The purposes of this study aimed at assessing the entry level nursing administrators’ knowledge of the dilemma of current nursing work environment and how individual characteristics affect their level of knowledge.
Methods:
This study was designed to be a cross sectional study. After two research team discussions and two rounds of expert focus group discussion, all the dilemmas which entry level nursing administrators are facing in current nursing work environment were laid out. Experts of this field were engaged to devise test questions for relevant issues. Every version of test has twenty questions. The numbers of questions pertaining to each issue are apportioned according their importance. Of the twenty, there are four questions for flexible scheduling and scheduling rules-maximization of scheduling satisfaction, five for nursing models and job design - including skill-mix care model, three for effective handover, recording by importance and computerization, five for high performance leadership - pursing the balance between work and life for nurses, and three for planned cross training and job rotation in line with career development. After expert consultation, we devised 5 sets of tests for the 22 symposiums. Every set of test was analyzed for its level of difficulty and capability of differentiation. All of their difficulty range between 0.5 and 0.8, which means moderate difficulty. And the capability of differentiation ranges from 0.19 to 0.29. Only the fifth set is slightly lower than 0.19 and the other four sets are all greater than 0.2, which means acceptable capability of differentiation. Paper and pencil tests were administered before each symposium and the five tests were used in cycle to ensure fairness. 1,829 persons received the test in total.
Results:
The overall average is 65.37. Passing score is set at 60. As such, 1,384 persons passed with a pass rate of 75.5%. 66.86% of the questions were correctly answered. The highest correct answer rate is for the issue of planned cross training and job rotation in line with career development(87.13%), followed by flexible scheduling and scheduling rules - maximization of scheduling satisfaction at 77.35%, high performance leadership - pursing the balance between work and life for nurses at 70.04%, effective handover, recording by importance and computerization at 56.20%. The issue of nursing models and job design - including skill-mix care model has the lowest correct rate at 43.56%. According to ANOVA and post hoc analyses, the level of knowledge of the dilemma of current nursing work environment significantly differs among regions in which the hospital is located. In the issues of planned cross training and job rotation in line with career development and effective handover, recording by importance and computerization, the eastern region is superior to the northern, central and southern. The levels of knowledge of planned cross training and job rotation in line with career development and high performance leadership - pursing the balance between work and life for nurses significantly differ among hospital accreditation levels. Medical centers are better than regional and district hospitals. The levels of knowledge of high performance leadership - pursing the balance between work and life for nurses and nursing models and job design - including skill-mix care model significantly differ among educational levels. Graduate school level is better than two year college and bachelor.
Conclusion:
The knowledge of entry level nursing administrators in Taiwan on the dilemma of current nursing work environment has barely made the passing grade. There is plenty of room for improvement. The on the job trainings of future entry level nursing administrators should strengthen the knowledge and understanding of nursing models and job design, and emphasize the issue of effective handover, recording by importance and computerization in the hope of increasing the knowledge of nursing administrators on the dilemma of current nursing work environment and improving nursing work environment. We hope the findings of this study can provide references for future education and training so as to elevate the leading and management ability of nursing administrators and improve nurses’ retention intention.