DOI QR코드

DOI QR Code

Impact of Unit-level Nurse Practice Environment on Nurse Turnover Intention

간호단위별 간호근무환경이 간호사의 이직의도에 미치는 영향

  • Received : 2016.04.29
  • Accepted : 2016.06.20
  • Published : 2016.06.28

Abstract

The purpose of this study was to conduct the impact of unit-level nurse practice environment on turnover intention among nurses in a tertiary hospital. A cross-sectional study was carried out using questionnaires with 267 nurses in 24 nursing units of hospital in Seoul. Data were collected in November 2013 and were analyzed using SPSS/WIN 23.0. The results of the study indicate that nurse turnover intention is associated with the nurse practice environment at the unit level. In addition, the model including age, unit-level nurse practice environment explained 23.0% of the variance for nurse turnover intention. Hospital can improve nurse retention and lower turnover intention by changing the nurse practice environment of unit, such as nurse participation in hospital affairs, improvement of the nurse manager leadership and nurse-physician collaborative relationships.

본 연구의 목적은 3차 의료기관 1개소에 재직 중인 간호사를 대상으로 간호사의 이직의도에 대한 간호단위별 간호근무환경의 영향을 파악하기 위함이다. 서울 소재 의료기관의 24개 간호단위, 간호사 267명을 대상으로 서술적 관계 조사연구를 시행하였다. 자료수집은 2013년 11월에 수행되었으며, 분석은 SPSS/WIN 23.0 프로그램을 이용하여 실시하였다. 연구결과, 간호사의 이직의도는 간호단위 차원의 간호근무환경과 관련이 있는 것으로 나타났다. 또한, 간호사의 이직의도 예측요인으로 연령, 간호근무환경이 유의한 변수로 도출되었으며, 23.0%의 설명력을 보였다. 본 연구결과를 토대로 의료기관은 간호사의 병원운영 참여, 간호 관리자의 리더십 향상, 간호사와 의사의 협력적 관계형성 등 간호단위별 간호근무환경의 개선을 통해 간호사의 확보수준 향상 및 이직의도 감소를 위한 전략을 수립할 수 있다.

Keywords

References

  1. H.-I. Park, K. Lee. "The effects of Social Intelligence and Burnout on Turnover Intention in Nurses : An exploratory study". Journal of Digital Convergence. Vol. 14, No. 4, pp.325-336, 2016.
  2. B.-M. Bang, S. Y. Lee, J. O. Cheong. "Empirical study on the turn-over intention of university hospital nurses". Journal of Digital Convergence. Vol. 13, No. 2, pp.205-213, 2015. https://doi.org/10.14400/JDC.2015.13.2.205
  3. H.-J. Kim, D. Park. "The effects of workplace bullying on turnover intention in hospital nurses". Journal of Digital Convergence. Vol. 14, No. 1, pp.241-252, 2016. https://doi.org/10.14400/JDC.2016.14.1.241
  4. C. M. Duffield, M. A. Roche, C. Homer, J. Buchan, S. Dimitrelis. "A comparative review of nurse turnover rates and costs across countries". J Adv Nurs. Vol. 70, No. 12, pp.2703-2712, 2014. Epub 2014/07/24. doi: 10.1111/jan.12483
  5. A. Kutney-Lee, A. W. Stimpfel , D. M. Sloane, J. P. Cimiotti, L. W. Quinn, L. H. Aiken, "Changes in patient and nurse outcomes associated with magnet hospital recognition", Medical Care. Vol. 53, No. 6, pp.550-557, 2015. https://doi.org/10.1097/MLR.0000000000000355
  6. C. R. Friese, R. Xia, A. Ghaferi, J. D. Birkmeyer, M. Banerjee, "Hospitals in 'Magnet' program show better patient outcomes on mortality measures compared to non-'Magnet' hospitals", Health Affairs. Vol. 34, No. 6, pp.986-992, 2015. https://doi.org/10.1377/hlthaff.2014.0793
  7. E. T. Lake, "Development of the practice environment scale of the nursing work index", Research in Nursing & Health. Vol. 25, No. 3, pp.176-188, 2002. https://doi.org/10.1002/nur.10032
  8. S. Wang, Y. Liu, "Impact of professional nursing practice environment and psychological empowerment on nurses' work engagement: test of structural equation modelling", Journal of Nursing Management. Vol. 23, No. 3, pp. 287-96. 2015. https://doi.org/10.1111/jonm.12124
  9. O. Petit Dit Dariel, J. P. Regnaux. "Do Magnet(R)-accredited hospitals show improvements in nurse and patient outcomes compared to non-Magnet hospitals: a systematic review". JBI Database System Rev Implement Rep. Vol. 13, No. 6, pp.168-219, 2015. Epub 2015/10/13. doi: 10.11124/jbisrir-2015-2262
  10. L. Claudia, B. Luk, M. Trevor, D. Gilles, H. de Jesus Elvio, S. Walter, et al. "Work environment issues and intention-to-leave in Portuguese nurses: a cross-sectional study", Health Policy. Vol. 119, No. 12, pp. 1584-1592. 2015. https://doi.org/10.1016/j.healthpol.2015.09.006
  11. R. AbuAlRub, F. El-Jardali, D. Jamal, N. Abu Al-Rub, "Exploring the relationship between work environment, job satisfaction, and intent to stay of jordanian nurses in underserved areas", Applied Nursing Research. Vol. 31, No. 3, pp. 19-23. 2016. doi: 10.1016/j.apnr.2015.11.014.
  12. B. Head, K. Washington, J. Myers, L. Earnshaw, "Job satisfaction, intent to leave, and work improvements as perceived by hospice and palliative nursing assistants (TH330-C)", Journal of Pain and Symptom Management. Vol. 2, No. 45, pp.352-353, 2013.
  13. M. Flinkman, "Young registered nurses' intent to leave the profession in Finland-a mixed-method study", 2014.
  14. R. Redknap, D. Twigg, D. Rock, A. Towell, "Nursing practice environment: A strategy for mental health nurse retention?", International journal of mental health nursing. Vol. 24, No. 3, pp.262-271, 2015. https://doi.org/10.1111/inm.12126
  15. H. Arslan Yurumezoglu, G. Kocaman, "Predictors of nurses' intentions to leave the organisation and the profession in Turkey", Journal of Nursing Management. 2015. doi: 10.1111/jonm.12305.
  16. K. Liu, L. M. You, S. X. Chen, Y. T. Hao, X. W. Zhu, L. F. Zhang, et al. "The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey", Journal of Clinical Nursing. Vol. 21, No. 9, pp.1476-1485, 2012. https://doi.org/10.1111/j.1365-2702.2011.03991.x
  17. C. Ma, D. M. Olds, N. E. Dunton, "Nurse work environment and quality of care by unit types: A cross-sectional study", International Journal of Nursing Studies. Vol. 52, No. 10, pp.1565-1572, 2015. https://doi.org/10.1016/j.ijnurstu.2015.05.011
  18. E. T. Lake, S. G. Hallowell, A. Kutney-Lee, L. A. Hatfield, M. Del Guidice, B. B. Alan, et al. "Higher quality of care and patient safety associated with better NICU work environments", Journal of Nursing Care Quality. Vol. 31, No. 1, pp.24-32, 2015. https://doi.org/10.1097/NCQ.0000000000000146
  19. E. Cho, D. L. Chin, S. Kim, O. Hong, "The relationships of nurse staffing level and work environment with patient adverse events", Journal of Nursing Scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. Vol. 48, No. 1, pp.74-82, 2016. doi: 10.1111/jnu.12183.
  20. S. Y. Kang, Y. R. Um, S. S. Han, "A professional nursing practice environment and its impact on nurses' task motivation" Taehan Kanho Hakhoe Chi. Vol. 35, No. 2, pp.353-361, 2005.
  21. M. Y. Han, M. S. Lee, J. Y. Bae, Y. S. Kim, "Effects of nursing practice environment, compassion fatigue and compassion satisfaction on burnout in clinical nurses", Journal of Korean Academy Nursing. Vol. 21, No. 2, pp.193-202. 2015 https://doi.org/10.11111/jkana.2015.21.2.193
  22. E. Cho, M. Choi, E-Y. Kim, I. Y. Yoo, N. J. Lee, "Construct validity and reliability of the Korean version of the practice environment scale of nursing work index for Korean nurses", Journal of Korean Academy of Nursing. Vol. 41, No. 3, pp.325-332, 2011. https://doi.org/10.4040/jkan.2011.41.3.325
  23. J. O. Kwon, E-Y. Kim, "Impact of unit-level nurse practice environment on nurse turnover intention in the small and medium sized hospitals", Journal of Korean Academy of Nursing Administration. Vol. 18, No. 4, pp.414-423, 2012. https://doi.org/10.11111/jkana.2012.18.4.414
  24. L. H. Aiken, D. M. Sloane, S. Clarke, L. Poghosyan, E. Cho, L. You, et al., "Importance of work environments on hospital outcomes in nine countries", International Journal of the International Society for Quality in Health Care. Vol. 23, No. 4, pp.357-364, 2011.
  25. E. Cho, D. M. Sloane, E-Y. Kim, Kim S, Choi M, Yoo IY, et al. "Effects of nurse staffing, work environments, and education on patient mortality: An observational study", International Journal of Nursing Studies. Vol. 52, No. 2, pp.535-542, 2015. https://doi.org/10.1016/j.ijnurstu.2014.08.006
  26. L. H. Aiken, S. P. Clarke, D. M. Sloane, E. T. Lake, T. Cheney, "Effects of hospital care environment on patient mortality and nurse outcomes", The Journal of Nursing Administration. Vol. 38, No. 5, pp. 223-229, 2008. https://doi.org/10.1097/01.NNA.0000312773.42352.d7
  27. W. H. Mobley, "Employee turnover: Causes, consequences, and control", 1992.
  28. T. E. Becker, "Foci and bases of commitment: are they distinctions worth making?", Academy of Management Journal. Vol. 35, No. 1, pp. 232-244, 1992. https://doi.org/10.2307/256481
  29. M-R. Kim, "Influential factors on turnover intention of nurses: The affect of nurse's organizational commitment and career commitment to turnover intention", Journal of Korean Academy of Nursing Administration. Vol. 13, No. 3, pp. 335-344, 2007.
  30. K. Han, A. M. Trinkoff, A. P. Gurses, "Workrelated factors, job satisfaction and intent to leave the current job among United States nurses", Journal of Clinical Nursing. Vol. 24, No. 21-22, pp. 3224-3232, 2015. https://doi.org/10.1111/jocn.12987
  31. S. H. Kim, M-A. Lee, "Effects of emotional labor and communication competence on turnover intention in nurses", Journal of Korean Academy Nursing Administration. Vol. 20, No. 3, pp.333-342, 2014.
  32. S. J. Moon, S. S. Han, "A predictive model on turnover intention of nurses in Korea", Journal of Korean Academy of Nursing. Vol. 41, No. 5, pp.633-641, 2011. https://doi.org/10.4040/jkan.2011.41.5.633
  33. H. S. Seok, "Factors affecting organizational commitment and turnover tntention of hospital nurses: Focused on the mediating effects of person-environment fit", Journal of Korean Academy of Nursing Administration. Vol. 19, No. 3, pp.361-371, 2013. https://doi.org/10.11111/jkana.2013.19.3.361
  34. N. E. Warshawsky, D. S. Havens, "Nurse manager job satisfaction and intent to leave", Nursing economics$. Vol. 32, No. 1, pp.32-39. 2014.

Cited by

  1. Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals vol.24, pp.4, 2018, https://doi.org/10.11111/jkana.2018.24.4.265