Work environment and accreditation: analysis by mixed explanatory sequential method

Abstract

Objective: To analyze the - possible - interference of Accreditation in the work environment of the nursing team. Method: Mixed explanatory sequential method study. The first (preponderant) quantitative phase of the research was the application of the Brazilian version of Nursing Work Index Revised (B-NWI-R) to a representative sample (n = 226) of nursing workers from three hospitals, one of them being certificate of excellence by national Accreditation and two unsealed hospitals. After descriptive analysis of the data, it was possible to connect the information, which culminated in the data collection, through interviews (n = 39), of the second (qualitative) stage of the mixed research. The final analysis included the application of inferential statistics and qualitative analysis by the Collective Subject Discourse (DSC), connected in the B-NWI-R dimensions. Results: There was no statistically significant association in the comparisons. However, the results presented better in the certified hospital, ratifying the DSC of this institution. Conclusion: Accreditation did not significantly interfere with nursing staff perception of the work environment.

The environment of the nursing team's professional practice in inpatient units of a university hospital

“…The process of working in hospital nursing involves daily complex decisions and attitudes that ensure viability of care (7) . In the perspective of contextualizing this theme, many studies were conducted with the objective of identifying and analyzing the professional practice environment of the nursing team and how much it can affect care quality (4,6,(8)(9) .…”

Quality improvement programs and the professional nursing practice environment: an integrative review

“…Of ten surveys composing the review, three (15)(16)22) applied questionnaires to the entire nursing staff, which two of them (16,22) were conducted in Brazil; in the other the questionnaire were only applied to nurses. This finding makes us reflect on the importance of investigating the environment for all nursing professionals: due to the class professional power structure, the direct leader of the assistants and technicians is unit's nurse, who, in turn, is led by a higher management.…”

“…In all surveys, the practice environment was evaluated using scale-based instruments (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) , such as NWI-R, PES and HWEA. We will address each one below.…”

“…The NWI-R derived from the Nursing Work Index (NWI), it is the most applied instrument in different cultures and practice environments and has already been translated and adapted to various locations around the world. It consists of 57 items arranged in four sub-scales: autonomy, control over the work environment, relationship between nurse and physicians and organizational support (14)(15)17,(22)(23)(24) .…”

“…An accredited institution is seen as a symbol of quality and high standards of management and assistance, ensuring its space and recognition within the list of institutions of excellence/gold standard. Accreditation programs provide a range of assessments based on classical quality management principles and management strategies, systematically leading to improvements in the health care service (14)(15)(22)(23) .…”