How nursing practice environments limit implicit rationing of care and nurse-assessed adverse events: the role of flow at work.

Autor: El-Gazar HE; Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt., Abousoliman AD; Nursing Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.; Nursing Administration Department, Faculty of Nursing, Kafrelsheikh University, Kafr el-sheikh, Egypt., Shawer M; High Institution of Nursing, Mansoura, Egypt.; Nursing Education and Training, King's College Hospital London, Jeddah, Saudi Arabia., Coelho P; Nursing Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia., Zoromba MA; Nursing Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia. zromba2010@mans.edu.eg.; Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt. zromba2010@mans.edu.eg.
Jazyk: angličtina
Zdroj: BMC nursing [BMC Nurs] 2024 Jan 03; Vol. 23 (1), pp. 19. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1186/s12912-023-01644-8
Abstrakt: Background: The nursing practice environment is beneficial in curbing implicit rationing of nursing care and adverse patient events. However, the underlying mechanisms of these relationships remain unexplored.
Aim: To test whether flow at work mediates the relationship between the nursing practice environment, implicit rationing of nursing care, and nurse-assessed adverse patient events.
Methods: This cross-sectional study involved 231 nurses from five hospitals in Port Said, Egypt. The participants completed Arabic-translated versions of the Practice Environment Scale of the Nursing Work Index, the Work-Related Flow Inventory, the Perceived Implicit Rationing of Nursing Care instrument, and the Adverse Patient Events scale. Structural equation modeling was used to test the hypothetical model.
Results: The favorable nursing practice environment positively predicted nurses' flow at work (β = 0.64, p < 0.001), while inversely predicting implicit rationing of nursing care (β = -0.23, p = 0.014) and adverse patient events (β = -0.35, p < 0.001). Nurses' flow at work inversely predicted implicit rationing of nursing care (β = -0.30, p = 0.002) and adverse patient events (β = -0.29, p = 0.002). Moreover, nurses' flow at work acted as a mediator, linking the nursing practice environment to the rationing of nursing care and adverse patient events, with 500 bootstrap results for the indirect effects (β = -0.24, p = 0.001, 95% CI: -0.43 to -0.09; and β = -0.44, p = 0.003, 95% CI: -0.79 to -0.16, respectively).
Conclusion: Nurses working in a favorable nursing practice environment are more likely to experience flow at work, limiting implicit rationing of nursing care and adverse patient events.
Implications for Nursing Management: Nursing administrators should strive to create a healthy nursing practice environment to foster nurses' flow and thereby reduce the frequency of implicit rationing of nursing care and adverse patient events.
(© 2023. The Author(s).)
Databáze: MEDLINE
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