Objectives: The purpose of the study is to determine the level of rationing of nursing care and its relationship to nurses' perception of their practice environment.

Methods: The study employed a descriptive, cross-sectional study design. The Basel Extent of Rationing of Nursing Care (BERNCA) was administered to assess the level of care rationing while the Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to describe nurses' practice environment. A total of 147 nurses participated in the study. Multiple regression analysis was conducted to determine the effect of various respondent characteristics and nurse practice environment on care rationing.

Results: Only practice environment total score was significantly associated with rationing of care total scores (B = -0.20, p < 0.05). Results of the regression show that for every unit increase in nurse practice environment total score, indicating a better work environment, there is a 0.20 unit decrease in rationing of nursing care total score, which indicated less rationing of care. Respondent characteristics are not significantly related.

Conclusion: Nurses most frequently rationed tasks in the areas of caring/support and monitoring. The less frequently rationed tasks involved medical, technical, and therapeutic aspects of care. The identification of rationing predictors can aid in determining starting points for hospital policy reforms. Prevalence levels can indicate when care rationing exceeds identified thresholds, if any. Nursing administrators can use implicit rationing of nursing care as a crucial indicator of the impact of strategies and changes in the nurse practice environment (e.g., changes in staffing levels, skill mix, and other resources).

Key Words: Health Care Rationing, Health Facility Environment, Nursing Care

PURPOSE: This study was conducted to investigate and compare the characteristics and relations of nursing practice environment, professionalism and job satisfaction among nurses in general hospitals according to hospital size. METHODS: The participants included 314 staff and charge nurses who were working in the general medical/surgical nursing units in one large hospital, three medium sized hospitals, and four small hospitals. Data collected through using self-report questionnaire were analyzed using the SPSS and SAS statistical programs. RESULTS: Nursing practice environment and job satisfaction had significant differences according to hospital size. Both of these scales were highest for medium hospitals and lowest for small hospitals. For all hospital sizes there were positive correlations between each of the variables. Multiple regression analysis showed that both nursing practice environment and job satisfaction were affected by hospital size, but professionalism was not. CONCLUSION: The results of this study indicate that nursing practice environment and job satisfaction vary with the size of the hospital. Therefore, further study is necessary to identify the work environment variables of nurses for performance management and to implement appropriate policies.
Health Facility Environment ; Health Facility Size ; Hospitals, General ; Job Satisfaction ; Nursing, Supervisory ; Phenothiazines ; Professional Competence ; Surveys and Questionnaires ; Weights and Measures

PURPOSE: This cross-sectional descriptive study was to explore the relationship among practice environment, organizational justice, and job satisfaction of male nurses. METHODS: Subjects were 115 male nurses who were the member of the Korean man nurses association, and they were asked to complete self-administration questionnaires via internet site for this survey which included nurse's practice environment, organizational justice, and job satisfaction. Collected data were analyzed using SPSS/WIN version 21.0 software. RESULTS: The mean scores of the nurse's practice environment, organizational justice, and job satisfaction were 2.9, 3.0, 3.1 out of 5 Likert scale respectively. The job satisfaction was positively correlated with the nurse's practice environment (r=.70, p<.001) and organizational justice (r=.78, p<.001). The job satisfaction was affected by procedure-related justice, interpersonal justice, adequacy of staffing and resources in nursing work environment, compensation justice, and good healthy status. These variables explained 68.6% of male nurse's job satisfaction. CONCLUSION: This finding suggest that suitable organization management for male nurses are necessary through improvement of practice environment and organizational justice in hospital.
Compensation and Redress ; Health Facility Environment ; Humans ; Internet ; Job Satisfaction* ; Male* ; Nurses, Male* ; Nursing ; Social Justice*

PURPOSE: The purpose of this study was to investigate factors affecting turnover intention in pediatric nurses. METHODS: A survey was conducted with 212 nurses working in pediatric units at 15 hospitals in Busan, K city. Data were collected from September 1 to October 31, 2014. and analyzed with SPSS PASW 18.0. RESULTS: In Stepwise multiple regression analysis, factors affecting the nurses' turnover intention were emotional burnout (beta =.37, p<.001), relationship between nurse and doctor (beta =.20, p<.001), turnover plan (beta =.17, p<.001), and annual salary (beta =-.13, p<.001), and these variables accounted for 32.2% of the variance in turnover intention. CONCLUSION: The findings indicate that the major factors influencing pediatric nurses' turnover intention are emotional burnout, cooperative relationship between nurse and doctor, turnover plan, and annual salary. Thus, in order to reduce pediatric nurses' turnover intention, it is necessary to develop intervention programs to prevent emotional burnout, the most influencing factor, and enhance cooperative relationship between nurse and doctor and to examine their effects.
Busan ; Child ; Health Facility Environment ; Humans ; Intention* ; Personnel Turnover ; Salaries and Fringe Benefits

OBJECTIVETo explore the relationship between the strength of tobacco control and the effectiveness of creating smoke-free hospital, and summarize the main factors that affect the program of creating smoke-free hospitals.

METHODSA total of 210 hospitals from 7 provinces/municipalities directly under the central government were enrolled in this study using stratified random sampling method. Principle component analysis and regression analysis were conducted to analyze the strength of tobacco control and the effectiveness of creating smoke-free hospitals.

RESULTSTwo principal components were extracted in the strength of tobacco control index, which respectively reflected the tobacco control policies and efforts, and the willingness and leadership of hospital managers regarding tobacco control. The regression analysis indicated that only the first principal component was significantly correlated with the progression in creating smoke-free hospital (P<0.001), i.e. hospitals with higher scores on the first principal component had better achievements in smoke-free environment creation.

CONCLUSIONSTobacco control policies and efforts are critical in creating smoke-free hospitals. The principal component analysis provides a comprehensive and objective tool for evaluating the creation of smoke-free hospitals.

PURPOSE: This study was done to analyze the problems and desired work conditions of nursing organizations in small-medium hospitals. METHODS: Delphi Technique was used. In the first stage, the work conditions of nurses in small-medium hospitals were identified through a literature review. In the second stage, through 3 consultations with 20 nurse advisory groups, feedback was received on the desired work conditions for nurses in small-medium hospitals. In the third stage, 415 nurses and nurse managers were selected to examine the content validity and importance of the desired work conditions identified in the second stage. RESULTS: Sixty-four items were developed along eight domains of desired work conditions for nurses in small-medium hospitals. The survey on the desired work conditions revealed the following in order of importance: ‘wages’, ‘personnel’, ‘job’, ‘work hours’, ‘welfare’, ‘education’, ‘culture’, and and ‘other incentives’. CONCLUSION: The results of this study suggest that small-medium hospitals need to recognize the desired work conditions desired by nurses and accordingly change policies through the efforts of hospitals and professional groups.
Delphi Technique ; Health Facility Environment ; Humans ; Nurse Administrators ; Nursing ; Personnel Turnover ; Referral and Consultation

PURPOSE: This study was done to build and verify a model of clinical nurses' turnover intention using organizational characteristics, job satisfaction and job embeddedness. METHODS: The study participants were 389 hospital nurses. SPSS and AMOS 22.0 program were used to analyze the data and the modeling of turnover intention. RESULTS: A total of 41% of turnover intention was explained by job satisfaction, job embeddedness and organizational characteristics. Nurses with higher job satisfaction and job embeddedness showed lower turnover intention, while organizational characteristics had an indirect effect on their turnover intention. It was found that organizational characteristics had positive effects on both job satisfaction and job embeddedness, and job embeddedness played a mediating role between organizational characteristics and turnover intention. CONCLUSION: To reduce nurses' turnover intention, hospitals' organizational characteristics should be considered. Nurse managers should strive to increase nurses' job satisfaction and job embeddedness through an understanding of the factors of organizational characteristics such as organizational fairness, nursing work environment, motivation, organizational citizenship behavior, and transformational leadership.
Health Facility Environment ; Humans ; Intention* ; Job Satisfaction* ; Leadership ; Models, Structural* ; Motivation ; Negotiating ; Nurse Administrators ; Nursing ; Organization and Administration ; Personnel Turnover

PURPOSE: To develop and test the validity and reliability of the Korean version of PES-NWI measuring nursing work environments in hospitals. METHODS: The Korean version of the PES-NWI was developed through forward-backward translation techniques, and revision based on feedback from focus groups. An internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS WIN (16.0) and AMOS (18.0). Survey data were collected from 733 nurses who worked in three acute care hospitals in Seoul, South Korea. RESULTS: The Korean version of PES-NWI showed reliable internal consistency with a Cronbach's alpha for the total scale of .93. Factor loadings of the 29 items on the five subscales ranged from .28 to .85. The five subscales model was validated by confirmatory factor analysis (RMR<.05, CFI>.9). CONCLUSION: The findings of this study demonstrate that the Korean version of PES-NWI has satisfactory construct validity and reliability to measure nursing work environments of hospitals in Korea.
Adult ; Female ; Health Facility Environment ; Humans ; Male ; Nursing Staff, Hospital/*psychology ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; Translations ; *Workplace

PURPOSE: The purposes of this study were; 1) to test the validity and reliability of the Korean version of Rantz's Observable Indicators of Nursing Home Care Quality Instrument (ONHQ) and 2) to evaluate the quality of Korean nursing homes. METHODS: The study employed a three-phase methodological research design. 1) The original instrument of Rantz's ONHQ was translated into Korean and modified by Korean nursing home experts. 2) A pilot study using the modified instrument was done in 20 nursing homes to examine inter-rater reliability. 3) The validity and reliability were tested in 98 nursing homes. RESULTS: Seven factors were extracted through factor analysis: 'communication', 'care delivery', 'grooming', 'odor', 'environment-basics', 'environment-access', and 'environment-homelike'. These factors explained 86.07% of the total variance. Cronbach's alpha coefficient of the 30 items was .97 indicating a high internal consistency of the instrument. Inter-rater reliability according to Kappa was .82. The average score of nursing home quality was 112.07 indicating an average range of quality level. CONCLUSION: The Korean version of the ONHQ was identified as a tool with a high degree of validity and reliability. This tool can be effectively used to assess the quality of nursing homes by professions as well as family members.
Aged ; Aged, 80 and over ; Assisted Living Facilities ; Factor Analysis, Statistical ; Health Facility Environment ; Homes for the Aged ; Humans ; Korea ; Nursing Homes/*standards ; *Quality of Health Care ; Questionnaires ; Reproducibility of Results

PURPOSE: This study was designed to search for nursing intervention strategies centering around the meaning structure of the nurse's turnover experience by applying phenomenological methods. METHODS: The participants were 6 nurses in small and medium sized hospitals who had experienced at least 1 turnover. Data were collected used MP3 records. The data analysis was done by Giorgi (1985) method. RESULTS: The results were divided into the following categories: 1) Careless decision: wrong decisions, imprudent desire, insufficient patience, unclear future, 2) Inappropriate working environment: irregular working hours, high workload, poor working environment, insufficient understanding of related divisions, lack of opinion collection, low salary, 3) Interpersonal relations problems: discord with colleagues, difficulty in relationships with others, difficulty in daily lives, 4) Lack of specialization: feeling of inertia, lack of role identification, lack of self identification, 5) Inappropriate coping: regret with clinical challenges, difficulty with a new environment, repentance, expectation, relative humility, 6) New self-dignity: expectation, new challenge, relaxing lives, decisions based on future-oriented confidence. CONCLUSION: The finding of this study will offer profound information on the nurse's turnover experience and provide basic raw materials for improving the quality of nursing performance and contribute to the development of hospital organization.
Adaptation, Psychological ; Career Mobility ; Health Facility Environment ; Humans ; Job Satisfaction ; Nursing Staff, Hospital/organization & administration/*psychology ; Personal Satisfaction ; *Personnel Turnover ; Salaries and Fringe Benefits ; Workload ; Workplace