驾驭不确定性,促进护士主导的工作环境变化:参与式行动研究

Julia van Kraaij , Lotte Spruit-Bentvelzen , Famke van Lieshout , Hester Vermeulen , Catharina van Oostveen , RN2Blend consortium
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引用次数: 0

摘要

背景护理工作环境对护士的福祉和患者的护理质量至关重要。尽管采取了有效的干预措施来改善护理工作环境,但了解护士最有效的类型和整合机制仍具有挑战性。随着护理实践在复杂的护理需求和人员短缺的情况下不断发展,了解护士面临的挑战、支持系统和采用机制对于优化工作环境、提高护理质量、工作满意度和员工保留率至关重要。每个病房都成立了由不同病房护士组成的行动研究小组。研究时间为 2022 年 9 月至 2023 年 10 月。通过观察、PhotoVoice 工作坊和个别访谈收集数据。结果护士和管理人员表现出阻碍或促进变革的行为模式,从而产生了三个主题:加强关系、发挥领导作用和胜任任务。这些主题强调了促进合作、鼓励积极主动的态度以及培养应对挑战和推动工作环境积极变化的能力的重要性。所有主题中都出现了不确定感,这种不确定感阻碍了护士承担促进变革的责任。护士们强调了合作和积极主动态度的重要性,但在认识责任和认知能力方面面临挑战。加强护士对不确定性的适应能力和管理至关重要。医疗机构应帮助护士驾驭不确定性,以促进积极的变革。Tweetable 摘要合作、积极主动和能力是护士主导变革的关键。加强护士对不确定性的应变能力和管理至关重要。
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Navigating uncertainties for promoting nurse-led changes in work environments: A participatory action research

Background

The nursing work environment is crucial for nurses' well-being and patients’ quality of care. Despite effective interventions to improve the nursing work environment, understanding the most effective types and integration mechanisms for nurses remain challenging. As nursing practices evolve amid complex care demands and staff shortages, understanding nurses’ challenges, support systems, and adoption mechanisms is vital to optimize the work environment and to enhance quality of care, job satisfaction, and staff retention.

Purpose

To explore strategies for promoting and supporting nurse-led changes to improving their work environment.

Methods

The study employed a participatory action research design on three nursing wards in a Dutch academic hospital. Action research teams with diverse ward nurses were established on each ward. The research took place between September 2022 and October 2023. Data were collected during observations, PhotoVoice workshops, and individual interviews. Data were analyzed using the rigorous and accelerated data reduction technique.

Results

Nurses and managers showed patterns of behavior that either hindered or facilitated changes, leading to the emergence of three themes: strengthening relationships, taking the lead, and being up to the task. These themes highlight the importance of fostering collaboration, encouraging proactive attitudes, and building capabilities to address challenges and drive positive changes in their work environment. Feelings of uncertainty emerged in all themes, and this uncertainty hindered nurses from taking responsibility for facilitating change.

Conclusions

This study demonstrated different mechanisms that either facilitate or hinder nurse-led changes and how feelings of uncertainty play a role. Nurses emphasized the importance of collaboration and proactive attitudes but faced challenges in recognizing responsibility and their perceived competencies. Strengthening nurses' resilience to and management of uncertainty is essential. Healthcare organizations should help nurses navigate uncertainty to foster positive changes.

Tweetable abstract

Collaboration, proactivity, and competency are key in nurse-led changes. Strengthening nurses' resilience and uncertainty management is crucial.
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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
45
审稿时长
81 days
期刊最新文献
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