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Practice Environment (practice + environment)
Kinds of Practice Environment Terms modified by Practice Environment Selected AbstractsHEALTH POLICY AND SYSTEMS: Critical Thinking of Nurse Managers Related to Staff RNs' Perceptions of the Practice EnvironmentJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2010NEA-BC, Susan Zori RN Abstract Background Information and Significance: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Research Question: Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? Design: A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Findings: Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Conclusions: Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Clinical Relevance: Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care. [source] The problem of postoperative pain: Issues for future researchINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2004Mari Botti RN DipNsg BA PGDCAP PhD MRCNA Uncontrolled postoperative pain continues despite abundant research in the area. The purposes of the paper are to review how past research influences our understanding of pain in the postsurgery context and to argue for a methodological shift towards naturalistic inquiry. Such a shift incorporates the complexities of pain assessment and management in the clinical practice environment. Decisions regarding pain are often examined outside of the contextual concerns of clinical practice. Research approaches have involved analyses of nurse and patient-related factors associated with pain. These approaches do not account for complex interactions that occur between nurses, patients and the dynamic environment in which these interactions take place. The failure of research to address the context of pain decisions has several implications. It limits our understanding of why pain continues despite ongoing research and it does not enable evaluation of clinical strategies to improve pain decision-making and pain outcomes for patients. [source] Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation unitsINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 1 2009Geraldine McCarthy MSc Background., Bladder and bowel incontinence is a major health care problem, which adversely affects the lives of many individuals living at home or in health service facilities. Current approaches to continence care emphasize comfort, safety and reduction of risk, rather than detailed individualized assessment and management. The literature illustrates a gap between evidence and actual practice and emphasizes the context of care as being a key element for successful implementation of evidence based practice. Aims., To identify prevalence of bowel and bladder incontinence and its management, investigate continence knowledge and describe the professional practice environment within a rehabilitation unit for older people. Method., An integrated evaluation of continence prevalence, staff knowledge and the work environment was adopted. Results., Findings revealed a high incidence of incontinence (60% urinary, 3% faecal, 37% mixed) a lack of specific continence assessment and specific rationale for treatment decisions or continuation of care. The focus was on continence containment rather than on proactive management. Staff demonstrated a reasonable knowledge of incontinence causation and treatment as measured by the staff knowledge audit. The evaluation of the work environment indicated a low to moderate perception of control over practice (2.39), autonomy in practice (2.87), nurse doctor relationship (2.67) and organizational support (2.67). [source] Service quality in hospital wards with different nursing organization: nurses' ratingsJOURNAL OF ADVANCED NURSING, Issue 2 2009Ingeborg S. Sjetne Abstract Title.,Service quality in hospital wards with different nursing organization: nurses' ratings. Aim., This paper is a report of a study to assess: (1) the relations between nursing organization models in hospital wards and nurses' perception of the quality of patient care and dimensions of the practice environment, and (2) if these relations were modified by variations in local conditions at the ward level. Background., Previous literature is inconclusive concerning what model of nursing organization maximizes the quality of nursing services. Method., A cross-sectional survey was carried out in a representative sample of Norwegian hospital wards in 2005. Intra-ward organization models were classified as: (1) Team leader (n = 30), characterized by extensive responsibilities for team leaders, (2) Primary nurse (n = 18), with extensive responsibilities for named nurses, and (3) Hybrid (n = 37), (1) and (2) combined. We prepared multilevel regression models using scales describing quality of patient care, learning climate, job satisfaction, and relationships with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results., Eighty-seven wards and 1137 nurses (55% response rate) provided complete data. The ward level proportion of variance ranged from 0·10 (job satisfaction) to 0·22 (relationships with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions led to a statistically significant effect of primary nurse organization on relationships with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32% (quality of patient care) to 24% (learning climate). Conclusion., Caution is needed about using service quality arguments when considering the possible benefits and drawbacks of different organizational models. [source] An evaluation of the nursing practice environment and successful change management using the new generation Magnet ModelJOURNAL OF NURSING MANAGEMENT, Issue 3 2010BETTYANNE GRANT RNBC grant b., colello s., riehle m. & dende d. (2010) Journal of Nursing Management18, 326,331 An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model Aim, To discuss the new Magnet Model as it relates to the successful implementation of a practice change. Background, There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. Evaluation, The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Key issues, Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses' work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Conclusion, Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. Implications for nursing management, The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality. [source] HEALTH POLICY AND SYSTEMS: Critical Thinking of Nurse Managers Related to Staff RNs' Perceptions of the Practice EnvironmentJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2010NEA-BC, Susan Zori RN Abstract Background Information and Significance: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Research Question: Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? Design: A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Findings: Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Conclusions: Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Clinical Relevance: Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care. [source] Validation of the Professional Practice Environment Scale in Australian General PracticeJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2010BN(Hons), Elizabeth J. Halcomb RN, FRCNA Abstract Purpose: To validate the Professional Practice Environment Scale (PPE) in Australian general practice. Methods: The PPE was modified slightly for appropriateness for the practice setting and administered to a sample of 342 Australian general practice nurses via an online survey tool. The factor structure of the 38-item PPE was examined using principal components analysis with Varimax rotation. Findings: An eight-factor solution accounted for 71.6% of the variance. Low factor loading (<0.3) or cross-component loadings were detected in eight items. A comparison of Cronbach's alpha values demonstrated little change in the deletion of eight items from four of the eight related components. Conclusions: Findings demonstrated that a 30-item version of the PPE was reliable and valid for use to assess the professional practice environment of nurses working in Australian general practice. Clinical Relevance: A tool to measure the professional practice environment in general practice is important as it will assist in monitoring the impact of the work environment on the recruitment, retention, and satisfaction of nurses in this setting. [source] Psychometric Analysis of the Brisbane Practice Environment Measure (B-PEM)JOURNAL OF NURSING SCHOLARSHIP, Issue 1 2010Anndrea Flint RN, MHSc(HSM) Abstract Purpose: To undertake rigorous psychometric testing of the newly developed contemporary work environment measure (the Brisbane Practice Environment Measure [B-PEM]) using exploratory factor analysis and confirmatory factor analysis. Methods: Content validity of the 33-item measure was established by a panel of experts. Initial testing involved 195 nursing staff using principal component factor analysis with varimax rotation (orthogonal) and Cronbach's alpha coefficients. Confirmatory factor analysis was conducted using data from a further 983 nursing staff. Results: Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 52.53% of the variance. These factors were then verified using confirmatory factor analysis. Goodness-of-fit indices showed an acceptable fit overall with the full model, explaining 21% to 73% of the variance. Deletion of items took place throughout the evolution of the instrument, resulting in a 26-item, four-factor measure called the Brisbane Practice Environment Measure-Tested. Conclusions: The B-PEM has undergone rigorous psychometric testing, providing evidence of internal consistency and goodness-of-fit indices within acceptable ranges. The measure can be utilised as a subscale or total score reflective of a contemporary nursing work environment. Clinical Relevance: An up-to-date instrument to measure practice environment may be useful for nursing leaders to monitor the workplace and to assist in identifying areas for improvement, facilitating greater job satisfaction and retention. [source] Measuring the hospital practice environment: A Canadian contextRESEARCH IN NURSING & HEALTH, Issue 4 2002Carole A. Estabrooks Abstract The primary purpose of this study is to document the psychometric properties of the revised Nursing Work Index (NWI-R) in the context of a large Canadian sample of registered nurses. A self-administered survey containing the NWI-R was completed by 17,965 registered nurses working in 415 hospitals in three Canadian provinces. Using exploratory principal components analysis, with a forced one-factor solution, the practice environment index was obtained. In addition, key assumptions were tested from previous work about the rationale for the aggregation of NWI-R responses. In the Canadian context the one-factor solution provides a parsimonious index of the practice environment of registered nurses working in acute care hospitals. Further work is needed to determine the predictive capability of this index and its relevance to cross-national organizational contexts. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:256,268, 2002 [source] Development of the practice environment scale of the nursing work index,,RESEARCH IN NURSING & HEALTH, Issue 3 2002Eileen T. Lake Abstract Five subscales were derived from the Nursing Work Index (NWI) to measure the hospital nursing practice environment, using 1985,1986 nurse data from 16 magnet hospitals. The NWI comprises organizational characteristics of the original magnet hospitals. The psychometric properties of the subscales and a composite measure were established. All measures were highly reliable at the nurse and hospital levels. Construct validity was supported by higher scores of nurses in magnet versus nonmagnet hospitals. Confirmatory analyses of contemporary data from 11,636 Pennsylvania nurses supported the subscales. The soundness of the new measures is supported by their theoretical and empirical foundations, conceptual integrity, psychometric strength, and generalizability. The measures could be used to study how the practice environment influences nurse and patient outcomes. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:176,188, 2002 [source] Perspectives on professional values among nurses in TaiwanJOURNAL OF CLINICAL NURSING, Issue 10 2009Fu-Jin Shih Aim., The purpose of this study was to identify the most important contemporary professional nursing values for nursing clinicians and educators in Taiwan. Background., Nursing values are constructed by members of political and social systems, including professional nursing organisations and educational institutions. Nurses' personal value systems shape the development of these professional values. An understanding of nurses' perceptions of professional values will enable the profession to examine consistencies with those reflected in existing and emerging educational and practice environments. Design., A qualitative descriptive study was conducted using the focus-group discussion method. Methods., A purposive sample of 300 registered nurses in Taiwan, consisting of 270 nursing clinicians and 30 faculty members, participated in 22 focus-group interviews. Data were analysed using a systematic process of content analysis. Results., Six prominent values related to professional nursing were identified: (a) caring for clients with a humanistic spirit; (b) providing professionally competent and holistic care; (c) fostering growth and discovering the meaning of life; (d) experiencing the ,give-and-take' of caring for others; (e) receiving fair compensation; and (f) raising the public's awareness of health promotion. Four background contexts framed the way participants viewed the appropriation of these values: (a) appraising nursing values through multiple perspectives; (b) acquiring nursing values through self-realisation; (c) recognising nursing values through professional competency and humanistic concerns and (d) fulfilling nursing values through coexisting self-actualisation. A conceptual framework was developed to represent this phenomenon. Conclusion., The most important professional nursing values according to the perspectives of nurses in Taiwan were identified. These values reflect benefits to society, to nurses themselves and to the interdisciplinary team. Relevance to clinical practice., Nurses' awareness of their own values and of how these values influence their behaviour is an essential component of humanistic nursing care. Nursing educators need to develop better strategies for reflection and integration of both personal and professional philosophies and values. [source] HEALTH POLICY AND SYSTEMS: Critical Thinking of Nurse Managers Related to Staff RNs' Perceptions of the Practice EnvironmentJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2010NEA-BC, Susan Zori RN Abstract Background Information and Significance: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Research Question: Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? Design: A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Findings: Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Conclusions: Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Clinical Relevance: Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care. [source] Instructional Design Practice: Career Environments, Job Roles, and a Climate of ChangePERFORMANCE IMPROVEMENT QUARTERLY, Issue 1 2004Miriam B. Larson ABSTRACT Instructional Design and Technology (IDT) professionals practice their skills in a broad range of career environments and job roles. The resulting collection of competency lists and wide range of practice environments, coupled with the frequent changes that have always characterized the field, produce complexity that is difficult to communicate to IDT students. However, students need to understand these complex aspects of the field so that they can make informed decisions about their career goals and educational direction. This review of the current literature looks at the current issues impacting practice and preparation. It concludes that the path professional academic preparation programs choose will depend on their orientation to instructional design and performance improvement, and whether they see themselves as preparing students for specific career environments or are pursuing a generalist program. [source] Nurse burnout and quality of care: Cross-national investigation in six countries,RESEARCH IN NURSING & HEALTH, Issue 4 2010Lusine Poghosyan Abstract We explored the relationship between nurse burnout and ratings of quality of care in 53,846 nurses from six countries. In this secondary analysis, we used data from the International Hospital Outcomes Study; data were collected from 1998 to 2005. The Maslach Burnout Inventory and a single-item reflecting nurse-rated quality of care were used in multiple logistic regression modeling to investigate the association between nurse burnout and nurse-rated quality of care. Across countries, higher levels of burnout were associated with lower ratings of the quality of care independent of nurses' ratings of practice environments. These findings suggest that reducing nurse burnout may be an effective strategy for improving nurse-rated quality of care in hospitals. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:288,298, 2010 [source] Organizational determinants of work outcomes and quality care ratings among Army Medical Department registered nurses,RESEARCH IN NURSING & HEALTH, Issue 2 2010Patricia A. Patrician Abstract The Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and several single-item measures were administered to registered nurses (RNs) working within 23 U.S.-based Army Medical Department (AMEDD) hospitals. Data were analyzed with logistic regression for nested data. Unfavorable nursing practice environments had a substantial association with job dissatisfaction (OR 13.75, p,<,.01), emotional exhaustion (OR 12.70, p,<,.01), intent to leave (OR 3.03, p,<,.01), and fair to poor quality of care (OR 10.66, p,<,.01). This study provides the first system-wide analyses of nursing practice environments in AMEDD hospitals in the U.S. Similar to findings in civilian samples, poor quality work environments are associated with less favorable RN work outcomes and quality of care ratings. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:99,110, 2010 [source] The Use of Health Care Policy to Facilitate Evidence-based Knowledge Translation in Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 11 2007Charlene B. Irvin MD Health care policy can facilitate emergency medicine knowledge translation (KT). Because of this, the 2007 Academic Emergency Medicine Consensus Conference on KT identified a specific theme regarding issues of health care policy and KT. Six months before the Consensus Conference, international experts in the area were invited to communicate on health care policies regarding all areas of KT via e-mail and "Google groups." From this communication, and using available evidence, specific recommendations and research questions were developed. At the Consensus Conference, additional comments were incorporated. This report summarizes the results of this collaborative effort and provides a set of recommendations and accompanying research questions to guide development, implementation, and evaluation of health care policies intended to promote KT in emergency medicine. The recommendations are to 1a) involve appropriate stakeholders in the health care policy process; 1b) collaborate with policy makers when health care policy focus areas are being developed; 2) use previously validated clinical practice guideline development tools; 3) address implementation issues during the development of health care policies; 4) monitor outcomes with performance measures appropriate to different practice environments; and 5) plan periodic reviews to uncover new clinical evidence, new methods to improve KT, and new technologies. To advance the further development of these recommendations, a research agenda is proposed. [source] | ||||||||||