Elementos esenciales de los entornos profesionales enfermeros en Atención Primaria y su influencia en la calidad del cuidado

  1. Vicente Gea-Caballero
  2. Enrique Castro-Sánchez
  3. Raúl Júarez-Vela
  4. Miguel Ángel Díaz-Herrera
  5. Isabel de Miguel-Montoya
  6. José Ramón Martínez-Riera
Revista:
Enfermería clínica

ISSN: 1130-8621

Ano de publicación: 2018

Volume: 28

Número: 1

Páxinas: 27-35

Tipo: Artigo

DOI: 10.1016/J.ENFCLI.2017.07.008 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Enfermería clínica

Resumo

Objectives Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. Method We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). Results One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Conclusions Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions.

Referencias bibliográficas

  • McClure, M.L., Poulin, M.J., Sovie, M., Wandelt, M., Magnet hospitals. Attraction and retention of professional nurses.Task Force on Nursing Practice in Hospitals.American Academy of Nursing. ANA Publ. (G-160): 1983, 1–135.
  • Santillán García, A., Evidencia para determinar el impacto de la designación “Hospital Imán” sobre la práctica en enfermería y los resultados de los pacientes. Ene, 9, 2015.
  • Aiken, L.H., Sloane, D.M., Bruyneel, L., Heede KVd, Griffiths, P., Busse, R., et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 383 (2014), 1824–1830.
  • Trinkoff, A., Johantgen, M., Storr, C., Han, K., Liang, Y., Gurses, A., et al. A Comparison of Working Conditions Among Nurses in Magnet® and Non-Magnet® Hospitals. JONA 40:7/8 (2010), 309–315.
  • Kramer, M., Schmalenberg, C., The practice of clinical autonomy in hospitals: 20 000 nurses tell their story. Crit Care Nurse, 28, 2008, 58.
  • Lake, E.T., Development of the practice environment scale of the nursing work index. Res Nurs Health 25 (2002), 176–188.
  • Kramer, M., Schmalenberg, C., Development and evaluation of essentials of magnetism tool. J Nurs Manage 34:7–8 (2004), 365–378.
  • Gajewski, B., Boyle, D., Miller, P., Oberhelman, F., Dunton, N., A multilevel confirmatory factor analysis of the practice environment scale: A case study. Nurs Res 59 (2010), 147–153.
  • Alzate, L.C.C., Bayer, G.L.A., Squires, A., Validation of a Spanish version of the practice environment scale of the nursing work index in the Colombian context. Hisp Health Care Int 12 (2014), 34–42.
  • De Pedro-Gómez, J., Morales-Asencio, J.M., Sesé-Abad, A., Bennasar-Veny, M., Pericas-Beltran, J., Miguélez-Chamorro, A., Psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index in a primary healthcare context. J Nurs Adv 68 (2012), 212–221.
  • Mensik, J., The essentials of magnetism for home health. JONA 37 (2007), 230–234.
  • Jarrín, O., Flynn, L., Lake, E., Aiken, L., Home health agency work environments and hospitalizations. Med Care 52 (2014), 877–883.
  • González-Torrente, S., Pericas-Beltrán, J., Bennasar-Veny, M., Adrover-Barceló, R., Morales-Asencio, J.M., de Pedro-Gómez, J., Perception of evidence-based practice and the professional environment of primary health care nurses in the Spanish context: a cross-sectional study. BMC Health Serv Res, 12, 2012, 227.
  • Parro Moreno, A., Serrano Gallardo, P., Ferrer Arnedo, C., Serrano Molina, L., de la Puerta Calatayud, M.L., Barberá Martín, A., et al. Influence of socio-demographic, labour and professional factors on nursing perception concerning practice environment in Primary Health Care. Aten Prim, 45, 2013, 476.
  • De Pedro-Gómez, J., Morales-Asencio, J.M., Sesé Abad, A., Bennasar Veny, M., Artigues Vives, G., Perelló Campaner, C., Nursing practice settings and competence to incorporate evidence into decisions: analysis of the situation in the Balearic Islands (Spain). Gac Sanit, 25, 2011, 191.
  • Kieft, R.A., de Brouwer, B.B., Franckl, A.L., Delnoij, D.M., How nurses and their work environment afect patient experiences of the quality of care: a qualitative study. BMC Health Serv Res, 13, 2014, 24.
  • Martínez Riera, J.R., Pino Casado, Rd., Estrategias para mejorar la visibilidad y accesibilidad de los cuidados enfermeros en atención primaria de salud. Revista de administración sanitaria siglo XXI 5 (2007), 311–337.
  • Ruíz Hontangas A. Análisis organizativo sobre la provisión de cuidados en la práctica enfermera en los centros hospitalarios de la Comunidad Valenciana [tesis doctoral en internet]. Valencia: CEU Cardenal Herrera; [consultado 19 Mar 2017). 2011. Disponible en: http://dspace.ceu.es/bitstream/10637/5552/1/Ruiz%20Hontangas,%20Antonio_Tesis.pdf.
  • Salcedo Álvarez, S.A., Huerta González, S., Bustamante Edquén, S., Enfermería: la némesis de la ciencia y filosofía del cuidado. Enf Neurol 12 (2013), 998–1001.
  • Juvé Udina, M.E., Farrero Muñoz, S., Monterde Prat, D., Hernández Villen, O., Sistac Robles, M., Rodríguez Cala, A., et al. Análisis del contexto organizativo de la práctica enfermera: El Nursing Work Index en los hospitales públicos. Metas Enferm 10 (2007), 67–73.
  • Donald, F., Martin-Misener, R., Carter, N., Donald, E.E., Kaasalainen, S., Wickson-Griffiths, A., et al. A systematic review of the effectiveness of advanced practice nurses in long-term care. J Adv Nurs 69 (2013), 2148–2161.
  • Pérez-Campos, M.A., Sánchez-García, I., Pancorbo-Hidalgo, P.L., Assessment of the professional practice environment by Spanish nurses who participate in Internet forums. Enfermería Clínica, 23, 2013, 271.
  • Aiken, L., Clarke, S., Sloane, D., Lake, E., Cheney, T., Effects of hospital care environment on patient mortality and nurse outcomes. JONA 38 (2008), 223–229.
  • Heierle Valero, C., La especialidad de Enfermería Familiar y Comunitaria. Enferm Comun, 5, 2009.
  • Yakusheva, O., Lindrooth, R., Weiss, M., Economic Evaluation of the 80% Baccalaureate Nurse Workforce Recommendation: A Patient-level Analysis. Med Care 52 (2014), 864–869.
  • Kim, H., Harrington, C., Greene, W.H., Registered nurse staffing mix and quality of care in nursing homes: A longitudinal analysis. The Gerontologist 49 (2009), 81–90.
  • McClure, M.L., Magnet hospitals: insights and issues. Nurs admin quarterly, 29, 2005, 198.
  • Buerhaus, P.I., DesRoches, C., Applebaum, S., Hess, R., Norman, L.D., Donelan, K., Are nurses ready for health care reform?. A decade of survey research. Nursing Economic, 30, 2012, 318.
Fonte de datos: Dialnet