RESUMO
BACKGROUND: Previous studies evaluating work engagement of nurses revealed work-related factors and nurse demographics affecting work engagement. Low work engagement yields a decrease in productivity, high turnover, loss of revenue, and, most importantly, patient safety concerns. AIM: To investigate the relationship between nurse-related and work-related variables associated with work engagement and provide a model that explains work engagement. METHOD: This study employed an observational, cross-sectional study design, with 201 registered nurses working in acute care hospitals in the United States participating in the study. Four work-related and five nurse-related variables were evaluated and used in the work engagement model. A standard multiple regression was performed using the work- and nurse-related factors regressed onto work engagement. Structural equation model procedures were performed to examine the association between predictive variables and work engagement. RESULTS: Of the 201 participants, just over a third of the participants were over 50 years of age (33.5%), female (91.6%), married (68%), had a bachelor of science in nursing (58.1%), and have been a nurse <5 years (42.4%). Five of the variables were found to make a unique statistically significant contribution to the variance in work engagement, age (ß = .31, p = .001), workload (ß = .30, p < .001), Core Self-Evaluation Scale (ß = 0 .22, p = .002), Coping with Change Scale (ß = .20, p = .001), and Maslach Burnout Inventory (MBI)-General Scale score (ß = -.17, p = .03). The work engagement model indicated a satisfactory overall model fit of the model (GFI = .996; χ2 (2, N = 201) = 4.02, p = .135; RMSEA = .07; CFI = .983; NFI = .976). LINKING EVIDENCE TO ACTION: The results of this study confirm a work engagement model that incorporates both nurse- and work-related factors. Overall, the results indicate that the level of work engagement is predicted more by nurse-related factors than by work-related factors.
RESUMO
Electronic health records are integral to the advanced practice registered nurse role, yet access and training during academic preparation are profoundly limited. Lack of exposure to electronic health records prevents students from becoming fully prepared for the responsibilities of clinical practice and potentially impacts quality of care, patient safety, and communication among patients and providers. This scoping review of 20 articles on electronic health record use in advanced practice registered nursing student education shows significant gaps in current research. Nine articles were classified as research. The remaining 11 were non-research reports of teaching innovations describing the use of simulated electronic health records in graduate nursing education or the use of an electronic health record in interprofessional education activities. Most of the limited research did not use valid and reliable instruments or robust designs, employed disparate approaches and tools to study the phenomenon, and measured low-level outcomes such as student navigation and confidence in using electronic health records. The non-research literature draws attention to the deficits in educational resources, including unaffordable electronic health records for academic use. Although rigorous evidence is lacking, a common theme throughout the reviewed literature was the benefit of simulation to develop electronic health record skills.