The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
ABSTRACT Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses. Methods: a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environ...
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| Vydané v: | Revista Brasileira de Enfermagem Ročník 77; číslo 6; s. e20230315 - 8 |
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Brazil
Associação Brasileira de Enfermagem
01.01.2024
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| Abstract | ABSTRACT Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses. Methods: a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach. Results: the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment. Conclusions: the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
RESUMEN Objetivos: analizar la relación entre el entorno de práctica profesional de enfermería y la complejidad sociotécnica hospitalaria desde la percepción de los enfermeros. Métodos: estudio explicativo secuencial de métodos mixtos realizado en un hospital del sur de Brasil. Se aplicaron la versión brasileña de la Practice Environment Scale-Nursing Work Index y el Cuestionario de Caracterización de la Complejidad a 132 enfermeros. Posteriormente, se realizaron entrevistas semiestructuradas con 18 participantes, sometidas a análisis temático. La integración de los datos se llevó a cabo mediante conexión. Resultados: el entorno de práctica se mostró favorable, excepto en la subescala de Adecuación de personal y recursos, donde se observó complejidad en las actividades. Las tres categorías emergentes explicaron aspectos humanos y técnicos relacionados con la complejidad en el entorno de práctica, la calidad del cuidado y la seguridad del paciente. La variabilidad inesperada se correlacionó inversamente con el entorno de práctica. Conclusiones: los resultados del estudio indican una relación entre estos constructos, con implicaciones para la calidad y la seguridad del cuidado.
RESUMO Objetivos: analisar a relação entre o ambiente de prática profissional da enfermagem e a complexidade sociotécnica hospitalar na percepção de enfermeiros. Métodos: estudo explanatório sequencial de métodos mistos realizado em hospital do sul do Brasil. Aplicou-se a versão brasileira da Practice Environment Scale-Nursing Work Index e o Questionário de Caracterização da Complexidade para 132 enfermeiros. Após, realizaram-se entrevistas semiestruturadas com 18 participantes, submetidas à análise temática. A integração dos dados foi por conexão. Resultados: o ambiente de prática revelou-se favorável, exceto na subescala Adequação da equipe e de recursos, e a complexidade presente nas atividades. As três categorias emergentes explicaram aspectos humanos e técnicos, relacionados com a complexidade no ambiente de prática, qualidade do cuidado e segurança do paciente. A variabilidade inesperada correlacionou-se inversamente com o ambiente de prática. Conclusões: os resultados do estudo apontam relação entre os construtos, com implicações para a qualidade e segurança do cuidado. |
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| AbstractList | to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care. ABSTRACT Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses. Methods: a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach. Results: the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment. Conclusions: the study results indicate a relationship between these constructs, with implications for the quality and the safety of care. RESUMEN Objetivos: analizar la relación entre el entorno de práctica profesional de enfermería y la complejidad sociotécnica hospitalaria desde la percepción de los enfermeros. Métodos: estudio explicativo secuencial de métodos mixtos realizado en un hospital del sur de Brasil. Se aplicaron la versión brasileña de la Practice Environment Scale-Nursing Work Index y el Cuestionario de Caracterización de la Complejidad a 132 enfermeros. Posteriormente, se realizaron entrevistas semiestructuradas con 18 participantes, sometidas a análisis temático. La integración de los datos se llevó a cabo mediante conexión. Resultados: el entorno de práctica se mostró favorable, excepto en la subescala de Adecuación de personal y recursos, donde se observó complejidad en las actividades. Las tres categorías emergentes explicaron aspectos humanos y técnicos relacionados con la complejidad en el entorno de práctica, la calidad del cuidado y la seguridad del paciente. La variabilidad inesperada se correlacionó inversamente con el entorno de práctica. Conclusiones: los resultados del estudio indican una relación entre estos constructos, con implicaciones para la calidad y la seguridad del cuidado. RESUMO Objetivos: analisar a relação entre o ambiente de prática profissional da enfermagem e a complexidade sociotécnica hospitalar na percepção de enfermeiros. Métodos: estudo explanatório sequencial de métodos mistos realizado em hospital do sul do Brasil. Aplicou-se a versão brasileira da Practice Environment Scale-Nursing Work Index e o Questionário de Caracterização da Complexidade para 132 enfermeiros. Após, realizaram-se entrevistas semiestruturadas com 18 participantes, submetidas à análise temática. A integração dos dados foi por conexão. Resultados: o ambiente de prática revelou-se favorável, exceto na subescala Adequação da equipe e de recursos, e a complexidade presente nas atividades. As três categorias emergentes explicaram aspectos humanos e técnicos, relacionados com a complexidade no ambiente de prática, qualidade do cuidado e segurança do paciente. A variabilidade inesperada correlacionou-se inversamente com o ambiente de prática. Conclusões: os resultados do estudo apontam relação entre os construtos, com implicações para a qualidade e segurança do cuidado. INTRODUCTION METHODS Large hospital organizations with high levels of care requirements possess characteristics that tend to amplify their complexity, such as a diversity of pathologies and professional specialties, patients with multiple chronic conditions and clinical severity, demand for hard-to-replace services, and the use of innovative diagnostic and therapeutic technologies, among others. [...]all these elements do not behave in an isolated or linear manner, as they are subject to the stimuli, resources, information, and feedback present in the environment where they are embedded0'. Complexity, on the other hand, is addressed in studies on healthcare services'11', manufacturing systems'12', and civil construction'13'. [...]understanding the relationship between the constructs of the professional practice environment and hospital sociotechnical complexity is relevant, as it will enable a better understanding of nursing work in a dynamic, diverse, and unpredictable setting, allowing for actions that promote more effective outcomes for quality and safety of care from the perspective of building a favorable environment. At all planned stages, the Informed Consent Form was administered, ensuring that participants received information about the research.The authors of the instruments used for data collection were consulted to obtain permission for their use in this study.To ensure anonymity, each participant was assigned a letter based on their workplace (L = clinical inpatient unit; C = surgical inpatient unit; E = emergency;T= intensive care), followed by a numerical digit in ascending order of participation. The research was conducted in clinical and surgical inpatient units, emergency, and adult intensive care units at a large public university hospital (836 beds) located in southern Brazil, which has quality and safety standards certified by the Joint Commission International. ABSTRACT Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses. Methods: a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach. Results: the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment. Conclusions: the study results indicate a relationship between these constructs, with implications for the quality and the safety of care. to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.OBJECTIVESto analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.METHODSa sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.RESULTSthe nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.CONCLUSIONSthe study results indicate a relationship between these constructs, with implications for the quality and the safety of care. |
| Author | Magalhães, Ana Maria Müller de Gasparino, Renata Cristina Henriqson, Eder Wegner, Wiliam Riboldi, Caren de Oliveira Saurin, Tarcísio Abreu |
| AuthorAffiliation | IV Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil II Universidade Estadual de Campinas. Campinas, São Paulo, Brazil III Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil I Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil |
| AuthorAffiliation_xml | – name: II Universidade Estadual de Campinas. Campinas, São Paulo, Brazil – name: I Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil – name: III Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil – name: IV Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil |
| Author_xml | – sequence: 1 givenname: Caren de Oliveira orcidid: 0000-0002-7685-9183 surname: Riboldi fullname: Riboldi, Caren de Oliveira organization: Hospital de Clínicas de Porto Alegre, Brazil – sequence: 2 givenname: Renata Cristina orcidid: 0000-0001-8729-4707 surname: Gasparino fullname: Gasparino, Renata Cristina organization: Universidade Estadual de Campinas, Brazil – sequence: 3 givenname: Wiliam orcidid: 0000-0002-0538-9655 surname: Wegner fullname: Wegner, Wiliam organization: Universidade Federal do Rio Grande do Sul, Brazil – sequence: 4 givenname: Eder orcidid: 0000-0003-1081-6583 surname: Henriqson fullname: Henriqson, Eder organization: Pontifícia Universidade Católica do Rio Grande do Sul, Brazil – sequence: 5 givenname: Tarcísio Abreu orcidid: 0000-0003-2929-5888 surname: Saurin fullname: Saurin, Tarcísio Abreu organization: Universidade Federal do Rio Grande do Sul, Brazil – sequence: 6 givenname: Ana Maria Müller de orcidid: 0000-0003-0691-7306 surname: Magalhães fullname: Magalhães, Ana Maria Müller de organization: Universidade Federal do Rio Grande do Sul, Brazil |
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| Snippet | ABSTRACT Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.... to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses. a sequential explanatory... INTRODUCTION METHODS Large hospital organizations with high levels of care requirements possess characteristics that tend to amplify their complexity, such as... to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.OBJECTIVESto analyze the... |
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| Title | The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study |
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