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在不断变化的医疗保健环境中留住护士:工作嵌入和自我效能的作用。

Retaining nurses in a changing health care environment: The role of job embeddedness and self-efficacy.

机构信息

James M. Vardaman, PhD, is Associate Professor and Nancy Allen Fellow, Department of Management and Information Systems, College of Business, Mississippi State University, Starkville. E-mail:

出版信息

Health Care Manage Rev. 2020 Jan/Mar;45(1):52-59. doi: 10.1097/HMR.0000000000000202.

Abstract

BACKGROUND

Because nurses are on the front lines of care delivery, they are subject to frequent changes to their work practices. This change-laden environment puts nurses at higher risk for turnover. Given the frequent disruption to the way nurses perform their jobs, change-related self-efficacy (CSE), or confidence that one can handle change, may be vital to their retention.

PURPOSE

The purpose of this article is to examine the roles of CSE and job embeddedness in reducing turnover intentions among nurses. Specifically, this article tests a model in which CSE is the intervening mechanism through which job embeddedness influences turnover intentions.

METHODS

Drawing on a sample of 207 nurses working in the medical/surgical unit of a major metropolitan hospital in the United States, this study employs OLS regression to test for direct effects of job embeddedness and CSE on turnover intentions and bias-corrected bootstrapping to test for the indirect effects of job embeddedness on turnover intentions through CSE.

FINDINGS

Results show that CSE is directly linked to turnover intentions, and the effects of job embeddedness on turnover intentions become fully manifest through CSE.

PRACTICE IMPLICATIONS

Improved nurse retention may lead to stable patient care and less disruption in service delivery. Improved retention also benefits health care organizations financially, as costs of replacing a nurse can exceed 100% of the salary for the position. Given the shortage of nurses in some geographic areas, retention remains an important goal.

摘要

背景

由于护士处于护理服务的第一线,他们的工作实践经常发生变化。这种充满变化的环境使护士更容易离职。鉴于护士的工作方式经常受到干扰,与变化相关的自我效能感(CSE),即一个人应对变化的信心,对他们的留任可能至关重要。

目的

本文旨在探讨 CSE 和工作嵌入度在降低护士离职意愿中的作用。具体来说,本文检验了这样一个模型,即 CSE 是工作嵌入度影响离职意愿的中介机制。

方法

本研究以美国一家主要大都市医院的医疗/外科病房的 207 名护士为样本,采用 OLS 回归检验工作嵌入度和 CSE 对离职意愿的直接影响,采用偏误校正自举法检验工作嵌入度通过 CSE 对离职意愿的间接影响。

结果

结果表明,CSE 与离职意愿直接相关,工作嵌入度对离职意愿的影响完全通过 CSE 来体现。

实践意义

提高护士留任率可能会导致稳定的患者护理和服务提供中断减少。改善留任率也会使医疗保健组织在财务上受益,因为替换一名护士的成本可能超过该职位工资的 100%。鉴于某些地区护士短缺,留任仍然是一个重要目标。

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