The impact of nursing practice environments on patient safety culture in primary health care: a scoping review.

BACKGROUND: Patient safety has in recent decades become a global concern. It is a key priority area of healthcare organisations, and has a direct impact on patient health and wellbeing. Work environments can strongly impact nurses' wellbeing and may ultimately produce different outcomes for both professionals and patients. The adverse events occurrence is an example of how work environments influence outcomes, and there is evidence of this correlation in several studies conducted in recent years. AIM: To map the knowledge regarding the impact that nursing practice environments have on safety culture in primary healthcare settings, as primary health care concentrates a significant portion of the population's care. DESIGN & SETTING: This review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI) for scoping reviews. METHOD: Study selection, data extraction, and synthesis were performed by two independent reviewers. Based on Population (or participants), Concept, and Context (PCC) framework, studies were considered that addressed nurses' practice environment and patient safety culture in primary health care. All studies published or unpublished from 2002 to the present were considered. RESULTS: Seven studies were included in this review; however, the existing evidence on the relation between nurses' practice environments and patient safety is still limited in primary healthcare settings. Although clear evidence was not found, several characteristics of nursing practice environments that may impact healthcare safety were found, such as leadership, communication, and organisational culture and policies. CONCLUSION: More research directed at primary healthcare nursing practice settings is needed and could be valuable in defining and implementing strategies that promote the safety of care.

The impact of nursing practice environments on patient safety culture in primary health care: a scoping review protocol.

BACKGROUND: Patient safety is a key priority for healthcare organisations. It impacts directly on patient health and wellbeing. The increasing complexity of current healthcare settings, which are associated with high work demands and increasingly stressful professional practice environments, contributes to an increased likelihood of errors and adverse events. Primary health care, given its comprehensiveness of care, makes up a large proportion of the care delivered to the population. AIM: To map the knowledge about the impact that nursing practice environments have on safety culture in the primary healthcare setting. This knowledge is essential for a more effective and appropriate understanding of this phenomenon and to enable the definition of strategies that can promote the provision of safer care to the population. DESIGN & SETTING: A scoping review will be conducted based on the method proposed by the JBI, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used. METHOD: Study selection, data extraction, and synthesis will be performed by two independent reviewers. Based on the Population (or participants), Concept, and Context (PCC) framework, this scoping review will consider studies that address nurses' practice environment and patient safety culture in primary health care. The review will consider all studies, published or unpublished, from 2002 to the present. CONCLUSION: The results from this scoping review are expected to provide an overview of the importance of the nursing practice environments on patient safety culture, which will be crucial to define an appropriate range of strategies to promote the delivery of the safest health care to the population.

Impact of COVID-19 on the Environments of Professional Nursing Practice and Nurses' Job Satisfaction.

(1) Background: The repercussions of work environments were widely studied before the pandemic. However, there are still many difficulties to be discovered considering the impact generated by it. Thus, this study aimed to analyse the impact of COVID-19 on nursing practice environments and nurses' job satisfaction. (2) Methods: A correlational study was conducted in a hospital in northern Portugal, with the participation of 416 registered nurses. Data were collected in June 2021 through questionnaires. The study was approved by the Institutional Ethics Committee. (3) Results: COVID-19 had a favourable impact on the structure component of the practice environments; the process component decreased compared to the pre-pandemic period; the outcome component remained moderately favourable to the quality of care. Nurses were not very satisfied or not at all satisfied with their valuation and remuneration; moderately satisfied with the leadership and staffing; and satisfied with the organisation and resources, co-workers and valuation by patients and families. In more favourable environments, nurses' job satisfactions were higher. (4) Conclusions: Identifying the dimensions with the best and worst scores allowed the institution's managers to concentrate efforts on where improvements were needed, thus preparing professional contexts for the recovery of care activities.

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals.

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.

Ambientes de trabalho de enfermagem durante a covid-19: contribuições para desenvolver uma ferramenta tecnológica / Ambientes de trabajo de enfermería durante covid-19: contribuciones para desarrollar una herramienta tecnológica / Nursing work environments during covid-19: contributions to develop a technological tool

Objetivo: avaliar o impacto da COVID-19 nos ambientes de trabalho de enfermagem e desenvolver uma ferramenta tecnológica para avaliar sistematicamente a qualificação desses contextos. Método: pesquisa de método misto realizada em seis hospitais portugueses, com participação de 442 enfermeiros. Utilizou-se um questionário com caracterização sociodemográfica e profissional, a Scale for the Environments Evaluation of Professional Nursing Practice e questões abertas. Resultados: a COVID-19 teve impacto negativo nos componentes Estrutura (ƿ<0,001), Processo (ƿ<0,001) e Resultado (ƿ=0,009) dos ambientes de trabalho de enfermagem. A monitorização da qualidade dos ambientes de trabalho foi apontada como uma estratégia de melhoria. A ferramenta tecnológica desenvolvida permite identificar precocemente as dimensões mais fragilizadas e priorizar melhorias. Conclusão: a COVID-19 repercutiu negativamente nos ambientes de trabalho. A ferramenta tecnológica construída, que tornou mais dinâmica a avaliação dos ambientes de trabalho, além de garantir o envolvimento dos enfermeiros, constitui uma importante ferramenta de gestão.

Objetivo: evaluar el impacto de COVID-19 en los entornos de trabajo de enfermería y desarrollar una herramienta tecnológica para evaluar sistemáticamente la calificación de estos contextos. Método: investigación de método mixto realizada en seis hospitales portugueses, con participación de 442 enfermeros. Se utilizó un cuestionario con caracterización sociodemográfica y profesional, la Scale for the Environments Evaluation of Professional Nursing Practice y cuestiones abiertas. Resultados: La COVID-19 tuvo impacto negativo en los componentes Estructura (ƿ<0,001), Proceso (ƿ<0,001) y Resultado (ƿ=0,009) de los ambientes de trabajo de enfermería. La monitorización de la calidad de los entornos de trabajo fue apuntada como una estrategia de mejora. La herramienta tecnológica desarrollada permite identificar precozmente las dimensiones más fragilizadas y priorizar mejoras. Conclusión: COVID-19 tuvo un impacto negativo en los entornos de trabajo. La herramienta tecnológica construida, que hizo más dinámica la evaluación de los ambientes de trabajo, además de garantizar la participación de los enfermeros, constituye una importante herramienta de gestión.

Objective: to evaluate the impact of COVID-19 on nursing work environments and to develop a technological tool to assess systematically the qualification of these contexts. Method: mixed method research conducted in six Portuguese hospitals, with the participation of 442 nurses. The questionnaire used contained sociodemographic and professional characterization, which was the Scale for the Environments Evaluation of Professional Nursing Practice and open questions. Results: COVID-19 had a negative impact on the components Structure (ƿ<0,001), Process (ƿ<0,001) and Result (ƿ=0,009) of nursing work environments. The monitoring of the quality of the work environments was pointed out as an improvement strategy. The technological tool developed allows identifying the most fragile dimensions early and prioritizing improvements. Final considerations: COVID-19 had a negative impact on work environments. The technological tool built, which made the evaluation of work environments more dynamic, in addition to ensuring the involvement of nurses, is an important management tool.