Gea-Caballero Vicente, Castro-Sánchez Enrique, Júarez-Vela Raúl, Díaz-Herrera Miguel Ángel, de Miguel-Montoya Isabel, Martínez-Riera José Ramón
Escuela Enfermería La Fe, centro adscrito a la Universidad de Valencia, IIS La Fe, @GREIACC, Valencia, España.
NIHR Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial College London, South Kensington, Londres, Reino Unido.
Enferm Clin (Engl Ed). 2018 Jan-Feb;28(1):27-35. doi: 10.1016/j.enfcli.2017.07.008. Epub 2017 Sep 27.
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.
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%).
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).
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.
护理工作环境是护理质量的关键决定因素。我们的研究旨在评估加那利群岛初级护理机构中护理环境的特征，并确定此类环境中有助于提高质量的关键要素。
我们使用“执业环境量表 - 护理工作指数”工具对初级护理机构进行了横断面研究。我们收集了社会人口统计学变量、得分，并选择了有助于提供最佳护理的关键项目。使用适当的参数和非参数统计检验来分析变量之间的关系（置信区间 = 95%，误差 = 5%）。
144名护士参与了研究。总平均分是81.6分。“执业环境量表 - 护理工作指数”所包含的五个维度的得分范围为2.25 - 2.92（平均分）。我们选出了12个护理质量关键项目；其中6个在加那利群岛表现为积极，2个表现不一，4个表现为消极。12个项目中有7个包含在维度2（护理基本要素）中。担任管理职位与得分较高在统计学上具有相关性（p<.000）。工作年限与这12个项目的得分呈负相关（p<.021）。
加那利群岛初级护理机构中的护理工作环境与西班牙之前研究的其他环境具有可比性。有待改进的方面是人力资源以及护士参与管理决策的情况。护士长必须了解其工作环境，以便能够专注于关键维度的改进。
