support for nursing had a pronounced effect on nurse dissatisfaction and burnout, and both organizational support for nursing and nurse staffing were directly, and independently, related to nurse-assessed quality of care. Multivariate results imply that nurse reports of low quality care were three times as likely in hospitals with low staffing and support for nurses as in hospitals with high staffing and support. CONCLUSION: Adequate nurse staffing and organizational/managerial support for nursing are key to improving the quality of patient care, to diminishing nurse job dissatisfaction and burnout and, ultimately, to improving the nurse retention problem in hospital settings.     

Nursing unit teams matter: Impact of unit-level nurse practice environment,nurse work characteristics,and burnout on nurse reported job outcomes,and quality of care,and patient adverse events—A cross-sectional survey

Aim

To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level.

Background

Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment.

Design

A cross-sectional design with a survey.

Method

In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques.

Results

Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors.

Conclusion

Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development.     

The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement

OBJECTIVE: To test a theoretical model of professional nurse work environments linking conditions for professional nursing practice to burnout and, subsequently, patient safety outcomes. BACKGROUND: The 2004 Institute of Medicine report raised serious concerns about the impact of hospital restructuring on nursing work environments and patient safety outcomes. Few studies have used a theoretical framework to study the nature of the relationships between nursing work environments and patient safety outcomes. METHODS: Hospital-based nurses in Canada (N = 8,597) completed measures of worklife (Practice Environment Scale of the Nursing Work Index), burnout (Maslach Burnout Inventory-Human Service Scale), and their report of frequency of adverse patient events. RESULTS: Structural equation modeling analysis supported an extension of Leiter and Laschinger's Nursing Worklife Model. Nursing leadership played a fundamental role in the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care (vs medical), and nurse/physician relationships. Staffing adequacy directly affected emotional exhaustion, and use of a nursing model of care had a direct effect on nurses' personal accomplishment. Both directly affected patient safety outcomes. CONCLUSIONS: The results suggest that patient safety outcomes are related to the quality of the nursing practice work environment and nursing leadership's role in changing the work environment to decrease nurse burnout.     

Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model

Title. Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model. Aim. The aim of the study was to investigate relationships between nurse practice environment, burnout, job outcomes and nurse‐assessed quality of care. Background. A growing line of work confirms that, in countries with distinctly different healthcare systems, nurses report similar shortcomings in their work environments and the quality of care in hospitals. Neither the specific work environment factors most involved in dissatisfaction, burnout and other negative job outcomes, and patient outcomes, nor the mechanisms tying nurse job outcomes to quality of care are well understood. Method. A Nurse Practice Environment and Outcome causal structure involving pathways between practice environment dimensions and outcome variables with components of burnout in a mediating position was developed. Survey data from 401 staff nurses across 31 units in two hospitals (including the Revised Nursing Work Index, the Maslach Burnout Inventory, and job outcome and nurse‐assessed quality of care variables) were used to test this model using structural equation modelling techniques. The data were collected from December 2006 to January 2007. Results. Goodness of fit statistics confirmed an improved model with burnout dimensions in mediating positions between nurse practice environment dimensions and both job outcomes and nurse‐assessed quality of care, explaining 20% and 46% of variation in these two indicators, respectively. Conclusion. These findings suggest that hospital organizational properties, including nurse–physician relations, are related to quality of care assessments, and to the outcomes of job satisfaction and turnover intentions, with burnout dimensions appearing to play mediating roles. Additionally, a direct relationship between assessments of care quality and management at the unit level was observed.     

Nurse burnout and quality of care: Cross‐national investigation in six countries

We explored the relationship between nurse burnout and ratings of quality of care in 53,846 nurses from six countries. In this secondary analysis, we used data from the International Hospital Outcomes Study; data were collected from 1998 to 2005. The Maslach Burnout Inventory and a single‐item reflecting nurse‐rated quality of care were used in multiple logistic regression modeling to investigate the association between nurse burnout and nurse‐rated quality of care. Across countries, higher levels of burnout were associated with lower ratings of the quality of care independent of nurses' ratings of practice environments. These findings suggest that reducing nurse burnout may be an effective strategy for improving nurse‐rated quality of care in hospitals. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:288–298, 2010     

Gender role attitudes of hospital nurses in Japan: Their relation to burnout, perceptions of physician–nurse collaboration, evaluation of care, and intent to continue working

Aim:  The purpose of the present study is to examine the relationship between gender role attitudes of nurses and burnout, perceptions of physician–nurse collaboration, evaluation of care, and intent to continue working.
Methods:  The subjects of the study were 798 full-time female nurses working in non-managerial positions at three large hospitals. We analyzed five key survey items – gender role attitudes, burnout, perceptions of physician–nurse collaboration, evaluation of care, and intent to continue working – and showed how these items are related using structural equation modeling.
Results:  Whether nurses' gender role attitudes were egalitarian or conservative, we found a direct positive effect on burnout. However, a conservative gender role attitude not only showed a direct positive effect on burnout, but also exhibited a direct negative effect on the intent to continue working and on the collaboration constructs cooperativeness with physicians. Conservative gender role attitudes thus have an indirect positive effect on burnout through the corollaries cooperativeness and intent to continue working. We found that cooperativeness not only has a direct negative effect on burnout, but also an indirect negative effect on burnout through evaluation of care.
Conclusions:  It was found that nurses harboring conservative gender role attitudes are more vulnerable to burnout, and also less likely to improve their quality of care.     

Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records

CONTEXT: Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. OBJECTIVES: To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse-rated quality of care. DESIGN AND SETTING: Cross-sectional analysis combining nurse survey data with discharge abstracts. PARTICIPANTS: Nurses (N=3984) and general, orthopaedic, and vascular surgery patients (N=118752) in 30 English acute trusts. RESULTS: Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient-to-nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in the hospitals with the highest patient to nurse ratios had 26% higher mortality (95% CI: 12-49%); the nurses in those hospitals were approximately twice as likely to be dissatisfied with their jobs, to show high burnout levels, and to report low or deteriorating quality of care on their wards and hospitals. CONCLUSIONS: Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.     

Effects of hospital care environment on patient mortality and nurse outcomes

OBJECTIVE: The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. BACKGROUND: Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. METHODS: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. RESULTS: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. CONCLUSION: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.     

Burnout contagion among intensive care nurses

AIM: This paper reports a study investigating whether burnout is contagious. BACKGROUND: Burnout has been recognized as a problem in intensive care units for a long time. Previous research has focused primarily on its organizational antecedents, such as excessive workload or high patient care demands, time pressure and intensive use of sophisticated technology. The present study took a totally different perspective by hypothesizing that--in intensive care units--burnout is communicated from one nurse to another. METHODS: A questionnaire on work and well-being was completed by 1849 intensive care unit nurses working in one of 80 intensive care units in 12 different European countries in 1994. The results are being reported now because they formed part of a larger study that was only finally analysed recently. The questionnaire was translated from English to the language of each of these countries, and then back-translated to English. Respondents indicated the prevalence of burnout among their colleagues, and completed scales to assess working conditions and job burnout. RESULTS: Analysis of variance indicated that the between-unit variance on a measure of perceived burnout complaints among colleagues was statistically significant and substantially larger than the within-unit variance. This implies that there is considerable agreement (consensus) within intensive care units regarding the prevalence of burnout. In addition, the results of multilevel analyses showed that burnout complaints among colleagues in intensive care units made a statistically significant and unique contribution to explaining variance in individual nurses' and whole units' experiences of burnout, i.e. emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, for both emotional exhaustion and depersonalization, perceived burnout complaints among colleagues was the most important predictor of burnout at the individual and unit levels, even after controlling for the impact of well-known organizational stressors as conceptualized in the demand-control model. CONCLUSION: Burnout is contagious: it may cross over from one nurse to another.