Physical Environment and Workgroup Cohesion Are Important In Nurses’ Rating of Patient Care

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Nurse-patient ratios have been deemed as an essential factor to achieve quality patient care. However, increasing these ratios is only possible with significant cost and investment of resources. Also, the projected nurses’ shortage becomes a definite hindrance for institutions to increase staffing.

A study published in the current issue of Health Care Management Review presented other aspects of RNs work environments that they believe can have a huge impact on the quality of care they deliver. Those factors are ranked in order of influence: (1) physical work environment; (2) workgroup cohesion; (3) nurse-physician relations; (4) procedural justice; (5) and job satisfaction. It was also observed that nurses’ ratings of patient care quality were higher in hospitals with Magnet recognition programs, and lower in settings with more organizational limitations, like lack of supplies.

The investigators of the published research were Maja Djukic, PhD, RN, assistant professor at the New York University College of Nursing (NYUCN); Christine Kovner, PhD, RN, FAAN, professor at NYUCN; Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo; Farida Fatehi, BDS, MS, junior research analyst at the New York University College of Dentistry (NYUCD); and Daniel Cline, MSN, RN, CRNP, PhD candidate, and the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity scholar, at NYUCN. Their study is based on a 98-question survey of 1,226 RNs, which is part of RN Work Project, started by Kovner and Brewer in 2006, and supported by a grant from the Robert Wood Johnson Foundation.

Djukic emphasized that improvements should be strategic, because improving the work settings varies across different factors. For example, they discovered that magnetic recognition has parallel impact with workgroup cohesion. In this case, it is wiser to invest with the latter because it is less costly and less complicated. Moreover, nurses perceive that enhancing the physical working environment is better than improvements in nurse-physician relations, in achieving quality patient care.

Also, initiating team- building activities for the staff is more beneficial and easier than remodeling a unit. When remodeling a unit, it is also important to incorporate the nurses’ preferences in the work setting designs because this can lead to positive outcomes in terms of patient care.

Kovner believed that it is necessary for health care managers to think on how best they can redesign the physical working environment of the nurses to uphold quality patient care. Moreover, he elaborated that the managers should evaluate their resources and decide what changes are needed and possible that can better patient care.




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