Competency-based management effects on satisfaction of nurses and patients

PurposeTo evaluate the effect of competency-based management in improving nurse and patient satisfaction.MethodsAccording to the competency-based management objectives and principles, 821 nurses were classified into different levels based on clear nurse qualifications and post responsibilities. According to the different levels of nursing staff and training plans with different emphases, the goal was for the nursing staff to gradually achieve the corresponding level. Targeted training programs for different levels of nurses were formulated to enable nurses to gradually increase their competency levels.ResultsAfter implementation of competency-based management, nurse job satisfaction and patient satisfaction increased significantly (P < 0.01). Additionally, the reported nurse job burnout decreased (P < 0.01).ConclusionCompetency-based management can promote nurses' enthusiasm, reduce job burnout, improve job satisfaction, as well as improve patient satisfaction.     

Hospital nursing organizational factors,nursing care left undone,and nurse burnout as predictors of patient safety: A structural equation modeling analysis

BackgroundPromotion of patient safety is among the most important goals and challenges of healthcare systems worldwide in countries including China. Donabedian’s Structure-Process-Outcome model implies that patient safety is affected by hospital nursing organizational factors and nursing care process. However, studies are imperative for a clear understanding about the mechanisms by which patient safety is affected to guide practice.ObjectiveThe objective of this study was to explore the impact of hospital nursing work environment, workload, nursing care left undone, and nurse burnout on patient safety.DesignThis was a cross-sectional study conducted in 23 hospitals in Guangdong province, China in 2014. Data from nurses (n = 1542) responsible for direct care on 111 randomly sampled medical and surgical units were analyzed.MethodsWork environment was measured by the Practice Environment Scale of Nursing Work Index. Workload was measured by day shift unit patient-nurse ratio and non-professional tasks conducted by nurses. Nursing care left undone was measured by 12 items addressing necessary nursing activities. Nurse burnout was measured by the emotional exhaustion subscale of the Maslach Burnout Inventory-Human Services Survey. Patient safety was measured by three items indicating nurses’ perception of overall patient safety and nine items addressing patient adverse events. Structural equation modeling was used to examine a hypothesized model that supposed work environment and workload have both direct and indirect effects on patient safety through nursing care left undone and nurse burnout.ResultsThe findings generally supported the hypothesized model. Better work environment was associated with better patient safety both directly and indirectly. Lower workload primarily indirectly related to better patient safety. Nursing care left undone and nurse burnout were mediators negatively associated with patient safety.ConclusionsImproving work environment, increasing nurse staffing levels, and providing sufficient support for nurses to spend more time on direct patient care would be beneficial to patient safety improvement.     

Effects of Trait Anger and Anger Expression on Job Satisfaction and Burnout in Preceptor Nurses and Newly Graduated Nurses: A Dyadic Analysis

PurposeThe preceptor–newly graduated nurse (NGN) relationship is integral to the successful experience of clinical teaching and learning and new nurses' transition. However, interpersonal conflicts between them are common. Little is known whether their anger contributes to their level of job satisfaction and burnout. This study aimed to examine the effects of each nurse's anger on job satisfaction and burnout in preceptor–NGN dyads.MethodsA cross-sectional, correlational survey design was used. This study involved 121 preceptor–newly graduate nurse dyads in two hospitals in South Korea. Nurses completed a questionnaire about demographics, the State-Trait Anger Expression Inventory-Korean version, a job satisfaction measure, and the Copenhagen Burnout Inventory. This study adopted the Actor-Partner Interdependence Model to handle dyadic data.ResultsPreceptor nurses reported higher frequencies of feeling anger than did new nurses and appear to have higher levels of trait anger, anger-out, and burnout. Both the preceptors' and NGNs' trait anger was positively associated with preceptors' burnout. Suppressing anger was closely related to the nurses’ own job satisfaction and burnout. Preceptors with a higher level of anger-control had higher job satisfaction, and NGNs with a higher level of anger-control had less burnout.ConclusionThe results indicate that preceptors and new nurses appear to experience significant anger, which is closely associated with their job satisfaction and burnout during their preceptorship. Anger management training programs geared toward educating both preceptors and new nurses about appropriate anger expression in the workplace should be developed to retain valuable nurses.     

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 value of intentional self-care practices: The effects of mindfulness on improving job satisfaction,teamwork, and workplace environments

BackgroundBurnout rates among nurses have detrimental impact on job satisfaction, teamwork, and patient care. This costs millions of dollars in the healthcare system and challenges nurse leaders to address in order to keep up with the healthcare demands. Furthermore, burnout is especially relevant in our current healthcare climate, as frontline nurses have increased workload and multiple psychosocial stressors during the coronavirus disease (COVID-19) pandemic (Sultana, Sharma, Hossain, Bhattacharya, & Purohit, 2019). Literature also suggests that mindful self-care practices need to be reinforced in order to impact burnout long term (Chamorro-Premuzic & Lusk, 2017). Project7 Mindfulness Pledge© is an accessible and voluntary mindfulness tool that nurses can utilize in their individual practice to reduce burnout and does not require significant time commitment.ObjectiveTo evaluate the effectiveness of intentional self-care practices on nurse burnout and workplace environment by measuring job satisfaction and teamwork among nurses.MethodsComparisons between inpatient units on data from the National Database of Nursing Quality Indicators (NDNQI) with the Practice Environment Scale (PES), specifically on job enjoyment and teamwork, were done utilizing ANOVA.ResultsResults show that nurses in an inpatient unit that implemented Project7 has significantly higher job satisfaction as compared to units that did not implement Project7.ConclusionsThis suggests that this tool provides an effective and accessible mindfulness framework managers and directors can utilize to improve job satisfaction, teamwork, and thereby reduce burnout to create healthier work environments.     

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.     

Work-related stress,job satisfaction,and quality of work life among cardiovascular nurses in Italy: Structural equation modeling

AimTo investigate the simultaneous effects of work-related stress and job satisfaction on cardiovascular nurses' quality of work life.BackgroundPrior research has investigated nurses' work-related stress, job satisfaction, and quality of work life as separate aspects and not in specific nursing settings, such as cardiovascular wards. Cardiovascular care settings can be particularly stressful for nurses, who are often faced with distress, depression and patients and caregivers' physical and psychological exhaustion.MethodsA multicenter cross-sectional study was conducted among 1126 cardiovascular nurses from 10 hospitals in Italy. Work-related stress, job satisfaction, and quality of work life were measured using valid and reliable questionnaires. Structural equation modeling was performed.ResultsNurses working in critical cardiac care units experienced more stress than their colleagues working in other cardiac units. Nurses working in cardiac outpatient clinics reported lower quality of work life than those working in other cardiac settings. There was a negative relationship between work-related stress and nurses' quality of work life, which was partially mediated by job satisfaction, indicating that stress generated by the work environment negatively affect nurses' quality of work life by reducing their job satisfaction.ConclusionCardiovascular nurses' quality of work life is negatively affected by work-related stress. The work-related stress is mediated through job satisfaction. Nurse managers should maximize nurses' job satisfaction by providing comfort at work, supporting professional development opportunities, sharing organizational objectives, and actively listening and addressing nurses' concerns. When cardiovascular nurses' quality of work life is elevated, patients' care quality and outcomes are improved.     

Resilience of nurses at the epicenter of the COVID-19 pandemic in Lebanon

ObjectiveThe study aimed to investigate the level and factors associated with the resilience of nurses practicing at the main COVID-19 referral center in Lebanon.MethodsThe study utilized a cross-sectional survey design. Data were collected electronically in the spring of 2020 from 265 nurses. The questionnaire included five sections: demographic characteristics, job satisfaction, turnover intentions, exposure to violence, and resilience levels. Multiple linear regression was used to determine factors associated with resilience.ResultsResults showed that the overall score of resilience among nurses was 66.91 ± 13.34. Most nurses were satisfied with their job (67.8%), and most nurses reported that it is unlikely for them to quit their present work in the coming year (76.2%). Over the last year, three-quarters of nurses (74.7%) reported being ever exposed to a form of occupational violence. The resilience of nurses was directly associated with job satisfaction and male gender and inversely associated with intention-to-quit and exposure to violence (P < 0.05).ConclusionsEnhancing the resilience of nurses at the frontline of the COVID-19 pandemic improves their job satisfaction and retention and would help support the effectiveness and efficiency of care services. Nurse managers can regularly investigate the resilience of nurses and offer interventions that would strengthen it, especially at times of crisis.     

Nurses' experience of adjusting to workplace violence: A theory of adaptation

Workplace violence directed at nurses working in both the mental health and general areas of the hospital is a common occurrence and the impact of these events on all parties may be severe. A consequence of these confronting situations is the possibility that nurse victims will leave the profession. To help administrators facilitate nurses' psychological recovery, this qualitative study identified how nurses in several areas of a hospital setting adapted to workplace violence, research which has been previously unexamined. This study was the first of its kind to use a theory of cognitive adaptation to explore nurses' experiences of workplace violence. Participants were found to use the cognitive processes of finding meaning, gaining mastery and enhancing the self to adapt to workplace violence. Critical incident debriefing may facilitate the nurse victim's psychological recovery following an episode of workplace violence.     

Conferences,Courses & Events

Abstract

This paper introduces expressive writing as a new tool to build psychological resilience in nurses by helping them to reduce the negative impact of the primary sources of stress in their jobs. Delivering care to patients exposes nurses to intense stressors including staffing and workload problems, communication breakdowns, death, bereavement, and medical error. Not surprisingly, these conditions contribute to job dissatisfaction and burnout which are primary causes of nurse turnover. There is an acute need for low cost and simple interventions that enhance nurses' coping with problems leading up to burnout and turnover. We found almost 2 out of 3 RNs reported trouble sleeping, almost half reported feeling burned out, and 1 out of 4 were depressed. Expressive writing has been widely used and is well validated in many non-nursing populations in helping people cope more effectively with job-related stress and traumatic events. Writing improves health in several ways. One way is through exposure, the process by which difficult emotions become less potent and more manageable. Second is cognitive restructuring, which brings about new ways of thinking about stress that makes painful events less upsetting. Third is improved self-regulation, which is the ability to cope with and regulate one's emotions. The well-being of nurses directly affects the quality of patient care. Expressive writing is a time-efficient and easy-to-use intervention to help nurses cope with job upheavals in an effort to reduce job distress, turnover and, ultimately, improve the work environment and patient outcomes.     

Violence in hospitals and burnout among nursing staff

BackgroundNursing staff, especially in violence-prone emergency departments (ED), are at high risk of burnout. Frequently experienced violence is expected to have a strong impact on the nursing staff's burnout. This study aimed to examine the differences in the level of burnout between nursing staff who work in the ED and nursing staff who work in other inpatient departments, and its relationship with violence in various hospitals in Israel.MethodA cross-sectional study that utilized a three-part questionnaire: demographic data, degree of burnout, and frequency occurrence of violence events against nurses.Results150 nurses in EDs (N = 75) and inpatient departments (N = 75) were sampled. Significant differences were found between the two groups: Nurses in EDs experienced a higher degree of burnout than nurses in other hospital departments, and the degree of burnout was found to have a positive relationship with exposure to both verbal and physical workplace violence.ConclusionsNursing staff in EDs could develop a high degree of burnout, and exposure to workplace violence could exacerbate it. The physical and emotional safety of the staff is an important aspect in preventing burnout, and creating a secure work environment.     

Exploring the relationships among training needs,willingness to participate and job satisfaction in disaster nursing: The mediating effect of achievement motivation

ObjectivesDisaster nursing competencies and their willingness to participate are essential for the success of disaster relief nurses. This study investigates the correlations among emergency room and intensive care unit nurses' training needs, willingness to participate, achievement motivation and job satisfaction as well as their mutual influences on disaster relief efforts.MethodsA convenience sampling cross-sectional study was conducted, where 488 emergency room and intensive care unit nurses from five hospitals in Taiwan participated (response rate: 84.4%). The relationships among the variables were verified using structural equation modelling.ResultsTraining needs in disaster nursing were found to be positively correlated with willingness to participate and job satisfaction. Moreover, willingness to participate was found to be positively correlated with achievement motivation and job satisfaction. Achievement motivation was found to be positively correlated with job satisfaction. Furthermore, willingness to participate in disaster relief was found to indirectly mediate job satisfaction through achievement motivation.ConclusionsThe fulfilment of training needs for disaster nursing and willingness to participate may have an impact on nurses' job satisfaction through the mediating effect of achievement motivation. Nurses' learning needs should be the foremost consideration in disaster nursing training to alleviate human resource shortages and improve disaster responses. These findings can serve as a reference for increasing preparedness training for nurses in disaster management.Relevance to clinical practiceNurses substantially contribute to the progression of disaster relief and postdisaster reconstruction. Successful and effective disaster management relies on sufficient nurse responses and training preparedness. Nurses' willingness to participate and achievement motivation in disaster nursing can have an impact on their job satisfaction and alleviate distress for both themselves and patients for the purpose of disaster relief.     

患者暴力事件对肿瘤医院护士工作满意度的影响

目的探讨肿瘤医院患者暴力事件及护士工作满意度的相关性,分析影响护士工作满意度的因素。方法采用一般资料问卷、患者暴力事件量表和护士工作满意度量表对肿瘤医院306名护士进行问卷调查。结果患者暴力事件评分为(10.07±3.62)分,肿瘤医院护士工作满意度评分为(114.26±31.59)分,二者呈负相关(P0.01),肿瘤医院护士职称和患者暴力事件为工作满意度的主要影响因素(P0.01)。结论肿瘤医院患者暴力事件发生率较高,医院管理者应采取针对性措施,降低患者暴力事件的发生率,改善护士的工作满意度和护理质量。     

Job dissatisfaction and burnout of nurses in Hunan,China: A cross‐sectional survey

In this study, we focused on measuring levels of nurse burnout and job dissatisfaction in the daily practice of nurses in Hunan province, China, analyzed factors related to nurse burnout and job dissatisfaction, and explored the relationship between them. Previous studies have shown a high level of burnout and job dissatisfaction among nurses worldwide. A cross‐sectional survey of 1100 nurses was conducted. The nurses worked at 20 hospitals in 11 cities and counties throughout China's Hunan province. Nurse burnout was measured by the Maslach Burnout Inventory. Nurse‐rated job dissatisfaction was described using a four point scale, and work environment was measured using the Nursing Work Index – Practice Environment Scale. The results showed that nurses had high burnout scores and were dissatisfied with their jobs. Staffing, work environment, and work hours were all significantly associated with nurse burnout and job dissatisfaction. Adequate staffing, improved work environment, and reasonable work hours are related to decreasing nurse burnout and job dissatisfaction.     

Effect of transformational leadership on job satisfaction and patient safety outcomes

Background

Improving patient safety within health care organizations requires effective leadership at all levels.

Addressing a Key Leadership Challenge: Workplace Violence

Workplace violence is a growing concern among health care workers, especially staff working in emergency departments. Emergency department leaders have oversight accountability that includes mitigation of workplace violence risks and staff education related to workplace violence prevention. Challenges associated with workplace violence events include disruption of safe patient care, decreased staff job satisfaction, and increased turnover. Improving safety for staff, patients, and visitors requires a culture focused on safety. A summary of current regulations, standards, and resources available to date is provided, including a list of mitigation strategies that can be easily translated into practice by emergency nurse leaders.     

The role of job satisfaction,work engagement,self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction

BackgroundNurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs.ObjectivesThis research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction.Setting and participantsThis study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy.ResultsCorrelation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention.ConclusionResults highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.     

A research regarding the relationship among intensive care nurses' self-esteem,job satisfaction and subjective well-being

ObjectiveThe paper aims to explore the status of intensive care unit (ICU) nurses' self-esteem, job satisfaction, and subjective well-being and to investigate the relationship among the three elements.MethodsA cross-sectional survey of 224 nurses from five teaching hospitals in Tianjin, China, was conducted. Self-esteem scale, job satisfaction scale, and subjective well-being scale were used to explore the status of ICU nurses' self-esteem, job satisfaction, and subjective well-being. Correlation among the three elements was calculated by SPSS 17.0.ResultsThe scores of three scales (i.e., ICU nurses' self-esteem, job satisfaction, and subjective well-being) were 27.67 ± 3.41, 43.57 ± 9.04, and 69.73 ± 11.60, respectively. The subjective well-being was significantly positively correlated with self-esteem and job satisfaction (r = 0.454, P < 0.01; r = 0.584, P < 0.01, respectively).ConclusionThe study shows that the prevalence of subjective well-being and self-esteem with ICU nurses are at a low level, and job satisfaction is at the median level. Associations among self-esteem, job satisfaction, and subjective well-being in ICUs have been confirmed. Self-esteem and job satisfaction positively correlated with nurse subjective well-being. The higher the self-esteem and job satisfaction levels are, the stronger the subjective well-being is. The working pressure in ICUs cannot be alleviated temporarily; hence, to promote a high subjective well-being, managers and ICU nurses increase their self-esteem and job satisfaction through taking strategies that strengthen psychological construction.