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The Relationship between the Work Environment and Person-centered Critical Care Nursing for Intensive Care Nurses

중환자실 간호사의 근무환경과 인간중심 간호의 관계

  • Kang, Jiyeon (Department of Nursing, Dong-A University) ;
  • Lim, Yun Mi (Trauma ICU, Pusan National University Hospital)
  • 강지연 (동아대학교 간호학과) ;
  • 임윤미 (부산대학교병원 외상중환자실)
  • Received : 2019.05.14
  • Accepted : 2019.06.12
  • Published : 2019.06.30

Abstract

Purpose : The purpose of this study was to investigate the effect of the perceived nursing work environment (NWE) on person-centered critical care nursing (PCCN) practices among nurses in intensive care units (ICUs). Methods : A cross-sectional research design was adopted for this study; participants were 126 ICU nurses working in five hospitals in B city. From December 2018 to February 2019, a survey questionnaire on NWE and PCCN were conducted. The collected data were analyzed with a multiple hierarchical regression analysis. Results : The mean score for NWE was $2.98{\pm}0.39$. Among the factors, basic work system was the highest ($3.39{\pm}0.41$), followed by leadership of the head nurse ($3.31{\pm}0.55$), interpersonal relationships ($2.77{\pm}0.62$), and institutional support ($2.58{\pm}0.52$). The mean score for PCCN was $3.52{\pm}0.46$. Among the factors, comfort was the highest ($3.77{\pm}0.62$), followed by respect ($3.55{\pm}0.56$), compassion ($3.43{\pm}0.60$), and individuality ($3.38{\pm}0.56$). The interpersonal relationship (${\beta}=.31$, p=.001) and the number of patients per shift (${\beta}=-.23$, p=.005) had a significant effect on PCCN, accounting for 25.9% of the total variance. Conclusion : These results suggest that it is necessary to enhance the relationship-oriented culture and reduce the workload of nurses in order to improve the quality of nursing care in ICUs.

Keywords

References

  1. Brownie, S., & Nancarrow, S. (2013). Effects of personcentered care on residents and staff in aged-care facilities: A systematic review. Clinical Interventions in Aging, 8, 1-10. https://doi.org/10.2147/CIA.S38589
  2. Cabrini, L., Landoni, G., Antonelli, M., Bellomo, R., Colombo, S., Negro, A., ... Zangrillo, A. (2015). Critical care in the near future: Patient-centered, beyond space and time boundaries. Minerva Anestesiologica, 82(5), 599-604.
  3. Charmel, P. A., & Frampton, S. B. (2008). Building the business case for patient-centered care. Journal of the Healthcare Financial Management Association, 62(3), 80-85.
  4. Choi, Y. R. (2015). Influencing factors on the personcentered care of emergency room (ER) nurses (Unpublished master's thesis). Hanyang University, Seoul, Korea.
  5. Dingley, C., Daugherty, K., Derieg, M. K., & Persing, R. (2008). Improving patient safety through provider communication strategy enhancements. In K. Henriksen, J. B. Battles, M. A. Keyes & M. L. Grady (Eds.), Advances in patient safety: New directions and alternative approaches (pp. 1-18). Rockville, MD: Agency for Healthcare Research and Quality.
  6. Hong, H. J., & Kang, J. Y. (2018). A qualitative content analysis of the person-centered care experienced by critical care patients. Journal of Korean Critical Care Nursing, 11(2), 21-33.
  7. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academy.
  8. Jakimowicz, S., & Perry, L. (2015). A concept analysis of patient-centred nursing in the intensive care unit. Journal of Advanced Nursing, 71(7), 1499-1517. https://doi.org/10.1111/jan.12644
  9. Jakimowicz, S., Perry, L., & Lewis, J. (2018). Insights on compassion and patient-centred nursing in intensive care: A constructivist grounded theory. Journal of Clinical Nursing, 27(7-8), 1599-1611. https://doi.org/10.1111/jocn.14231
  10. Jung, H. J., & Kang, J. Y. (2014). Critical care nursing work environment and family satisfaction. Journal of Korean Critical Care Nursing, 7(2), 58-67.
  11. Kang, J. Y., Cho, Y. S., Jeong, Y. J., Kim, S. K., Yun, S. Y., & Shim, M. Y. (2018). Development and validation of a measurement to assess personcentered critical care nursing. Journal of Korean Academy of Nursing, 48(3), 323-334. https://doi.org/10.4040/jkan.2018.48.3.323
  12. Kelly, D., Kutney-Lee, A., Lake, E. T., & Aiken, L. H. (2013). The critical care work environment and nurse-reported health care-associated infections. American Journal of Critical Care, 22(6), 482-490. https://doi.org/10.4037/ajcc2013298
  13. Kim, J. W., Kim, K. H., Chung, H. K., & Kwak, Y. H. (2017). The influence of communication barriers on nursing performance of intensive care units nurses. The Journal of Korea Society for Wellness, 12(1), 45-56. https://doi.org/10.21097/ksw.2017.02.12.1.45
  14. Klopper, H. C., Coetzee, S. K., Pretorius, R., & Bester, P. (2012). Practice environment, job satisfaction and burnout of critical care nurses in south africa. Journal of Nursing Management, 20(5), 685-695. https://doi.org/10.1111/j.1365-2834.2011.01350.x
  15. Korean Association of Critical Care Nurses. (2016). A white paper of Korean association of critical dare nurses. Seoul: Author.
  16. Lee, H. J., & Bae, H. B. (2013). The association of nurse staffing levels and patient outcome in intensive care units. Korean Journal of Critical Care Medicine, 28(2), 75-79. https://doi.org/10.4266/kjccm.2013.28.2.75
  17. Lee, S. I., & Lee, E. J. (2016). Effect of nursing work environment, emotional labor and ego-resilience on nursing performance of clinical nurses. The Journal of Korea Society for Wellness, 11(4), 267-276. https://doi.org/10.21097/ksw.2016.11.11.4.267
  18. Lusk, J. M., & Fater, K. (2013). A concept analysis of patient-centered care. Nursing Forum, 48(2), 89-98. https://doi.org/10.1111/nuf.12019
  19. McCance, T., McCormack, B., & Dewing, J. (2011). An exploration of person-centredness in practice. Online Journal of Issues in Nursing, 16(2), 1-10.
  20. McCormack, B., Dewing, J., Breslin, L., Coyne-Nevin, A., Kennedy, K., Manning, M., ... Slater, P. (2010). Developing person-centred practice: Nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing, 5(2), 93-107. https://doi.org/10.1111/j.1748-3743.2010.00216.x
  21. Moon, J. Y. (2015). Ethical issues on critically ill patients. Korean Journal of Medical Ethics, 18(1), 1-9. https://doi.org/10.35301/ksme.2015.18.1.1
  22. Needham, D. M., Davidson, J., Cohen, H., Hopkins, R. O., Weinert, C., Wunsch, H., ... Harvey, M. A. (2012). Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Critical Care Medicine, 40(2), 502-509. https://doi.org/10.1097/CCM.0b013e318232da75
  23. O'Connell, E. (2008). Therapeutic relationships in critical care nursing: A reflection on practice. Nursing in Critical Care, 13(3), 138-43. https://doi.org/10.1111/j.1478-5153.2008.00273.x
  24. Park, E. M., & Park, J. H. (2018). Influence of moral sensitivity and nursing practice environment in person-centered care in long-term care hospital nurses. Journal of Korean Gerontological Nursing, 20(2), 109-118. https://doi.org/10.17079/jkgn.2018.20.2.109
  25. Park, S. H., & Kang, J. Y. (2015). Development and psychometric evaluation of the Korean nursing work environment scale. Journal of Korean Critical Care Nursing, 8(1), 50-61.
  26. Stimpfel, A. W., Rosen, J. E., & McHugh, M. D. (2014). Understanding the role of the professional practice environment on quality of care in magnet (R) and non-magnet hospitals. Journal of Nursing Administration, 44(1), 10-16. https://doi.org/10.1097/NNA.0000000000000015
  27. Tang, C. J., Chan, S. W., Zhou, W. T., & Liaw, S. Y. (2013). Collaboration between hospital physicians and nurses: An integrated literature review. International Nursing Review, 60(3), 291-302. https://doi.org/10.1111/inr.12034
  28. Won, Y. H., & Kang, J. Y. (2014). Intensive care unit nurse's communication experience. Korean Journal of Adult Nursing, 26(3), 352-361. https://doi.org/10.7475/kjan.2014.26.3.352
  29. Yang, Y. S., & Kang, Y. H. (2013). ICU new nurses' job stress, job satisfaction, organizational commitment and turnover intention. Nursing Science, 25(2), 47-58.
  30. You, S. J. (2013). Policy implications of nurse staffing legislation. The Journal of the Korea Contents Association, 13(6), 380-389. https://doi.org/10.5392/JKCA.2013.13.06.380

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