RESUMEN
PURPOSE: This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP. DESIGN/METHODOLOGY/APPROACH: Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted. FINDINGS: Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed. ORIGINALITY/VALUE: In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.
Asunto(s)
Personal de Enfermería en Hospital , Estudios Transversales , Humanos , Femenino , Adulto , Masculino , Encuestas y Cuestionarios , Personal de Enfermería en Hospital/psicología , Persona de Mediana Edad , Actitud del Personal de Salud , Aprendizaje , Enfermería Basada en la Evidencia , Práctica Clínica Basada en la EvidenciaRESUMEN
PURPOSE: Patient safety climate is an important factor in promoting patient safety for healthcare organizations. This study investigated the relationship between collaborative leadership and patient safety climate, the mediation effect of workplace social capital, or interprofessional collaboration practice. METHODS: A web-based cross-sectional questionnaire survey was administered between May 2021 and May 2022, to employees of three acute care hospitals in Japan. The relationship between variables was verified by structural equation modeling. RESULTS: A total of 1,276 staff members participated in the study. Collaborative leadership affected the workplace social capital (ß = .734) and interprofessional collaboration (ß = .561), which were positively associated with patient safety climate (ß = .403 and .405, respectively), verifying the mediating relationship of workplace social capital and interprofessional collaboration between collaborative leadership and patient safety climate. CONCLUSIONS: Collaborative leadership enhances the reciprocity and interprofessional practices of the healthcare team. The interaction among interprofessional team members fosters a patient safety climate. The results of this survey suggest that the development of collaborative leadership, which encourages interprofessional collaboration and fosters workplace social capital, is inherently crucial for cultivating a patient safety climate.
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Conducta Cooperativa , Relaciones Interprofesionales , Liderazgo , Seguridad del Paciente , Capital Social , Lugar de Trabajo , Humanos , Estudios Transversales , Masculino , Encuestas y Cuestionarios , Femenino , Adulto , Japón , Persona de Mediana Edad , Cultura Organizacional , Administración de la Seguridad/organización & administración , Grupo de Atención al Paciente/organización & administraciónRESUMEN
BACKGROUND AND OBJECTIVES: Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate. METHODS: This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J. RESULTS: A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (ß = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (ß = .430, P < .01). CONCLUSIONS: Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality.
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Capital Social , Humanos , Estudios Transversales , Seguridad del Paciente , Lugar de Trabajo , Japón , Encuestas y CuestionariosRESUMEN
AIM: Shift management and planning processes for shift-working nurses are important for their continued work. This study aimed to determine the association between shift assignments, organizational justice, and their interaction with turnover intention among shift-work nurses. METHODS: This cross-sectional study used an online questionnaire administered to Japanese nurses between January and February 2020. Enquiries pertaining to their daily start and end times for each shift type, the shift assignments, organizational justice, and their turnover intention were made. To examine the association with turnover intention, logistic regression analysis was performed with shift assignments, organizational justice, and their interaction terms as independent variables. RESULTS: A total of 386 nurses participated in the final analysis. Of these, 161 nurses (41.7%) had turnover intention. Unequal work assignments and procedural justice were significantly associated with turnover intention. However, the interaction between these factors was not significant. CONCLUSION: The results suggest that procedural justice in the workplace and turnover intention are related, but in shift planning, even procedural justice cannot buffer unequal work from leading to turnover intention. This study provides valuable insights for nursing managers who manage the schedules of shift-working nurses.
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Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Humanos , Estudios Transversales , Cultura Organizacional , Japón , Justicia Social , Satisfacción en el Trabajo , Hospitales , Reorganización del Personal , Lugar de Trabajo , Encuestas y CuestionariosRESUMEN
Supportive measures for employees raising children may have increased workloads on other nurses, causing psychological stress. This study aimed to clarify the differences in working conditions and psychological status among female Japanese nurses based on child-rearing attributes. We used data from 1,600 female nurses at 10 Japanese hospitals collected by the study of the Work Environment for Hospital Nurses in Japan conducted in 2016. The variables included work conditions (number of night shifts per month, daily overtime, number of paid holidays per year, and social support received), psychological status (sense of coherence, emotional exhaustion, and work engagement), and sociodemographic characteristics. An analysis of covariance was performed on the differences between the three groups (without children, with preschool-age children, and with children of other ages groups). The group without children had a relatively higher workload (p<0.01) and lower social support (p<0.01 and p<0.05). Additionally, they had higher emotional exhaustion and lower work engagement (p<0.01). This study confirmed the uneven distribution of work environment by work-life balance measures.
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Personal de Enfermería en Hospital , Estrés Laboral , Apoyo Social , Carga de Trabajo , Adulto , Femenino , Humanos , Persona de Mediana Edad , Agotamiento Profesional/epidemiología , Pueblos del Este de Asia , Japón/epidemiología , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/estadística & datos numéricos , Estrés Laboral/epidemiología , Sentido de Coherencia , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Compromiso Laboral , Equilibrio entre Vida Personal y Laboral , Condiciones de Trabajo , Carga de Trabajo/psicología , Lugar de Trabajo/psicologíaRESUMEN
AIM: This study aimed to examine the mediating effect of workplace social capital on the relationship between authentic leadership and the three dimensions of organizational commitment: affective, normative, and continuance. METHODS: In January 2019, anonymous self-reported questionnaires were distributed to 1220 nurses working in the general wards of two university hospitals in Japan. Structural equation modeling was used to examine the mediating effects of workplace social capital on the relationship between nurse managers' authentic leadership and the three dimensions of organizational commitment. RESULTS: Six hundred and fifty-nine data points were analyzed (valid response rate = 54.0%). Participants' average age was 28.6 years (standard deviation: 6.6), and 93.3% were female. The mediation indirect effect of workplace social capital between authentic leadership and organizational commitment was statistically significant in the models of affective organizational commitment and normative organizational commitment, but not in the model of continuance organizational commitment. CONCLUSIONS: The effects of authentic leadership and workplace social capital had different impacts on each of the three dimensions of organizational commitment. Nurse managers' authentic leadership and workplace social capital can enhance nurses' positive commitment to the organization.
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Enfermeras Administradoras , Capital Social , Humanos , Femenino , Adulto , Masculino , Estudios Transversales , Liderazgo , Satisfacción en el Trabajo , Lugar de Trabajo/psicología , Encuestas y Cuestionarios , Enfermeras Administradoras/psicología , Hospitales UniversitariosRESUMEN
Female nurses experience work-family conflict due to performing multiple roles, leading to burnout. Thus, this study aimed to verify the association between burnout and the multiple work and family roles performed among Japanese female nurses. The data for 2,255 nurses at 23 Japanese hospitals obtained from the Work Environment for Nurses Study in Japan were used. The variables included burnout, demographic information, additional work roles, and child-rearing or caregiving. Half of the nurses were categorized under the "no-role" group (NRG), approximately a quarter under the "work-role" group (WRG), 16% under the "family-role" group (FRG), and 7.3% under the "multiple-role" group (MRG). Compared to the NRG, the FRG and MRG showed statistically lower emotional exhaustion (B=-0.79, p<0.05; B=-0.94, p<0.05, respectively) and depersonalization (B=-0.80, p<0.05; B=-1.09, p<0.05, respectively). Personal accomplishment was not statistically different among the four groups. Burnout was relatively low among nurses with family roles, suggesting that family roles may have a positive spillover effect on work-related emotions.
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Agotamiento Profesional , Enfermeras y Enfermeros , Equilibrio entre Vida Personal y Laboral , Femenino , Humanos , Agotamiento Profesional/psicología , Estudios Transversales , Pueblos del Este de Asia , Emociones , Enfermeras y Enfermeros/psicología , Encuestas y CuestionariosRESUMEN
AIM: Temporary lodging facilities which were non-medical facilities were established to secure beds for severely and moderately ill patients with COVID-19, as well as for isolation, non-contact observation, and care of mildly ill and asymptomatic patients in Japan. This study aims to understand nursing management practices adopted in these facilities by examining cases of their establishment and operation. METHODS: A multiple-case study design was used. Interviews for qualitative data collection were conducted from August to October 2020. After analyzing the nursing management practices in four temporary lodging facilities, common points were collated and integrated. RESULTS: For the establishment and operation of temporary lodging facilities, a three-layer structure based on disaster management methods was adopted: headquarters at the helm as overseers, field supervisors in the middle, and frontline nursing staff at the base. The structure had clear roles, facilitated information exchange, and provided efficient and effective nursing care. Field supervisors mainly provided psychological and clinical support for staff and served as information and interprofessional hubs. CONCLUSION: It is recommended that temporary lodging facilities should be organized based on principles of the division of labor. The workforce should comprise nursing staff, and experienced nursing professionals should be recruited to the higher echelons.
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COVID-19 , Atención de Enfermería , Personal de Enfermería , Humanos , Pandemias , JapónRESUMEN
AIM: We aim to identify measures implemented by hospital nursing directors early in the COVID-19 pandemic and enabling factors. BACKGROUND: Managerial factors affect nurses' physical and mental health and willingness to work, especially early in a pandemic. METHOD: We used multiple-case study of 15 hospitals, comparing management approaches by interviewing 28 nursing directors and their assistants from August to December 2020. RESULTS: Hospitals that accepted COVID-19 patients and hospitals that unexpectedly experienced clusters underwent a nursing provision system organization phase, followed by an adjustment phase to maintain nursing organization function. Two factors aided measure implementation: an emergency system and staff protection policies. CONCLUSION: Early epidemic management strategies apply across contexts. The hospital's basic attitude is key to effective implementation of the strategies. IMPLICATIONS FOR NURSING MANAGEMENT: The results suggest that hospitals, nursing directors and nurses can each prepare for future emerging infectious disease epidemics.
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COVID-19 , Atención de Enfermería , Humanos , COVID-19/epidemiología , Pandemias , HospitalesRESUMEN
AIMS: The study aimed to identify the aspects and items of nurse turnover impact on organizations as perceived by nursing management. BACKGROUND: Turnover rate does not capture the extent to which an organization is affected by turnover. Another indicator is required to assess the control status of turnover impact. METHODS: A Delphi study was conducted in 2021, where 2670 managers of nursing at 712 hospitals were asked to complete the survey three times. Factor analysis was conducted on these items for which a consensus was reached. RESULTS: Overall, 232 managers who responded multiple times, including the third survey, were included in the analysis. Consensus was reached for 36 items affected by turnover and considered important for nursing management. Using exploratory factor analysis, the following six factors were extracted: quality of nursing care, physical and mental health of nursing staff, workload and working conditions of nursing staff, relationships among nursing staff members, sense of responsibility among nursing staff, and cost and benefit of hiring replacement personnel. CONCLUSIONS: Six factors consisting of 36 items were extracted that can be used to assess the impact of nurse turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can assess the status of the organization more appropriately by understanding the factors that impact nurse turnover in vaious facilitites and look at strategies to overcome the impact on nurse staffing.
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Enfermeras Administradoras , Personal de Enfermería en Hospital , Humanos , Personal de Enfermería en Hospital/psicología , Técnica Delphi , Reorganización del Personal , Enfermeras Administradoras/psicología , Carga de TrabajoRESUMEN
AIM: This study investigates which work-related communication mediates the relationship between diversity climate and psychological empowerment among part-time nurses. BACKGROUND: Part-time nurses' high psychological empowerment is desirable because it may lead to high quality nursing practice. METHODS: Anonymous self-report questionnaires or web-based surveys were used to measure diversity climate (Climate for Inclusion Scale), psychological empowerment (Japanese version of the Psychological Empowerment Scale) and work-related communication (scale developed in this study). The respondents were part-time nurses from departments with shift work in six Japanese hospitals having over 200 beds. The surveys were conducted from September to October 2020. Multiple regression analyses and a significance test of indirect effects were then conducted. RESULTS: Among the work-related communication components, 'expressing thoughts about their work' fully mediated the relationship between diversity climate and psychological empowerment. CONCLUSIONS: It is important for part-time nurses to be actively 'expressing thoughts about their work' to enhance their psychological empowerment. Positive diversity climate is also important because it allows part-time nurses to express their thoughts regarding work. IMPLICATIONS FOR NURSING MANAGEMENT: Managers can enhance part-time nurses' psychological empowerment by encouraging them to express their work-related opinions based on the diversity climate.
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Satisfacción en el Trabajo , Enfermeras y Enfermeros , Humanos , Estudios Transversales , Lugar de Trabajo/psicología , Poder Psicológico , Encuestas y Cuestionarios , ComunicaciónRESUMEN
PURPOSE: This study aimed to identify the working conditions (working hours, overtime work, number of night shifts, number of holidays, and work intervals) associated with fatigue, based on the shift patterns, and determine their thresholds. METHODS: From January to February 2020, a web-based questionnaire was sent to 4601 shift work nurses at 47 hospitals in Japan. The multivariate logistic analysis was conducted to predict high- and low-fatigue groups by working conditions, and receiver operating characteristic analysis was performed to clarify the high-fatigue thresholds by shift pattern. RESULTS: A total of 386 shift work nurses participated in this study. The threshold (fatigue was 3.0 or higher) of the two-shift rotation was 9 hours 50 minutes for daily working hours during day shifts (Odds ratio [OR] = 1.57, p < .01), 17 hours 15 minutes for daily working hours during night shifts (OR = 1.20, p < .01), and 8.0 days for the number of night shifts (OR = 1.09, p = .02). The threshold of the three-shift rotation was 9 hours 45 minutes (OR = 1.59, p < .01), 2.9 days for the number of midnight shifts (OR = 1.53, p < .01), and 2.0 times for the interval between day-shift and night-shifts within 12 hours (OR = 1.39, p < .01). CONCLUSION: Working hours and the number of night shifts are important for two-shift rotation, and working hours for the assignment of midnight shift are important for three-shift rotations. Nurse managers should manage shifts according to nurses' shift patterns.
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Enfermeras y Enfermeros , Horario de Trabajo por Turnos , Estudios Transversales , Fatiga , Humanos , Japón , Tolerancia al Trabajo ProgramadoRESUMEN
AIMS: To investigate the number of bed transfers (patient transfers within the same ward) and their reasons in acute care wards of mid-sized hospitals with multibed and private rooms. BACKGROUND: Bed transfers, even when necessary, are burdensome for patients; however, the reasons for bed transfers in various types of rooms remain unclear. METHODS: An observational study was conducted in seven wards in three hospitals in Japan. Nurses completed a questionnaire regarding each bed transfer, which elicited the reasons for the transfer. We classified transfer patterns based on the functions of the patients' rooms and the number of beds in each room and analysed scores. RESULTS: Overall, 560 responses were analysed. The average number of bed transfers per day was 2.7. In total, 43% of bed transfers were conducted for patients aged over 70. The most frequent bed transfer pattern was 'transfer between patient rooms with the same number of beds', and the most frequent reason was 'patient did not need that bed'. CONCLUSIONS: Unnecessary bed transfers could be reduced by ward designs that reflect nurses' clinical judgement. IMPLICATIONS FOR NURSING MANAGEMENT: Monitoring data for the reason regarding bed transfer contributes to hospital planning and decreases unnecessary bed transfers.
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Enfermeras y Enfermeros , Habitaciones de Pacientes , Anciano , Cuidados Críticos , Hospitales , Humanos , Encuestas y CuestionariosRESUMEN
AIM: To identify the effects of authentic leadership, structural empowerment and forms of communication as antecedent factors of workplace social capital in nursing. BACKGROUND: Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members. METHODS: In 2019, self-administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate relationships between perceived workplace social capital-the dependent variable-and authentic leadership, structural empowerment and forms of communication-the individual- and ward-level independent variables. RESULTS: Data from 463 nurses and 28 nurse managers were analysed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (standard deviation: 7.00), and 93.5% were female. Ward-level authentic leadership and semi-formal communication were found to be significantly related to workplace social capital. CONCLUSION: More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: Workplace social capital can be produced by improved management, environment and communication opportunities.
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Enfermeras Administradoras , Capital Social , Adulto , Comunicación , Estudios Transversales , Femenino , Hospitales , Humanos , Japón , Liderazgo , Encuestas y Cuestionarios , Lugar de TrabajoRESUMEN
AIMS: The study aimed to determine the influence of learning circumstances (learning inside and outside hospitals, and communication about the nursing practice with colleagues) and on-the-job opportunities for professional growth on each dimension of person-environment fit (needs-supplies, demands-abilities, person-organisation and person-group fit) among nurses. BACKGROUND: It is desirable for each dimension of person-environment fit to be high, as it links to many work-related outcomes. METHODS: A longitudinal survey using a questionnaire was conducted in February 2019 (Time 1) and October 2019 (Time 2). A simple linear regression analysis and a multiple linear regression analysis were conducted, using data from 324 nurses. RESULTS: The results of the simple regression analysis showed that three variables related to learning circumstances at Time 1 were positively related to each dimension of person-environment fit at Time 2. The multiple regression analysis showed on-the-job opportunities for professional growth at Time 1 related to person-environment fit at Time 2. CONCLUSIONS: To achieve high person-environment fit, nurses should be aware of on-the-job opportunities for professional growth. IMPLICATIONS FOR NURSING MANAGEMENT: To achieve high person-environment fit, nurse managers should evaluate nurses' abilities and assign them jobs that would help improve their nursing skills.