Front-line management, staffing and nurse–doctor relationships as predictors of nurse and patient outcomes. A survey of Icelandic hospital nurses
Section snippets
What is already known about the topic?
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Supportive work environments are important for the quality of working life for nurses, and improved patient outcomes
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There are gaps in the literature about the link between nurse work environment and nurse and patient outcomes, notably in countries other than the United States.
What this paper adds
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Re-emphasizes the important role of front line nurse managers and nurse–doctor relationships for successful hospital care.
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Provides further support for the idea that perceptions of staffing adequacy are linked to perceptions of quality.
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The NWI—R was successfully adapted into Icelandic and resulted in empirically and conceptually acceptable sub-scales that demonstrated all expected associations.
Participants
Subjects in this cross-sectional study included nurses working in direct patient care in all specialities at the Landspitali University Hospital, Reykjavik (LSH) including medicine, surgery, intensive care, emergency care, pediatrics, psychiatry, obstetrics and geriatric care. All eligible nurses were approached to participate in the study, a total of 930 nurses working in 98 clinical wards. Nurses who held more than 40% of a full-time equivalent position were eligible for the study. Nurses on
Sample characteristics
Of the final sample of 695 nurses working with direct nursing in all specialities at LSH, a majority of the study participants (64.2%) were between 31 and 50 years of age, 22.1% were older than 51 years, 13.6% were between 20 and 30 years of age, and 5.5% had a master's degree. A review of hospital records (LSH, 2003) indicated that the study cohort was representative for nurses at LSH as a whole with respect to the distribution of ages and nurse specialities. A large majority of the
Discussion
This paper indicates that an Icelandic adaptation of the NWI—R, a tool employed extensively in nursing administration research in English-speaking countries, shows a factor structure comparable to that found by researchers working with it elsewhere. The aspects of nurses’ work environments it measures appear to form stable clusters of items across the countries in which it has been tested. The five NWI—R scales identified here are similar to a factor solution for the NWI—R published by Lake
Acknowledgements
This study has been supported by the British Council Chevening Scholarship and by grants from the Icelandic Centre for Research, the Icelandic Nurse Association Scientific Fund, the Icelandic Nurse Association Continuing Education Fund, the Landspitali University Hospital Scientific Fund and the Landakot Hospital Scientific Fund.
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