Nurse safety outcomes: old problem, new solution - the differentiating roles of nurses' psychological capital and managerial support.

AIM: The aim of this study was to examine the impacts of nurses' psychological capital and managerial support, plus specific safety interventions (managerial safety priorities, safety training satisfaction), on nurses' in-role safety performance. BACKGROUND: Most hospitals in industrialized countries have adopted selective (often the least costly) aspects of safety, usually related to safety policies. However, patient safety remains a challenge in many countries. Research shows that training can be used to upskill employees in psychological capital, with statistically significant organizational and employee benefits, but this area is under-researched in nursing. DESIGN: Data were collected using a survey-based, self-report strategy. The emerging patterns of data were then compared with the findings of previous research. METHODS: Quantitative survey data were collected during 2014 from 242 nurses working in six Australian hospitals. Two models were tested and analysed using covariance-based Structural Equation Modelling. RESULTS: Psychological capital and safety training satisfaction were important predictors of nurses' in-role safety performance and as predictors of nurses' perceptions of whether management implements what it espouses about safety ('managerial safety priorities'). Managerial support accounted for just under a third of psychological capital and together, psychological capital and managerial support, plus satisfaction with safety training, were important to nurses' perceptions of in-role safety performance. CONCLUSION: Organizations are likely to benefit from upskilling nurses and their managers to increase nurses' psychological capital and managerial support, which then will enhance nurses' satisfaction with training and in-role safety performance perceptions.

The impact of workplace relationships on engagement, well-being, commitment and turnover for nurses in Australia and the USA.

AIMS: We examined the impact of workplace relationships (perceived organizational support, supervisor-nurse relationships and teamwork) on the engagement, well-being, organizational commitment and turnover intentions of nurses working in Australian and USA hospitals. BACKGROUND: In a global context of nurse shortages, knowledge about factors impacting nurse retention is urgently sought. We postulated, using the Social Exchange Theory, that nurses' turnover intentions would be affected by several factors and especially their relationships at work. DESIGN: Based on the literature review, data were collected via a self-report survey to test the hypotheses. METHODS: A self-report survey was used to gather data in 2010-2012 from 510 randomly chosen nurses from Australian hospitals and 718 nurses from US hospitals. A multi-group structural equation modelling analysis identified significant paths and compared the impact between countries. RESULTS: The findings indicate that this model was more effective in predicting the correlations between variables for nurses in Australia compared with the USA. Most paths predicted were confirmed for Australia, except for the impact of teamwork on organizational commitment and turnover, plus the impact of engagement on turnover. In contrast, none of the paths related to supervisor-subordinate relationships was significant for the USA; neither were the paths from teamwork to organizational commitment or turnover. CONCLUSION: Our findings suggest that well-being is a predictor of turnover intentions, meaning that healthcare managers need to consider nurses' well-being in everyday decision-making, especially in the cost-cutting paradigm that pervades healthcare provision in nearly every country. This is important because nurses are in short supply and this situation will continue to worsen, because many countries have an ageing population.