Investigation on nurses practice environment in tertiary hospitals in Shandong Province

doi:10.3761/j.issn.0254-1769.2020.11.013

Abstract

Abstract:

Objective To investigate nurses practice environment in tertiary hospitals in Shandong Province,which can provide a basis for the improvement and construction of a healthy nurse practice environment. Methods The convenience sampling method was used to investigate 56 776 nurses from 59 tertiary hospitals in Shandong Province by the Nursing Work Index-Revised（NWIR） from March to December 2018. Results The mean score of NWIR was 79.20±19.15. The items of “the hospital has a systematic training program for newly recruited nurses”,“nurses in the work team are qualified for nursing work” received the highest scores. The items of “the system of salary allotment is reasonable in hospital”,“the level of salary of nurses is reasonable in all sectors of the society”,“nurses have opportunities to participate in hospital internal management”,“nurses have opportunities to become members in the hospital management committee” and “nurses have opportunities to participate in hospital management decisions making” got the lowest scores. Multiple linear regression analysis showed that gender,age,education,professional title,years of work,whether being recruited by government agencies had an impact on the nursing practice environment scores（P<0.05）. Conclusion Nurses practice environment in tertiary hospitals in Shandong Province is generally optimistic,but it still requires continuous improvement. The nursing managers and experts should focus on the establishment and improvement of the authorization management mechanism,encourage nurses to actively engage in hospital affairs,and give much attention to the career development of male nurses and medium seniority nurses,so as to continuously improve and optimize the nursing practice environment.

Key words: Nurse, Practice Environment, Questionnaires, Root Cause Analysis, Nursing Administration Research

摘要：

目的了解山东省三级医院护士执业环境现状,为改善及构建健康的护士执业环境提供依据。方法采用便利抽样法,于2018年3月—12月采用护士执业环境测评量表对山东省59所三级医院共56 776名护士进行调查。结果调查对象的护士执业环境测评量表总均分为（79.20±19.15）分,其中“医院对新入职护士有系统培训”“工作团队中的护士能够胜任护理工作”等条目的得分较高。“医院的薪酬分配制度合理”“护士薪酬在社会各行业所处水平合理”等条目得分较低。多元线性回归分析显示,性别、年龄、学历、职称、工作年限、是否为事业编制均对护士执业环境测评量表得分有影响（P<0.05）。结论山东省护士执业环境总体水平尚可,但仍需持续改善。护理管理者应建立、健全授权管理机制,鼓励护士积极参与医院事务,关注男护士和中等年资护士职业发展,以持续改进和优化护士执业环境。

关键词: 护士, 执业环境, 问卷调查, 影响因素分析, 护理管理研究

ZHANG Xiaoman,MA Xinlu,LIU Yujie,LI Zhenxiang. Investigation on nurses practice environment in tertiary hospitals in Shandong Province[J]. Chinese Journal of Nursing, 2020, 55(11): 1680-1684.

张晓曼,马昕璐,刘玉杰,李振香. 山东省三级医院护士执业环境调查[J]. 中华护理杂志, 2020, 55(11): 1680-1684.

Figures/Tables 4

Table 1 The general data of the subjects and the results ofunivariate analysis of nurses working environment（n=56776）

Table 2 Top 5 items of nurses’ working environment evaluation score（n=56 776）

Table 3 The last five items of nurses’ workingenvironment evaluation score（n=56 776）

Table 4 Results of multiple linear regression analysis on nurses’ working environment（n=56 776）

References 26

[1]	国家卫生计生委医院管理研究所护理中心护理质量指标研发小组. 护理敏感质量指标实用手册:2016版[M]. 北京: 人民卫生出版社, 2016: 232-246.
	National Institute of Hospital Administration. Handbook of nursing-sensitive quality indicators(2016)[M]. Beijing: People’s Medical Publishing House, 2016: 232-246.
[2]	营晓, 张海燕, 简伟研, 等. 护士执业环境的研究现状[J]. 中国护理管理, 2016,16(6):767-772.
	Ying X, Zhang HY, Jian WY, et al. Review on the research status of the nursing practice environment[J]. Chin Nurs Manag, 2016,16(6):767-772.
[3]	万巧琴, 尚少梅, 谷水, 等. 临床护士工作投入现状与影响因素研究[J]. 中国护理管理, 2018,18(10):1326-1331.
	Wan QQ, Shang SM, Gu S, et al. Research on the status of work engagement and its influencing factors among clinical nurses[J]. Chin Nurs Manag, 2018,18(10):1326-1331.
[4]	Van Bogaert P, Wouters K, Willems R, et al. Work engagement supports nurse workforce stability and quality of care:nursing team-level analysis in psychiatric hospitals[J]. J Psychiatr Ment Heal Nurs, 2013,20(8):679-686.
[5]	Kelly LA, McHugh MD, Aiken LH. Nurse outcomes in Magnet and non-magnet hospitals[J]. J Nurs Adm, 2011,41(10):428-433. DOI URL PMID
[6]	Lee SY, Kim CW, Kang JH, et al. Influence of the nursing practice environment on job satisfaction and turnover intention[J]. J Prev Med Public Heal, 2014,47(5):258-265.
[7]	张洪福, 刘彦慧, 杨洋, 等. 在职护士离职倾向相关因素分析[J]. 中华护理杂志, 2015,50(2):155-160.
	Zhang HF, Liu YH, Yang Y, et al. The influencing factors of nurses’ turnover tendency[J]. Chin J Nurs, 2015,50(2):155-160.
[8]	McHugh MD, Kelly LA, Smith HL, et al. Lower mortality in magnet hospitals[J]. Med Care, 2013,51(5):382-388. DOI URL
[9]	Evans T, Rittenhouse K, Horst M, et al. Magnet hospitals are a magnet for higher survival rates at adult trauma centers[J]. J Trauma Acute Care Surg, 2014,77(1):89-94. DOI URL PMID
[10]	North N, Leung W, Ashton T, et al. Nurse turnover in New Zealand:costs and relationships with staffing practises and patient outcomes[J]. J Nurs Manag, 2013,21(3):419-428. DOI URL PMID
[11]	Choi J, Boyle DK. Differences in nursing practice environment among US acute care unit types:a descriptive study[J]. Int J Nurs Stud, 2014,51(11):1441-1449. DOI URL
[12]	邵静, 叶志弘, 汤磊雯, 等. 不同经济区域护理职业环境的对比研究[J]. 中华护理杂志, 2018,53(3):334-337.
	Shao J, Ye ZH, Tang LW, et al. Regional differences of the nursing work environment in mainland China[J]. Chin J Nurs, 2018,53(3):334-337.
[13]	王丽, 李乐之. 中文版护理工作环境量表的信效度研究[J]. 中华护理杂志, 2011,46(2):121-123.
	Wang L, Li LZ. Reliability and vadility of Chinese version of the Practice Environment Scale[J]. Chin J Nurs, 2011,46(2):121-123.
[14]	Lake ET. Development of the practice environment scale of the Nursing Work Index[J]. Res Nurs Heal, 2002,25(3):176-188. DOI URL
[15]	张海燕, 梁俊卿, 么莉, 等. 我国三级医院护士执业环境的现况研究[J]. 护理管理杂志, 2017,17(5):308-311.
	Zhang HY, Liang JQ, Yao L, et al. Status of practice environment among nurses in 3-level hosptials of China[J]. J Nurs Admin, 2017,17(5):308-311.
[16]	程超, 宋瑰琦, 秦玉霞, 等. 安徽省三级综合医院护士执业环境的调查研究[J]. 中华护理杂志, 2017,52(8):976-980.
	Cheng C, Song GQ, Qin YX, et al. The current situation of nurses’ practice environment in tertiary general hospitals in Anhui Province[J]. Chin J Nurs, 2017,52(8):976-980.
[17]	刘闻捷, 曹晓翼, 蒋晓莲. 四川省二、三级综合医院护士感知的工作环境现况及其影响因素分析[J]. 中华护理杂志, 2014,49(10):1211-1214.
	Liu WJ, Cao XY, Jiang XL. The level and influencing factors of nurses’ perceptive work environment in general secondary-level hospitals and tertiary-level hospitals in Sichuan province[J]. Chin J Nurs, 2014,49(10):1211-1214.
[18]	营晓, 张海燕, 尚文涵, 等. 5家大型医院护士执业环境测评结果分析[J]. 中国护理管理, 2016,16(7):873-878.
	Ying X, Zhang HY, Shang WH, et al. Nurses’ perceptions of professional practice environment:a cross-sectional study[J]. Chin Nurs Manag, 2016,16(7):873-878.
[19]	朱晓艳, 王国永, 郝连正, 等. 2010-2015年山东省HIV职业暴露情况分析[J]. 现代预防医学, 2017,44(1):29-31.
	Zhu XY, Wang GY, Hao LZ, et al. Occupational exposure to HIV in Shandong province,2010-2015[J]. Mod Preven Med, 2017,44(1):29-31.
[20]	Alilu L, Zamanzadeh V, Valizadeh L, et al. A grounded theory study of the intention of nurses to leave the profession[J]. Revista Latino-Am De Enfermagem, 2017,25:e2894.
[21]	陆敏敏, 阮卉, 邢唯杰, 等. 护士感知的医院事务参与度及其与工作疲溃的关系研究[J]. 护理学杂志, 2012,27(10):13-15.
	Lu MM, Luan H, Xing WJ, et al. The relationship between the participation of nurses in hospital affairs and their level of burnout[J]. J Nurs Sci, 2012,27(10):13-15.
[22]	朱乐凤, 刘彦慧, 丁慎勇. 专业护理实践环境与一般自我效能感对护士工作满意度的影响[J]. 中华护理杂志, 2011,46(9):845-848.
	Zhu LF, Liu YH, Ding SY. The impact of professional nursing practice environment and general self-efficacy on nurses’ job satisfaction[J]. Chin J Nurs, 2011,46(9):845-848.
[23]	Woltmann EM, Wilkniss SM, Teachout A, et al. Trial of an electronic decision support system to facilitate shared decision making in community mental health[J]. Psychiatr Serv Wash D C, 2011,62(1):54-60.
[24]	李梦琦, 郑晶, 刘佳丽, 等. 不同性别护士对护理工作环境评价的对比研究[J]. 中华护理杂志, 2017,52(9):1098-1103.
	Li MQ, Zheng J, Liu JL, et al. Nurses’ perception on nursing work environment:gender difference analysis[J]. Chin J Nurs, 2017,52(9):1098-1103.
[25]	Valizadeh L, Zamanzadeh V, Fooladi MM, et al. The image of nursing,as perceived by Iranian male nurses[J]. Nurs Heal Sci, 2014,16(3):307-313.
[26]	Yun H. A study on the adaption process of experienced male nurses[J]. Asia-Pac J Multimed Serv Convergent Art Humanit Soc, 2016,6(7):209-217.