The professional practice environment : hospital nurses' perspectives in three European countries
Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: During recent years European countries have faced ongoing organizational changes in their health care systems.Successful organizational redesign initiatives seek to improve the quality care, health and institutional outcomes.Numerous studies have shown relationships between work environment, registered nurses' (RNs') job satisfaction and retention, as well as patient safety outcomes.Most of the studies that reflect these matters have been conducted in the USA and Canada.The purpose of this study was to examine RNs practice environment in hospital settings in Estonia, Finland and The Netherlands.Furthermore, to investigate the relationships between RN practice environment and nurse reported job and patient outcomes, as well as to assess the effects of various staffing patterns (nurse to patient ratios) on patient outcomes in Finnish and Dutch hospitals.Data were collected from RNs working in hospital settings in three European countries: Finland (n=535), The Netherlands (n=334) and Estonia (n=478).The original questionnaire used in this study for data collection in Finland and The Netherlands was initially developed in Finnish, and included the international Nursing Work Index -Revised (NWI-R) instrument.The Estonian data included covered only the statements of the NWI-R instrument together with background variables.In data analysis descriptive statistics, factor and regression analysis, t-and chi-square tests, analysis of variance and Kruskal-Wallis H test were used.The presence of supportive management was identified most frequently as an important RN practice environment characteristic across the datasets.In addition, teamwork, adequacy of resources and assurance of quality care were found to be significant and common across participating countries.Participants from Finland expressed more critical views towards their practice environment than their colleagues from The Netherlands and Estonia.Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings.Shortcomings in resources and support referred to the negative correlations with job intentions.The incidence of patient adverse events were related to the staffing levels, and thus proved to be a nurse-sensitive patient outcome, irrespective of the country and the health care practices.This study has brought new evidence on the state of RN practice environment and its connection to several nurse-and patient outcomes.RNs' evaluations of their practice environment identified both positive as well as challenging features of nurses' everyday practice, specific to an individual country, and presented in European context comparison.Improving RNs' professional practice environment is an essential national as well as international challenge that needs to be tackled, especially due to the nursing workforce shortage.Additional research on and continuous monitoring of RNs' perceptions of their practice environment, including the adequacy of staffing levels, should be conducted systematically, and the gained information used, when making decisions affecting the nurses' working environment at the hospital level, as well as in strategic level both nationally and internationally.Studies with longitudinal designs and alternative data collection methods and sources must be implemented.
Author: Saima Hinno
Language: English
Subfield: Research and Theory
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3097182001