Structural characteristics of hospitals and nurse‐reported care quality, work environment, burnout and leaving intentions

Abstract

Structural characteristics of hospitals and nurse-reported care quality, work environment, burnout and leaving intentions Aim To investigate whether hospital characteristics not readily susceptible to change (i.e. hospital size, university status, and geographic location) are associated with specific self-reported nurse outcomes. Background Research often focuses on factors within hospitals (e.g. work environment), which are susceptible to change, rather than on structural factors in their own right. However, numerous assumptions exist about the role of structural factors that may lead to a sense of pessimism and undermine efforts at constructive change. Method Data was derived from survey questions on assessments of work environment and satisfaction, intention to leave, quality of care and burnout (measured by the Maslach Burnout Inventory), from a population-based sample of 11 000 registered nurses in Sweden. Mixed model regressions were used for analysis. Result Registered nurses in small hospitals were slightly more likely to rank their working environment and quality of nursing care better than others. For example 23% of staff in small hospitals were very satisfied with the work environment compared with 20% in medium-sized hospitals and 21% in large hospitals. Registered nurses in urban areas, who intended to leave their job, were more likely to seek work in another hospital (38% vs. 32%). Conclusion While some structural factors were related to nurse-reported outcomes in this large sample, the associations were small or of questionable importance. Implications for nursing management The influence of structural factors such as hospital size on nurse-reported outcomes is small and unlikely to negate efforts to improve work environment.

Intention to leave the workplace among nurses working with cancer patients in acute care hospitals in Sweden

“…This collaborative nursing workforce study involving 16 countries worldwide included a nurse survey, an optional patient survey (not carried out in Sweden) and an organizational survey (www.rn4cast.eu/en/ index.php) and has been described in depth elsewhere (Aiken et al, 2014;Lindqvist et al, 2015;Sermeus et al, 2011). The primary aim of RN4CAST was to introduce innovative workforce forecasting methods addressing characteristics of both nursing staff and work environment with attention given to effects on patient care (Sermeus et al, 2011).…”

Factors Associated With Provider Burnout in the NICU

“…among people less familiar with their coworkers. 23 Furthermore, the association of nursing burnout with average number of daily admissions suggests that the nursing workload associated with a new admission may be underappreciated, creating the potential for relative understaffing. 24 Although there is a paucity of published data on the subject, 25 new admissions may necessitate more rapid and efficient decisionmaking, increased intellectual effort to address diagnostic uncertainty, and emotional expenditure related to engaging and orienting new family members.…”

Occupational Burnout Syndrome in the nursing context: an integrative literature review

“…Furthermore, emergency rooms and palliative care units are the least investigated sites probably due to difficulties in research operationalization (14,41,57,102) , although a small concentration of studies on OBS in intensive care nurses can be found (19,22,(39)(40)(92)(93) . Still, the need for further investigations on OBS in professionals from acute care (59,62) and psychiatric ward units (57,86) is clear, given that these are places which in theory present greater risks in relation to the syndrome due to the type of work performed and the attended patients.…”

“…Studies rely on samples ranging from 11 to 11,000 participants, and because there is no standard for measuring the syndrome, it is not possible to conduct a more categorical assessment of the results. However, by analyzing the mean scores of some studies, in most cases it can be noticed that nursing professionals manifest low-moderate EE, low DS and moderate PA (2)(3)17,19,23,(27)(28)30,34,36,(49)(50)(51)(52)(53)(54)57,(59)(60)(62)(63)(64)(73)(74)(75)(76)(77)(78)(79)(81)(82)(83)(84)(85)(86)91,(93)(94)101,105) . Nursing technicians and assistants have higher levels of the syndrome compared to nurses, although this difference is small (10,13,50,91) .…”

“…The studies applied the MBI and the Practice Environment Scale of the Nursing Work Index (PES-NWI). The latter measures the presence of variables related to the nurses' work environment (56)(57)(58)(59)(60)(61)(62)(63) . The PES-NWI and the MBI have already been revalidated into the Portuguese language and applied in Brazilian investigations (19,49,87) .…”