Stone Patricia W, Larson Elaine L, Mooney-Kane Cathy, Smolowitz Janice, Lin Susan X, Dick Andrew W
Columbia University School of Nursing, New York, NY, USA.
Crit Care Med. 2006 Jul;34(7):1907-12. doi: 10.1097/01.CCM.0000218411.53557.29.
The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon.
Cross-sectional design.
Hospitals and critical care units.
Registered nurses (RNs) employed in adult intensive care units.
Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey.
Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers.
A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05).
Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
本研究的目的是：a）估计重症监护病房护士因工作条件而打算离职的发生率；b）确定预测这一现象的因素。
横断面设计。
医院和重症监护病房。
受雇于成人重症监护病房的注册护士（RN）。
通过自我报告调查收集组织氛围、护士人口统计学信息、离职意向及离职原因。
护士被分为两组：a）因工作条件打算离职的护士；b）其他护士（如不打算离职的护士或退休护士）。组织氛围测量指标有七个子量表：专业实践、人员配备/资源充足性、护士管理、护理流程、护士/医生协作、护士能力及积极的排班氛围。医院特征数据来自美国医院协会以及对首席护理官的调查。
全国范围内对来自66家医院和110个重症监护病房的2323名注册护士进行了调查。平均而言，注册护士年龄为39.5岁（标准差 = 9.40），有15.6年（标准差 = 9.20）的医疗保健工作经验，在当前岗位工作了8.0年（标准差 = 7.50）。17%（n = 391）的受访者表示打算在来年离职。其中，52%（n = 202）报告称原因是工作条件。对重症监护病房护士因工作条件而打算离职有独立影响的组织氛围因素是专业实践、护士能力和任期（p < 0.05）。
改善工作环境中的专业实践、护士的临床能力以及支持新入职员工可能会减少人员流动，并有助于确保拥有稳定且合格的劳动力队伍。
