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Hospital nurse shift length, patient-centered care, and the perceived quality and patient safety

Jarrar M, Minai MS, Al-Bsheish M, Meri A, Jaber M

Int J Health Plann Manage, 2019 Jan;34(1):e387-e396.
PMID: 30221794 DOI: 10.1002/hpm.2656

BACKGROUND: There is no clear evidence that can guide decision makers regarding the appropriate shift length in the hospitals in Malaysia. Further, there is no study that explored the value of patient-centered care of nurses working longer shifts and its impact on the care outcomes.
OBJECTIVE: The study aims to investigate the effect of the hospital nurse shift length and patient-centered care on the perceived quality and safety of nurses in the medical-surgical and multidisciplinary wards in Malaysia.
METHODS: A cross-sectional survey has been conducted on 12 hospitals in Malaysia. Data have been collected via a questionnaire. A stratified sampling has been used. The Hayes macro regression analyses have been used to examine the mediating effects of patient-centered care between the effect of working long shifts on the perceived quality and patient safety.
RESULTS: There is a significant mediation effect of patient-centered care between the effect of shift length on the perceived quality (F = 42.90, P ˂ 0.001) and patient safety (F = 25.12, P ˂ 0.001).
CONCLUSION: Patient-centered care mitigates the effect of the shift length on the care outcomes. The study provides an input for the policymakers that patient-centered care and restructuring duty hours are important to provide high-quality patient care.

Matched MeSH terms: Nursing Staff, Hospital/organization & administration*
Fulltext Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study

Musa Mb, Harun-Or-Rashid MD, Sakamoto J

BMC Med Ethics, 2011;12:23.
PMID: 22085735 DOI: 10.1186/1472-6939-12-23

Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues.

Matched MeSH terms: Nursing Staff, Hospital/organization & administration
The impact of workplace spirituality dimensions on organisational citizenship behaviour among nurses with the mediating effect of affective organisational commitment

Kazemipour F, Mohd Amin S

J Nurs Manag, 2012 Dec;20(8):1039-48.
PMID: 23151106 DOI: 10.1111/jonm.12025

AIM: To investigate the relationship between workplace spirituality dimensions and organisational citizenship behaviour (OCB) among nurses through the mediating effect of affective organisational commitment.
BACKGROUND: Nurses' OCB has been considered recently to improve the quality of services to patients and subsequently, their performance. As an influential attitude, affective organisational commitment has been recognized to influence OCB, and ultimately, organisational performance. Meanwhile, workplace spirituality is introduced as a new organisational behaviour concept to increase affective commitment influencing employees' OCB.
METHODS: The cross-sectional study and the respective data were collected with a questionnaire-based survey. The questionnaires were distributed to 305 nurses employed in four public and general Iranian hospitals. To analyse the data, descriptive statistics, Pearson coefficient, simple regression, multiple regression and path analyses were also conducted.
RESULTS: The results indicated that workplace spirituality dimensions including meaningful work, a sense of community and an alignment with organisational values have a significant positive relationship with OCB. Moreover, affective organisational commitment mediated the impact of workplace spirituality on OCB.
CONCLUSION: The concept of workplace spirituality through its dimensions predicts nurses' OCB, and affective organisational commitment partially mediated the relationship between workplace spirituality and OCB.
IMPLICATIONS FOR NURSING MANAGEMENT:
Nurses' managers should consider the potentially positive influence of workplace spirituality on OCB and affective commitment among their nurses. With any plan to increase workplace spirituality, the respective managers can improve nurses' performance and would be of considerable importance in the healthcare system.

Matched MeSH terms: Nursing Staff, Hospital/organization & administration*
Factors influencing registered nurses perception of their overall job satisfaction: a qualitative study

Atefi N, Abdullah KL, Wong LP, Mazlom R

Int Nurs Rev, 2014 Sep;61(3):352-60.
PMID: 24902878 DOI: 10.1111/inr.12112

AIM: The purpose of this qualitative descriptive study was to explore factors related to critical care and medical-surgical nurses' job satisfaction as well as dissatisfaction in Iran.
BACKGROUND: Job satisfaction is an important factor in healthcare settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care.
METHOD: A convenient sample of 85 nurses from surgical, medical and critical care wards of a large hospital was recruited. Ten focus group discussions using a semi-structured interview guide were conducted. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach.
FINDINGS: The study identified three main themes that influenced nurses' job satisfaction and dissatisfaction: (1) spiritual feeling, (2) work environment factors, and (3) motivation. Helping and involvement in patient care contributed to the spiritual feeling reported to influence nurses' job satisfaction. For work environment factors, team cohesion, benefit and rewards, working conditions, lack of medical resources, unclear nurses' responsibilities, patient and doctor perceptions, poor leadership skills and discrimination at work played an important role in nurses' job dissatisfaction. For motivation factors, task requirement, professional development and lack of clinical autonomy contributed to nurses' job satisfaction.
CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers should ensure a flexible practice environment with adequate staffing and resources with opportunities for nurses to participate in hospital's policies and governance. Policy makers should consider nurses' professional development needs, and implement initiatives to improve nurses' rewards and other benefits as they influence job satisfaction.
KEYWORDS: Environment; Iran; Motivation Factors; Qualitative

Matched MeSH terms: Nursing Staff, Hospital/organization & administration*
Nursing workforce planning: insights from seven Malaysian hospitals

Drake R

Br J Nurs, 2013 Jan-Feb;22(2):95-100.
PMID: 23587892

In 2010, the Royal College of Nursing asked: 'What is the optimal level and mix of nurses required to deliver quality care as cost-effectively as possible?' This question implies there is a relationship between staffing levels, quality of care and financial efficiency. This paper examines the relationship between the staff budget, the number of staff required to achieve a target level of care and the actual number of staff employed in seven hospitals in Malaysia. It seeks to critically evaluate local challenges arising from staff budgeting/planning procedures, identify general issues that apply beyond Malaysian healthcare institutions and, finally, to propose a model that combines finance, staffing and level of care.

Matched MeSH terms: Nursing Staff, Hospital/organization & administration*