Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
The Ohio State University College of Nursing, Columbus, OH, USA.
Worldviews Evid Based Nurs. 2021 Apr;18(2):129-137. doi: 10.1111/wvn.12497. Epub 2021 Mar 18.
Evidence-based management practices (EBMPs) that improve nurses' work environments have been linked to improvements in patient outcomes such as patient satisfaction and mortality. Yet, the extent to which nurse managers implement these EBMP or the factors associated with their implementation is not known.
Guided by the Promoting Action on Research Implementation in Health Services (PARIHS) Framework, we examined individual, evidence, and organizational characteristics associated with nurse managers' implementation of the five EBMPs.
A cross-sectional, correlational, survey design was used. Nurse managers from 10 public hospitals in New York City were recruited. Evidence and contextual variables were measured with the Organizational Readiness for Change Assessment instrument. EBMPs were measured with a modified version of the Practice Environment Scale of the Nursing Work Index. All multi-item scales were validated with confirmatory factors analysis in the studied sample. Additionally, the scales had Cronbach's alpha reliability greater than .8. A multivariate linear regression analysis with robust standard error correction was used to analyze the data and to adjust for clustering of managers in hospitals.
A total of 331 nurse managers responded for a 47.4% response rate. Bachelor's degree, number of staff supervised, managers' personal experience with evidence for EBMPs, staff culture, and organizational resources were significant predictors of nurse managers' implementation of EBMPs for NWE improvement (p < .05).
Staff culture was positively associated with implementation of all five EBMPs for improving nurses' work environments. Managers should prioritize nursing unit culture that encourages staff to innovate and change in order to improve care.
已证实，改善护士工作环境的循证管理实践（EBMP）与改善患者结局（如患者满意度和死亡率）有关。然而，护士管理者实施这些 EBMP 的程度或与实施相关的因素尚不清楚。
在促进卫生服务实施研究行动（PARIHS）框架的指导下，我们研究了与护士管理者实施五项 EBMP 相关的个体、证据和组织特征。
采用横断面、相关性、调查设计。从纽约市 10 家公立医院招募了护士管理者。使用组织变革准备评估工具测量证据和背景变量。使用护理工作指数实践环境量表的修订版测量 EBMP。在研究样本中，所有多项目量表均通过验证性因素分析进行验证。此外，这些量表的克朗巴赫α信度大于 0.8。采用具有稳健标准误差校正的多元线性回归分析来分析数据，并调整医院中管理者的聚类。
共有 331 名护士管理者做出回应，回应率为 47.4%。学士学位、监督的员工人数、管理者对 EBMP 证据的个人经验、员工文化和组织资源是护士管理者实施 EBMP 以改善新环境（NWE）的重要预测因素（p < 0.05）。
员工文化与实施所有五项 EBMP 以改善护士工作环境呈正相关。管理者应优先考虑鼓励员工创新和变革的护理单元文化，以改善护理。
