Paper
Wednesday, July 21, 2004
This presentation is part of : Strategies to Create Evidence-Based Nursing Environments
Predictors of Organizational Improvement in Swedish Neonatal Care
Lars Wallin, PhD, RN, Faculty of Nursing, KUSP program, University of Alberta, Edmonton, AB, Canada, Uwe Ewald, PhD, MD, Dpt Of Women's and Childrens Health, Uppsala University, Uppsala, Sweden, Karin Wikblad, PhD, RN, Department of Welfare and Care, Linköping University, Norrkoping, Sweden, and Bengt B. Arnetz, PhD, MD, Dpt of Publich Helth and Care, Uppsala University, Uppsala, Sweden.
Learning Objective #1: Identify significant factors for organizational improvement
Learning Objective #2: Discuss ways to achieve organizational improvement
Background: A shortage of high quality research examining the impact of the workplace on outcomes exists, yet we are increasingly able to claim that contextual factors contribute importantly to provider and patient outcomes. This makes it imperative to investigate factors that nurse leaders can implement to improve work conditions, even in times of increased competition and structural changes.

Objectives: The aim of this study was to identify predictors of organizational and staff well-being by measuring staff perceptions of contextual work factors during the course of one year.

Design and Method: We used the Quality Work Competence (QWC) questionnaire, including 10 enhancement indices and an overall score, in a repeated measurement survey, with one year between the two periods of data collection.

Sample: The sample involved 134 employees, mainly nurses, at four neonatal units in Sweden.

Findings: Although survey outcomes on the aggregated level were stable over time, there were measurable changes within and between units over the study period. Changes in staffs’ perceptions over time on skills development (r2=0.295) and participatory management (r2=0.070) were the major predictors of overall organizational and staff well-being. Further, perceived improvements of leadership predicted improvements of mental energy (OR 2.2); perceived improvements of skills development predicted improvements in organizational efficacy (OR 2.7); and perceived improvements in skills development and performance feedback predicted improvements of leadership (OR 7.8 and OR 2.7). Finally, change commitment was predicted by perceived decreases in work tempo (r2=0.162) and work-related exhaustion (r2=0.080).

Conclusion and implications: These findings point strongly to the potential for organizational improvement by developing a learning and professional supportive environment as well as of involving staff in decision-making on the unit level.

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Sigma Theta Tau International
July 21, 2004