Background: Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave. Purpose: This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices. Methodological orientation: This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression. Results: The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction. Conclusions: Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan. Implications for practic: To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system.

Background Nurse practitioners (NPs) in Taiwan have practiced mainly in acute care hospitals since 2006. Although organizational support and level of support have been associated with the successful integration of NP roles and effective practice outcomes, organizational support in the context of NPs in inpatient settings is an area that has been rarely explored in the literature. Purpose The purpose of this study was to investigate the relationship between organizational support and the practice outcomes of job satisfaction, care effectiveness, and intention to leave in NPs. Methods A national survey of 512 NPs was conducted that included a demographic characteristics datasheet, the Nurse Practitioner Primary Care Organizational Climate Questionnaire, the Misener Nurse Practitioner Job Satisfaction Scale, and the Nurse Practitioner Care Effectiveness Scale. Multiple regression analysis was applied to explore the specific factors associated with job satisfaction. The statistical significance level was set at .05 with a two-tailed test. All statistical analyses were conducted using SPSS Statistics Version 22.0 software. Results More than half of the participants were found to be dissatisfied with their hospital managers (54.8%) and with each dimension of organizational support. Overall, 82.1% of the participants were satisfied with their current practice. A multiple regression analysis showed that the participants who perceived higher levels of organizational support in the workplace (β = .53, p < .001), expressed satisfaction with working with their managers (β = .25, p < .001), or perceived better care outcomes (β = .10, p < .001) reported higher job satisfaction. In addition, the participants who expressed intention to leave within 1 year (β = −.09, p < .001) and those with higher patient loads (β = −.09, p < .001) reported lower job satisfaction. Organizational support was found to explain 50% of the variance in job satisfaction. Conclusions/Implications for Practice The results of this study highlight organizational support as the most important factor affecting job satisfaction in NPs. Therefore, administrators work to promote organizational support and improve the work environment to enhance the job satisfaction, increase the clinical practice retention, and improve the care outcomes of NPs.

Background: Colonoscopy is considered a safe and effective tool for detecting colorectal cancer. Nevertheless, the proportion of patients are hesitating to receive colonoscopy. Smartphone education may decrease the barrier of colonoscopy. The aim of this study is to examine the effectiveness of smartphone education in colonoscopy. Methods: We conducted a prospective, double-blinded, randomized, controlled study to examine the effectiveness of smartphone education on embarrassment, bowel preparation, and satisfaction in colonoscopy. The patients’ embarrassment was measured by the colonoscopy embarrassment scale. The quality of the bowel preparation was evaluated by gastroenterologists according to the Aronchik Scale. The satisfaction of colonoscopy care was assessed by a satisfaction scale developed by the authors. Results: A total of 150 patients were analyzed in the smartphone education and control groups (n = 75 in each group). The smartphone education group reported fewer embarrassment ( B = −2.78, P = .02) than those of the control group, the patients who were older ( B = .15, P = .001) and who were male ( B = 2.91, P = .003) showed higher embarrassment. Additionally, smartphone education group were likely to have better colon preparation (odds ratio = 2.46, 95% confidence interval: 1.20–5.02) than that of the control group. Smartphone education also improved the satisfaction with care ( β = 4.60, P < .001), and above normal body mass index decreased the satisfaction with care ( β = −0.19, P < .05). Conclusion: Smartphone education improves embarrassment, bowel preparation, and satisfaction with care in patients receiving colonoscopy.

Background: Little is known regarding the factors that affect the team-based practice of nurse practitioners (NPs). Examining the relationships between these factors and team-based practice may provide important insights into the strength of the NP practice.Purpose: This study was designed to examine the effects of practice autonomy and leadership style on the team-based practice of acute care NPs working in hospitals.Methods: A cross-sectional, national survey design was conducted to examine the autonomy, leadership, and team-based practice of NPs. One thousand three hundred ninety-one NPs completed the questionnaire, which included demographic and practice variables, the Dempster Practice Behavior Scale, the Multifactor Leadership Questionnaire, and the NP-physician relations subscale of the Nurse Practitioner Primary Care Organizational Climate Questionnaire. The hierarchical linear model was used to differentiate between the NP-level and organization-level effects on team-based practice. Multiple regression was applied to explore the factors associated with team-based practice. Results:The hierarchical linear model results identified no organizationlevel effect on team-based practice. Moreover, the results of the regression model found that NPs with greater autonomy in actualization, empowerment and readiness, and idealized influence leadership style enhanced the performance of the doctor of medicine-NP team-based practice. The final model explained 39% of the variance in doctor of medicine-NP team-based practice. Autonomy in actualization and empowerment were identified as the two most important predictors.Conclusions/Implications for Practice: The practice autonomy and leadership style of NPs influence the efficiency of team-based practice in Taiwan. To improve the team-based practice of NPs, healthcare administrators must support the practice autonomy of NPs.

Background Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout. Methods Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction. Results The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction. Conclusions This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs’ job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.