Mphaphuli Lufuno M E, Coetzee Siedine K, Tau Babalwa, Ellis Suria M
NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag X6001, Potchefstroom, South Africa.
Unit for Business, Mathematics and Informatics, North-West University, Potchefstroom, South Africa.
BMC Nurs. 2024 Jun 6;23(1):390. doi: 10.1186/s12912-024-01998-7.
There is a substantial amount of literature on the perception of the practice environment and quality of care as perceived by registered nurses and community services nurses in South Africa and worldwide, but there is little to no research that could be found regarding other categories of nurses, and how these perceptions differ between the different categories. Therefore, the aim of this study is to describe the different nursing categories' perceptions of the practice environment and quality of care and the association between the variables.
This study applied a cross-sectional survey design. Data were collected in April 2021 in the public sector of the North West Province. Multiphase sampling was applied to all categories of nurses who worked in an in-patient unit in the selected hospital for at least 3 months (n = 236).
All nursing categories perceived the practice environment as negative, regarding nurse participation in hospital affairs; nurse manager ability, leadership, and support of nurses and staffing and resource adequacy. Perceived quality of care and patient safety items were perceived as neutral and good. However, in all instances, the perceptions of community service nurses and registered nurses were most negative, and enrolled nurse assistants most positive. Adverse events towards patients and nurses were perceived to only occur a few times a year. Overall, nurse perceptions of quality of care and patient safety were most correlated with the subscale of nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses. Adverse events towards patients were most correlated with the collegial nurse-physician relationship subscale, while adverse events towards nurses were correlated with the foundations of quality of care subscale.
Improving the practice environment, especially regarding the subscale nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses, is associated with improved quality of care. Nurses with higher qualifications, registered nurses and community service nurses rated quality of care lower than other categories of nurses, contributing to literature that higher qualified staff are more competent to assess the practice environment and quality of care.
在南非乃至全球，有大量关于注册护士和社区服务护士对执业环境及护理质量认知的文献，但关于其他类别护士以及这些认知在不同类别之间如何差异的研究却几乎没有。因此，本研究的目的是描述不同护理类别的执业环境及护理质量认知，以及这些变量之间的关联。
本研究采用横断面调查设计。2021年4月在西北省公共部门收集数据。对在选定医院住院部工作至少3个月的所有类别护士（n = 236）采用多阶段抽样。
所有护理类别都认为在护士参与医院事务、护士长能力、领导能力以及对护士的支持、人员配备和资源充足性方面，执业环境是负面的。对护理质量和患者安全项目的认知被认为是中性和良好的。然而，在所有情况下，社区服务护士和注册护士的认知最负面，注册护士助理最正面。对患者和护士的不良事件被认为一年只发生几次。总体而言，护士对护理质量和患者安全的认知与护理质量基础子量表以及护士长能力、领导能力和对护士的支持最相关。对患者的不良事件与护士 - 医生合作关系子量表最相关，而对护士的不良事件与护理质量基础子量表相关。
改善执业环境，特别是在护理质量基础子量表以及护士长能力、领导能力和对护士的支持方面，与改善护理质量相关。资质较高的护士（注册护士和社区服务护士）对护理质量的评分低于其他类别护士，这为高素质员工更有能力评估执业环境和护理质量的文献提供了补充。
