A Mixed Study On The Status Quo And Expectation Of Nurses' Practice Environment In Three-A Hospitals In A Certain District

ObjectiveTo understand the current situation and expectation of nurses' practice environment in third-grade class-A hospitals,eompare the gap between the two,and analyze the factors affecting nurses' practice environment.Through further in-depth interviews,to understand nurses1 real feelings and expectations of the practice environment,and to provide reference for hospital managers to improve the practice environment of nurses.MethodsThis research adopts the method of combining quantitative research with qualitative research.The first stage:quantitative study.A thousand nurses from three third-grade class-A hospitals in a certain region were selected for questionnaire survey by convenience sampling method.General demographic data of nurses were collected by self-made questionnaire,and nurses' practice environment status and expectation rating scale were used to investigate nurses' practice environment status and expectation of practice environment.SPSS22.0 statistical software was used to input and analyze the collected data.Statistical methods included descriptive statistics,paired sample t-test,two-independent sample t-test,one-way anova for homogeneity of variance,rank sum test for variance inhomogeneity,and multiple linear regression analysis.The second stage:qualitative research.Using the purpose sampling method,from November to December 2018,12 nurses who participated in the first phase of the survey and had a large difference in the status quo and expectations of the practice environment were interviewed to understand the true feelings and expectations of the nurses in the practice environment.The phenomenological research method refines and analyzes the subjects confirming and supplementing the quantitative research results.Results1.Quantitative research results(l)The total average score of nurses' environmental practice was(74.47±2 1.05)points,six dimensions of the nurses' practice environment from low to high were:the nurses participated in hospital affairs(63.42±18.92),salary and social status(69.74±16.17),the ability of the nursing management,leadership and support(74.65±17.04),human and material resources(74.66±15.35),medical cooperation(79.89±15.53),the basis of high quality nursing service(81.62±13.33).(2)The nurses' expectation environment expectation score was(82.97±9.64)points,the six dimensions from high to low were:the basis of high quality nursing service(86.08±9.70),salary and social status(84.81±7.06),medical cooperation(84.23±11.08),the ability of the nursing management,leadership and support(81.91±15.33),human and material resources(81.49±13.83),the nurses participate in hospital affairs(71.98±17.38).(3)The status and expectations of nurses' practice environment were statistic-ally significant in the overall score and the scores of the other six dimensions.(P<0.05).The biggest difference was the "salary and social status" dimension,the smallest difference was "medical cooperation" Dimensions.(4)Nurses of different genders(t=2.412,P=0.019),ages(?2=13.296,P=0.001),professional title(?2=20.547,P=0.000),working years(?2=8.308,P=0.040),department(?2=62.075,P=0.000),monthly income(?2=17.081,P=0.002)and whether the night shift(t=2.452,P=0.014)had an impact on the nurses' practice environment.(5)The results of regression analysis show that departments monthly income,and whether night shift is an important factor affecting the nurses' practice environment,can explain 23%of the variance.2.Qualitative research resultsThrough qualitative interviews,we found that nurses' real feelings about the practice environment include four themes:(1)imbalance between salary and income and labor;(2)limited professional growth and personal development of nurses;(3)unsafe working environment;(4)low social recognition.The expectation of nurses on practice environment includes four themes:(1)reasonable welfare;(2)status improvement,respect and recognition;(3)provide a platform to attach importance to the professional development of nurses;(4)participate in management decisions and have autonomy.ConclusionNurses in third-grade class-A hospitals generally agree with the practice environment.There are differences among nurses with different demographic characteristics,and there is a certain gap between practice environment and expectation.It is suggested that nursing managers should take corresponding measures to narrow the gap according to the actual situation such as different gender,age and titles of nurses.We can improve the welfare of nurses and recognize the value of their work;Let nurses participate more in hospital decision-making,enhance the autonomy of nurse;Focus on supporting the needs and pressures of key groups;Improve laws and regulations to build a safe working environment;Measures such as creating a good atmosphere for nurses to build a good practice environment,so as to improve the quality of nursing services.