Organizational empowerment and practice outcomes of acute care nurse practitioners in Taiwan: A national survey

Abstract

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.

The impact of organisational commitment and leadership style on job satisfaction of nurse practitioners in acute care practices

“…We used the TANP database to ensure all eligible NPs were approached. Nevertheless, this comes with the issue of a 20.19% response rate, which is comparable with other survey designs (Luo et al, 2021). Thus, the representativeness of the sample might be minimal and there might be sampling bias.…”

“…Brown et al (2019) pointed out that organisations with high organisational commitment are more likely to develop a healthy organisational climate, which motivates staff to achieve common goals and cohesion in the organisation, because they are empowered in their practice. Study results revealed that NPs perceived insufficient levels of organisational commitment for acute care practices, which might be explained by regulations requiring NPs to be supervised by and collaborate with physicians as they practice in Taiwan (Luo et al, 2021).…”

“…Study results revealed that NPs perceived insufficient levels of organisational commitment for acute care practices, which might be explained by regulations requiring NPs to be supervised by and collaborate with physicians as they practice in Taiwan (Luo et al, 2021). Each hospital has its own administrative system, so NP practices vary in each organisation, which could further limit NPs' contributions to the health care of older adults (Poghosyan et al, 2017).…”

“…Personal characteristic and practice factors might have links with the job satisfaction of NPs. For example, age, gender and years of NP practice might influence job satisfaction (Luo et al, 2021). Conversely, a higher patient load and prolonged working hours had negative associations with job satisfaction (Ho et al, 2021; Steinke et al, 2018).…”

“…Types of practices (Poghosyan et al, 2017) and shift work (Ball et al, 2017) also influenced job satisfaction. Likewise, one recent study noted that annual salary had a positive association with job satisfaction (Luo et al, 2021). These elements need to be taken into consideration when examining factors associated with job satisfaction.…”