Investigation and analysis on positive practice environments of nurses at public hospital

Objective To investigate the positive practice environments (PPE) of nurses and influencing factors at public hospitals, for reference of building a better PPE. Methods A national cross-sectional survey was performed at 77 public hospitals across seven provinces/metropolises, involving 5 374 nurses. PPE included organizational management (internal) and nurses-patient relationship (external). Results The scoring of positive practice environment was 18.51±4.69 (total score of 40). The scoring of organizational management and nurses-patient relationship was 9.87±3.11 and 8.64±2.51 respectively. The scoring of PPE of nurses of general hospital(GH) was higher than that of traditional Chinese medicine hospital(TCMH) (18.68±4.68 versus 18.08±4.67, P<0.01). Multivariable analysis showed that, compared with nurses who had not very much pressure about performance assessment, the scores of those who had were declined (βGH=-1.15, 95%CI: -1.55 to -0.76; βTCMH=-1.29, 95%CI: -1.92 to -0.66)); compared with nurses who paid less efforts in communicating with their patients, the scoring of those with greater efforts was higher (βGH=2.43, 95%CI: 2.00 to 2.86; βTCMH=2.84, 95%CI: 2.19 to 3.49). Conclusions PPE of nurses is poor in general in China, and the externally stressful nurse-patient relationship deserves greater attention and efforts than inefficient organization management internally. To improve PPE of nurses, hospitals need to moderate nurses′ performance assessment and the nurses need to pay more attention to patient communication. Key words: Practice environments; Organizational management; Nurses-patient relationship; Public hospitals; Cross-sectional survey