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Costa DK, Boltey EM, Mosley EA, Manojlovich M, Wright NC. Knowing your team in the intensive care unit: an ethnographic study on familiarity. J Interprof Care 2024:1-9. [PMID: 38517041 DOI: 10.1080/13561820.2024.2329968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
Effective interprofessional team function is integral to high-quality care in the intensive care unit (ICU). However, little is known about how familiarity develops among teams, which may be an important antecedent to effective team function and quality care. To examine team familiarity and how it impacts ICU team function and care, we conducted an ethnographic study in four ICUs (two medical ICUs, one mixed medical-surgical ICU, and one surgical ICU) in two community hospitals and one academic medical center. We conducted 57.5 h of observation, 26 shadowing experiences, and 26 interviews across the four ICUs sequentially. We used thematic analysis to examine familiarity among the team. We found that ICU team members become familiar with their team through interpersonal, relational interactions, which involved communication, time working together, social interactions, trust, and respect. Our findings underscore the relational aspect of effective teams and demonstrate that time working together, social interactions, communication, developing trust, and respect are pathways to familiarity and optimal team function. Leveraging unique and creative ways to enhance the relational aspects of ICU teams could be an area for future research and lead to improved ICU outcomes.
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Affiliation(s)
- Deena Kelly Costa
- Yale School of Nursing, Yale University, Orange, CT, USA
- Yale School of Medicine, Section on Pulmonary, Critical Care & Sleep Medicine, CT, USA
| | - Emily M Boltey
- Department of Education and Innovative Learning, VA Pittsburgh Health System, Pittsburgh, PA, USA
| | - Elizabeth A Mosley
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Milisa Manojlovich
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA
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Liu XM, Geng LX, Zhang H, Han JF, Wang ZG. Analysis of the inhibitory effect of a refined human resources salary system on job transfer and transfer tendency of nurses. Medicine (Baltimore) 2024; 103:e37257. [PMID: 38457561 PMCID: PMC10919535 DOI: 10.1097/md.0000000000037257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/10/2023] [Accepted: 01/23/2024] [Indexed: 03/10/2024] Open
Abstract
To evaluate the impact of a refined human resources salary system on job transfer and transfer tendency. From January 2019 to December 2019, a refined human resources salary system reform was implemented at the Tangshan Workers' Hospital in Hebei Province, and the job transfer and transfer tendency of clinical nurses was assessed using the nurse job transfer tendency scale before and 1 year after the intervention. A total of 640 nurses completed the intervention and evaluation. The results showed that the job transfer rate following the intervention reduced to 0.22%. The total score of clinical nurse job transfer tendency was (10.80 ± 3.23) before the intervention and (9.66 ± 3.58) after 1 year of intervention, which was substantially lower (P < .001). The satisfaction scores of nurses on performance-based salary increased significantly from (67.83 ± 18.54) before the intervention to (80.66 ± 15.87) after intervention, with varying degrees of increase observed in each dimension (P < .001). The refined human resources salary system effectively reduced job transfer and transfer tendency of clinical nurses in hospital nursing management, and can be widely promoted and applied.
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Affiliation(s)
- Xue-Ming Liu
- Department of Nursing, Tangshan Central Hospital, Tangshan 063000, Hebei Province, China
| | - Li-Xuan Geng
- Department of Nursing, Tangshan Central Hospital, Tangshan 063000, Hebei Province, China
| | - Hong Zhang
- Department of Neurology, Tangshan Gongren Hospital, Tangshan 063000, Hebei Province, China
| | - Jian-Fei Han
- Department of Neurosurgery, Tangshan Gongren Hospital, Tangshan 063000, Hebei Province, China
| | - Zhi-Guo Wang
- Department of Rheumatology, Tangshan Central Hospital, Tangshan 063000, Hebei Province, China
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Zhong Y, Ma H, Zhang CC, Jiang QY, Li J, Liao CJ, Liang YF, Shu L. Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study. Medicine (Baltimore) 2024; 103:e36903. [PMID: 38241583 PMCID: PMC10798701 DOI: 10.1097/md.0000000000036903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, "Whether living with relatives" and "Monthly income" had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = -0.459) and job satisfaction (r = -0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. "Whether living with relatives," "Professional identity," "Control and responsibility for work," and "Benefits" were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.
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Affiliation(s)
- Ying Zhong
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Huan Ma
- School of Nursing, Sichuan Vocational College of Health and Rehabilitation, Sichuan, China
| | - Cui-Cui Zhang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Qin-Ying Jiang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Jun Li
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Chang-Ju Liao
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Yu-Fen Liang
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
| | - Li Shu
- Nursing Department, Zigong First People’s Hospital, Sichuan, China
- Zigong Academy of Medical Sciences, Sichuan, China
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Ulupınar F, Erden Y. Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis. J Clin Nurs 2024; 33:393-403. [PMID: 36435976 DOI: 10.1111/jocn.16588] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/07/2022] [Indexed: 10/26/2023]
Abstract
AIMS AND OBJECTIVES The COVID-19 pandemic has caused an increase in the workload of nurses and changes in working conditions. Stress and the increase in workload during the COVID-19 pandemic had a negative effect on nurses' intention to leave. This study aimed to determine the current rate of intention to leave the job among nurses during the COVID-19 outbreak by conducting a rapid systematic review and meta-analysis. METHODOLOGY/METHODS The review procedure was conducted by the PRISMA criteria. The researchers searched PubMed and Web of Science databases for studies providing the rate of nurses' intent to leave, published until 31 December 2021. Heterogeneity was assessed using the I2 test, and publication bias was measured by Egger's test. RESULTS The estimated overall intent to leave the profession among nurses during the COVID-19 pandemic was 31.7% (95% CI: 25%-39%) with significant heterogeneity (Q test: 188.9; p = 0.0001; I2 : %95.2; Tau2 : 0.225). Additionally, Egger's regression test suggested no publication bias for estimating the pooled rate of nurses' intent to leave during the COVID-19 outbreak. NO PATIENT OR PUBLIC CONTRIBUTION Since the research is a meta-analysis study, a literature review model was used. Ethics committee approval was not obtained because the literature review did not directly affect humans and animals. CONCLUSION This study showed that approximately one-third of nurses working during the COVID-19 pandemic had thoughts about intending to leave their job. The findings indicate the need for strategies involving precautions and solutions to minimise the psychological impacts of COVID-19 among nurses. RELEVANCE TO CLINICAL PRACTICE In this period when the global nurse crisis exists, it is of great importance for institutions to retain their nurse workforce. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for intention to leave could be a significant weapon giving nurses and healthcare systems the ability to response in a better way against the following COVID-19 waves in the near future.
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Affiliation(s)
- Fadime Ulupınar
- Faculty of Health Sciences, Nursing Department, Erzurum Teknik University, Erzurum, Turkey
| | - Yasemin Erden
- Faculty of Health Sciences, Nursing Department, Erzurum Teknik University, Erzurum, Turkey
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Solberg MT, Pedersen I, Mathisen C, Finnstrøm IJ, Lundin PK, Nes AAG. Professional competence required in advanced practice nursing in critical care: An exploratory qualitative study. Nurs Open 2023; 10:7839-7847. [PMID: 37818774 PMCID: PMC10643827 DOI: 10.1002/nop2.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
AIM To identify the required competencies of advanced practice nurses (APNs) working with patients in critical care units in Norway. DESIGN An exploratory qualitative design. METHODS Four focus group interviews were performed with 18 nurses who worked in critical care units. The data were examined by inductive content analysis following Graneheim and Lundman's approach. FINDINGS Our study found that APNs in critical care require the following professional competencies to meet the needs of patients characterised by greater age, comorbidities and increased complexity: (1) intrapersonal skills as revealed in the subthemes of self-awareness; motivation and commitment; strong mental health and upholding ethical standards, (2) advanced clinical decision-making skills as identified in the subthemes of integration of theory and practice; complex practical and technical skills; dealing with increased delegated responsibility and taking the lead in managing increased practice complexity and (3) interpersonal skills, including peer guidance, practising collaboratively and the ability to position oneself.
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Affiliation(s)
| | | | - Cathrine Mathisen
- Lovisenberg Diaconal University CollegeDepartment for Postgraduate StudiesOsloNorway
| | | | - Per Kristian Lundin
- Intensive Care, Section 1, RikshospitaletDepartment of Postoperative and Intensive CareDivision of Emergencies and Critical CareOslo University HospitalOsloNorway
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L'Ecuyer KM, Subramaniam DS, Swope C, Lach HW. An Integrative Review of Response Rates in Nursing Research Utilizing Online Surveys. Nurs Res 2023; 72:471-480. [PMID: 37733644 DOI: 10.1097/nnr.0000000000000690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
BACKGROUND Online surveys in nursing research have both advantages and disadvantages. Reaching a sample and attaining an appropriate response rate is an ongoing challenge and necessitates careful consideration when designing a nursing research study using an online survey approach. OBJECTIVE In this study, we aimed to explore response rates and survey characteristics of studies by nurse researchers that used online methodologies to survey nurses, nursing students, and nursing faculty. METHODS We conducted an integrative review of research studies that used online surveys for data collection published from 2011 to 2021. We examined response rates and survey characteristics such as recruitment method, use of incentives, question type, length of survey, time to complete the survey, and use of reminders. RESULTS Our review included 51 studies published by nurses with target samples of nurses, nursing students, or nursing faculty. Study sample sizes ranged from 48 to 29,283, the number of respondents ranged from 29 to 3,607, and the response rates ranged from 3.4% to 98%, with an average of 42.46%. Few patterns emerged regarding recruitment or other factors to enhance response rates; only five studies used incentives. CONCLUSION Response rates to online surveys are unlikely to reach the rates seen in older mailed surveys. Researchers need to design online survey studies to be easily accessible, concise, and appealing to participants.
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Sardo PMG, Macedo RPA, Alvarelhão JJM, Simões JFL, Guedes JAD, Simões CJ, Príncipe F. Nursing workload assessment in an intensive care unit: A retrospective observational study using the Nursing Activities Score. Nurs Crit Care 2023; 28:288-297. [PMID: 36336353 DOI: 10.1111/nicc.12854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/28/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nursing Activities Score (NAS) is a promising tool for calculating the nursing workload in intensive care units (ICU). However, data on intensive care nursing activities in Portugal are practically non-existent. AIM To assess the nursing workload in a Portuguese ICU using the NAS. STUDY DESIGN Retrospective cohort study developed throughout the analysis of the electronic health record database from 56 adult patients admitted to a six-bed Portuguese ICU between 1 June-31 August 2020. The nursing workload was assessed by the Portuguese version of the NAS. The study was approved by the Hospital Council Board and Ethics Committee. The study report followed the STROBE guidelines. RESULTS The average occupancy rate was 73.55% (±16.60%). The average nursing workload per participant was 67.52 (±10.91) points. There was a correlation between the occupancy rate and the nursing workload. In 35.78% of the days, the nursing workload was higher than the available human resources, overloading nurse staffing/team. CONCLUSIONS The nursing workload reported follows the trend of the international studies and the results reinforce the importance of adjusting the nursing staffing to the complexity of nursing care in this ICU. This study highlighted periods of nursing workload that could compromise patient safety. RELEVANCE TO CLINICAL PRACTICE This was one of the first studies carried out with the NAS after its cross-cultural adaptation and validation for the Portuguese population. The nursing workload at the patient level was higher in the first 24 h of ICU stays. Because of the 'administrative and management activities' related to the 'patient discharge procedures', the last 24 h of ICU stays also presented high levels of nursing workload. The implementation of a nurse-to-patient ratio of 1:1 may contribute to safer nurse staffing and to improve patient safety in this Tertiary (level 3) ICU.
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Affiliation(s)
- Pedro Miguel Garcez Sardo
- Escola Superior de Saúde da Universidade de Aveiro (ESSUA), Universidade de Aveiro (UA), Aveiro, Portugal.,Institute of Biomedicine (iBiMED), Universidade de Aveiro (UA), Aveiro, Portugal
| | | | | | - João Filipe Lindo Simões
- Escola Superior de Saúde da Universidade de Aveiro (ESSUA), Universidade de Aveiro (UA), Aveiro, Portugal.,Institute of Biomedicine (iBiMED), Universidade de Aveiro (UA), Aveiro, Portugal
| | | | - Carlos Jorge Simões
- Escola Superior de Saúde da Universidade de Aveiro (ESSUA), Universidade de Aveiro (UA), Aveiro, Portugal.,Centro Hospitalar do Baixo Vouga, Hospital de Aveiro, Aveiro, Portugal
| | - Fernanda Príncipe
- Escola Superior de Saúde Norte da Cruz Vermelha Portuguesa, Oliveira de Azeméis, Portugal
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Timmins F, Green C, Parissopoulos S, Thompson DR. Management and leadership of intensive care units for the future. Nurs Crit Care 2023; 28:149-152. [PMID: 36843490 DOI: 10.1111/nicc.12892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 02/28/2023]
Affiliation(s)
- Fiona Timmins
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Chloe Green
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Stelios Parissopoulos
- Department of Nursing, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Poon YSR, Lin YP, Griffiths P, Yong KK, Seah B, Liaw SY. A global overview of healthcare workers' turnover intention amid COVID-19 pandemic: a systematic review with future directions. HUMAN RESOURCES FOR HEALTH 2022; 20:70. [PMID: 36153534 PMCID: PMC9509627 DOI: 10.1186/s12960-022-00764-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/29/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically. RESULTS Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. CONCLUSIONS A wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.
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Affiliation(s)
| | | | - Peter Griffiths
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (Wessex), University of Southampton, Southampton, UK
| | - Keng Kwang Yong
- Group Nursing, National Healthcare Group, Singapore, Singapore
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Ogata Y, Sato K, Sasaki M, Fujinami K, Taisuke T. Association between nursing practice environment and sense of coherence among staff nurses: A cross-sectional study in Japan. J Nurs Manag 2022; 30:3149-3159. [PMID: 35781366 DOI: 10.1111/jonm.13733] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022]
Abstract
AIM To investigate the association between work environment and sense of coherence among staff nurses. BACKGROUND In Antonovsky's salutogenetic theory, factors that causes stress aren't always harmful when people's sense of coherence is high. Although the effects of sense of coherence have repeatedly been confirmed, few studies have examined factors that increase sense of coherence. METHODS We used cross-sectional data (N=6,172) surveyed in 2017 from a 2-year longitudinal study in 2016 and 2017. Multiple group structural equation modeling was conducted for years of nurse experience of different groups. RESULTS Work environment subscale scores for nurses with less than five years of experience ranged from 2.3 to 2.9, and for those with more than five years, from 2.1 to 2.7. The averages of sense of coherence for the groups were 36.9 and 39.7, respectively. For both groups, there was a statistically significant association between work environment and sense of coherence. CONCLUSIONS Improvement of nurses' work environment may increase sense of coherence, leading to improvements in health. IMPLICATIONS FOR NURSING MANAGEMENT The study suggest that nurse managers should improve the work environment to increase sense of coherence of staff nurses, leading to improved health for any length of a nurse's experience.
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Affiliation(s)
- Yasuko Ogata
- Nursing Innovation Science, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kana Sato
- Nursing Innovation Science, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Miki Sasaki
- Nursing Innovation Science, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keiko Fujinami
- Nursing Innovation Science, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042470. [PMID: 35206656 PMCID: PMC8878484 DOI: 10.3390/ijerph19042470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/31/2022]
Abstract
Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment and intention to leave; (ii) analyzes the relationship between structural factors (such as, work environment and nurse staffing), individual factors (age), and nurses’ organizational commitments and intention to leave; and (iii) analyzes the differences in the intention to leave and in the organizational commitment according to service specialty, nurses’ specialization, and contractual relationship in Portuguese public hospitals. A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals units. The results show a high affective and continuance commitment of nurses with the hospital, and a reduced tendency of the intention to leave. A significant positive association was also found between the intent to leave and individual/structural factors. Organizational commitment and intention to leave levels are satisfactory, despite the influence of several factors, such as nurse staffing, work environment, or other opportunities for professional development. The results identify particularly sensitive areas that, through adequate health and management policies, can reduce nurses’ intentions to leave and promote the sustainability of the health system.
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