The Impact of Organizational Support on Practice Outcomes in Nurse Practitioners in Taiwan

Abstract

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.

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

“…We also found several work‐related variables with links with job satisfaction. For example, a higher patient load reduced job satisfaction, which was in line with previous studies (Ho et al, 2021; Steinke et al, 2018). To boost job satisfaction, organisations need to ensure sufficient manpower and reasonable workloads, thereby decreasing stress or burnout in practice and contributing to the exceptional effectiveness of organisations (Hoff et al, 2019).…”

“…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, expansion could reduce the workload and job demands for NPs (Hoff et al, 2019). A recent study documented that Taiwan NPs are generally faced with a high patient workload and little support from managers, which impacts job satisfaction in acute care practices (Ho et al, 2021). The complex nature of the work requires effective leadership to create an organisational structure that monitors NPs' job satisfaction, develops their knowledge and clinical skills, and builds coping abilities so they can survive the stressful demands of their work.…”

“…It also provides a level of satisfaction for NPs (Misener & Cox, 2001). Studies with a national sample showed that the level of job satisfaction among NPs in hospitals ranges from unsatisfied to slightly satisfied in Taiwan (Ho et al, 2021; Luo et al, 2021). Another study documented that NPs who work in hospitals are not satisfied with their work, mainly due to inadequate organisational support (Ho et al, 2021).…”

“…Studies with a national sample showed that the level of job satisfaction among NPs in hospitals ranges from unsatisfied to slightly satisfied in Taiwan (Ho et al, 2021; Luo et al, 2021). Another study documented that NPs who work in hospitals are not satisfied with their work, mainly due to inadequate organisational support (Ho et al, 2021). Organisational support and available resources have associations with higher job satisfaction, lower odds of leaving and higher quality of care (Poghosyan et al, 2020).…”