Monday, November 3, 2003

This presentation is part of : Satisfaction of Patients and Nurses

Use of Path Analysis to Demonstrate Relations between Staff Nurses' Organizational Support and Workload on Intent to Leave

Karen S. Cox, RN, PhD, CNAA1, Michelle Redfearn, PhD, RN1, and Susan R. Santos, RN, PhD2. (1) Patient Care Services, Children's Mercy Hospitals and Clinics, Kansas City, MO, USA, (2) School of Nursing, University of Missouri, Kansas City, Kansas City, MO, USA
Learning Objective #1: Describe the key organizational dimensions of organizational support for staff nurses in the literature
Learning Objective #2: Demonstrate understanding of how these dimensions and workload lead to intent to leave the organization

Objective

Research indicates organizational support elements are critical in nurse satisfaction and retention. This study used path analysis, a form of structural equation modeling, to test selected support and workload sub scales on intent to leave using the Individual Workload Perception Scale (IWPS). Previous work found support and workload sub scales combined explained 45% of the variance for intent to leave.

Design

Secondary analysis studied the direct and indirect relation of three support sub scales, peer, unit, and manager on the sub scale intent to leave while examining the direct relation of workload with intent to leave.

Population, Sample, Setting

The study used a voluntary sample of 687 inpatient staff RNs from a 187-bed pediatric academic hospital in the Midwest.

Concept or Variables Studied Together

There are five sub scales of the IWPS, a 46-item, five-point Likert scale instrument. Sub scales include support components within an organization: peer (PS), unit (US), manager (MS), and perception of workload (W). Alpha coefficients for these sub scales are .71, .61, .76 and, .73 respectively. Intent to leave, ITL, has a coefficient of .83.

Methods

AMOS, structural equation modeling software, was used to examine the relations between and among PS, US, MS, W and ITL.

Findings

All paths in the original model were significant based on analysis of critical ratios (CR). Workload had a significant relation with ITL, while PS, US, and MS all had significant relations with Workload. When additional models were examined the only support variable to have a direct relation with ITL was MS.

Conclusions

Implications for nurse executives are clear – key organizational support is critical for nurses to perceive their workload is reasonable, perception that workload is reasonable is critical to retaining nurses. Most importantly, manager support for the staff nurse is the linchpin for retaining nurses.

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