| Popis: |
Patient safety continues to be an area of concern, and attention to this topic is evident from a variety of perspectives and disciplines within current literature. Little literature, however, exists regarding aspects of the nursing practice environment, including the psychosocial elements, and their relationship to self-perceived nurse fatigue, as they relate to patient safety. The purpose of this dissertation is to describe and discuss a research study related to patient safety, aspects of the nursing practice environment, individual nurse characteristics, and self-perceived nurse fatigue, within the specific setting of the neonatal intensive care unit (NICU). This dissertation research study utilized a cross-sectional, correlational study design with a convenience sample of registered nurses working as direct patient care providers within one of five NICUs in the Midwestern United States. Using a secure, anonymous, web-based survey technique with a common survey link, demographic data, as well as data regarding the nursing practice environment and self-perceived nurse fatigue were gathered. The Practice Environment Scale of the Nurse Workload Index (PES-NWI) was used to collect data related to the nursing practice environment, while the Checklist Individual Strength (CIS) Questionnaire was employed to solicit information regarding self-perceived nurse fatigue. A hierarchical regression analysis was performed to examine the relationships among the variables. Results of the study indicated a 43% response rate (175/406 completed surveys) and confirmed prior nurse fatigue-related research by demonstrating statistically significant relationships between hours worked each shift in the past two weeks and self-perceived nurse fatigue (t = 2.30; p < .05) and hours of sleep each 24-hour period prior to shift and self-perceived nurse fatigue (t = -2.10; p < .05). Correlations between a physical or mental contributor to fatigue and self-perceived nurse fatigue (t = 3.61; p < .001) and a distressing patient event and self-perceived nurse fatigue (t = 2.13; p < .05) were also discovered to be statistically significant within this study. Additionally, a novel finding from this analysis included the significant relationship between nurse manager leadership, ability, and support and self-perceived nurse fatigue (t = -2.02; p < .05). Based on the study results, suggested implications for practice include the incorporation of organizational and individual strategies focused on alleviating nurse fatigue as well as tactics for the nurse manager when dealing with staff members who have a physical or mental health contributor to fatigue, as well as supporting staff members through a distressing patient situation. Ideas for future research include replication of this study within other nursing practice environments to compare results from varying environments and to improve generalizability, concentration on specific individual and system-level interventions designed to alleviate self-perceived nurse fatigue, incorporation of additional concepts into studies focused on understanding and alleviating nurse fatigue, and examination of optimal strategies for nurse managers to recognize and support staff members through difficult situations, both personal and patient-related. |
