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Item type Presentation

Format Text-based Document

Title The Practice Environment Scale of the Nurse Work Index:Translating Scores for Practice

Authors Warshawsky, Nora E.

Downloaded 29-May-2018 09:46:42

Link to item http://hdl.handle.net/10755/291010

The Practice Environment Scale of the Nurse Work Index: Translating Scores for Practice

Nora Warshawsky, PhD, RN nwa229@uky.edu University of Kentucky April 13, 2013

Creating Healthy Work Environments Conference Sigma Theta Tau International Indianapolis, IN

Theoretical Model

Work Environment Patient Outcomes

Nurse Outcomes

Practice Environment Scale of the Nurse Work Index

• Nurse Participation in Hospital Affairs

• Nursing Foundations for Quality Care

• Nurse Manager Leadership, Ability, & Support

• Adequate Staffing & Resources

• Collegial Nurse-Physician Relationships

Lake, E. T. (2002). Development of the Practice Environment Scale of the Nursing Work Index. Research in Nursing & Health, 25(3), 176-188.

Nurse Participation in Hospital Affairs

Subthemes Items

CNO and Administration A chief nursing officer who is highly visible and accessible to

staff.

A chief nursing officer equal in power and authority to

other top-level hospital executives.

Administration that listens and responds to employee

concerns.

Nursing administrators consult with staff on daily problems

and procedures.

Staff Nurses Involved in

Governance

Staff nurses are involved in the internal governance of the

hospital (i.e. practice and policy committees).

Opportunity for staff nurses to participate in policy

decisions.

Staff nurses have the opportunity to serve on hospital and

nursing committees.

Career Development Opportunities for advancement.

Career development/ clinical ladder opportunity.

Nursing Foundations for Quality Care

Subthemes Items

Competent Nurses Working with nurses who are clinically competent.

A preceptor program for newly hired nurses.

Active staff development or continuing education

programs for nurses.

Quality Culture A clear philosophy of nursing that pervades the patient

care environment.

High standards of nursing care are expected by the

administration.

An active quality assurance program.

Nursing care is based on a nursing, rather than medical

model.

Patient Care Management Use of nursing diagnosis.

Patient care assignments that foster continuity of care, i.e.,

the same nurse cares for the patient from one day to the

next.

Written up-to-date care plans for all patients.

Nurse Manager Leadership, Ability & Support

Subthemes Items

Nurse Manager A nurse manager who is a good manager and leader.

A nurse manager who backs up the nursing staff in

decision making, even if the conflict is with a physician.

Praise and recognition for a job well done.

Supervisor?? Supervisors use mistakes as learning opportunities, not

criticism.

A supervisory staff that is supportive of nurses.

Adequate Staffing & Resources

• Enough staff to get the work done.

• Enough registered nurses to provide quality patient care.

• Enough time and opportunity to discuss patient care problems with other nurses.

• Adequate support services allow me to spend time with my patients.

Collegial Nurse-Physician Relationships

• A lot of teamwork between nurses and physicians.

• Physicians and nurses have good working relationships.

• Collaboration (joint practice) between nurses and physicians.

Practice Environment Scale Data

2.44

2.62

2.80

2.81

2.91

2.72

1 2 3 4

Adequate Resources

Nurse Participation

Nurse Manager

Foundations for Quality

RN - MD Relationships

Composite

1. Create excel file displaying data and benchmarks.

HO

SPIT

AL

Med

ical

ICU

Surg

ical

ICU

Med

-Sur

g 1

Med

-Sur

g 2

Med

-Sur

g 3

Peri

-op

1

Peri

-op

2

Mean PES Score

2011 Benchmark 2.93 2.89 2.90 2.90 2.91 2.88 2.90 2.90

2011 2.72 2.95 2.85 2.63 3.05 2.87 2.46 2.42

Nursing Participation in Hospital Affairs

2011 Benchmark 2.84 2.77 2.86 2.86 2.90 2.85 2.79 2.79

2011 2.62 2.76 2.72 2.50 3.11 2.81 2.54 2.49

Nursing Foundations for Quality Care

2011 Benchmark 3.08 3.05 3.10 3.10 3.11 3.09 3.02 3.02

2011 2.81 2.98 2.92 2.81 3.17 2.98 2.68 2.69

Nurse Manager Ability, Leadership and Support of Nurses

2011 Benchmark 2.95 3.27 2.95 2.95 2.98 2.96 2.87 2.87

2011 2.80 3.27 3.21 3.00 3.22 3.26 2.17 2.35

Staffing and Resource Adequacy 2.70

2011 Benchmark 2.75 2.71 2.60 2.60 2.59 2.54 2.73 2.73

2011 2.44 2.70 2.33 2.24 2.51 2.48 2.04 2.08

Collegial Nurse Physician Relations

2011 Benchmark 3.05 3.03 2.97 2.97 2.97 2.95 3.07 3.07

2011 2.91 3.04 3.06 2.60 3.23 2.81 2.86 2.50

ADULT CRITICAL

CAREADULT Med/Surg

Peri-Operative

2. Apply stop light color coding.

> 5% Below Benchmark

Within 5% of Benchmark

Meet or Exceed Benchmark

HO

SPIT

AL

Me

dic

al IC

U

Surg

ical

ICU

Me

d-S

urg

1

Me

d-S

urg

2

Me

d-S

urg

3

Pe

ri-o

p 1

Pe

ri-o

p 2

Mean PES Score

2011 Benchmark 2.93 2.89 2.90 2.90 2.91 2.88 2.90 2.90

2011 2.72 2.95 2.85 2.63 3.05 2.87 2.46 2.42

Nursing Participation in Hospital Affairs

2011 Benchmark 2.84 2.77 2.86 2.86 2.90 2.85 2.79 2.79

2011 2.62 2.76 2.72 2.50 3.11 2.81 2.54 2.49

Nursing Foundations for Quality Care

2011 Benchmark 3.08 3.05 3.10 3.10 3.11 3.09 3.02 3.02

2011 2.81 2.98 2.92 2.81 3.17 2.98 2.68 2.69

Nurse Manager Ability, Leadership and Support of Nurses

2011 Benchmark 2.95 3.27 2.95 2.95 2.98 2.96 2.87 2.87

2011 2.80 3.27 3.21 3.00 3.22 3.26 2.17 2.35

Staffing and Resource Adequacy 2.70

2011 Benchmark 2.75 2.71 2.60 2.60 2.59 2.54 2.73 2.73

2011 2.44 2.70 2.33 2.24 2.51 2.48 2.04 2.08

Collegial Nurse Physician Relations

2011 Benchmark 3.05 3.03 2.97 2.97 2.97 2.95 3.07 3.07

2011 2.91 3.04 3.06 2.60 3.23 2.81 2.86 2.50

ADULT CRITICAL CARE ADULT Med/Surg Peri-Operative

3. Count the number of subscales by benchmark status to create summary report.

Subscale

Met or

Exceeded

Benchmark

Within 5% of

Benchmark

> 5% below

Benchmark

Nurse Manager Ability, Leadership, and Support

5 0 2

Collegial Nurse-Physician Relationships

3 1 3

Nursing Participation in Hospital Affairs

2 2 3

Nursing Foundations for the Quality Care

1 2 4

Staffing and Resource Adequacy 0 2 5

3. Draw conclusions

• Med-Surg 2

• Nurse Manager Leadership

• Peri-operative Services

• Staffing & Resources

Strengths Opportunities

Favorability Classification

Subscale scores >2.5

• Favorable if 4-5 subscales >2.5

• Mixed if 2 -3 subscales >2.5

• Poor if ≤ 1 subscales >2.5

Lake, E. T., & Friese, C. R. (2006). Variations in nursing practice environments: Relation to staffing and hospital characteristics. Nursing Research, 55(1), 1-9.