Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country,multilevel study

BackgroundNursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied.ObjectiveThe aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction.DesignMultilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied.ResultsRegarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied.ConclusionsWe conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries.     

情景模拟教学法在低年资护士基础生命支持培训中的应用

目的探讨情景模拟教学法对急诊科低年资护士基础生命支持培训的实践效果和应用体会。方法应用情景模拟教学法对我科24名N0、N1级护理人员进行理论和操作培训,培训结束后予以考核。并对培训前后急诊临床教学质量及各级医护人员的满意度进行评价。结果自实行情景模拟教学法培训以来,护理人员的心肺复苏考核成绩较前有较大提升(P0.01);各级医护人员的满意度均有所提高,受训护士自身满意度与情景模拟教学培训前比较,差异有统计学意义(P0.05)。结论情景模拟教学因材施教,效果显著,增进了急诊科教学效果,提高了急诊教学满意度。