Educational Preparation and Nurse Turnover Intention from the Hospital Bedside

Evidence of an association between nurses’ educational preparation and patient safety has prompted many hospitals to engage in preferential hiring of baccalaureate nurses or invest resources into tuition assistance. Meanwhile, the difficult nature of nursing at the hospital beside, demanding hospital practice environments, and the need for nurses in expanded roles are converging to create a situation whereby education might beget increased turnover from the hospital bedside. This article describes a study that examined the relationship between educational preparation and turnover intention from the hospital bedside in a sample of nurses from an integrated health system in Pennsylvania. The authors discuss the review of literature, theoretical framework, and study methods. Results indicated that educational preparation independently predicted turnover intention from the hospital bedside. In the discussion and conclusion, the authors suggest that to keep hospitalized patients safe and reduce costs, the hospital bedside should be re-envisioned as a specialty so as to retain baccalaureate nurses in this setting.

Nursing care based on risk assessment and classification: agreement between nurses and the institutional protocol

OBJECTIVE: to verify the degree of agreement between the levels of priority given by baccalaureate nurses in care based on risk assessment and classification and the institutional protocol, and also among peers. METHOD: descriptive study, using a questionnaire with thirty fictitious clinical cases based on the institutional protocol, which is considered the gold standard, answered by twenty baccalaureate nurses. RESULTS: the agreement analysis through the Kappa Coefficient concluded that the agreement between baccalaureate nurses and the institutional protocol in relation to prioritizing the levels of severity was moderate. When the agreement among peers was evaluated, it was low, as represented by the colorimetric density in shades of light gray. CONCLUSION: in Brazil, some institutions have developed their own protocol, which makes it necessary to develop tools in order to evaluate the accuracy of professionals in relation to the protocols, highlighting the need for capable people to perform this activity, thus contributing to patient safety.

Rasch Analysis of the Power as Knowing Participation in Change Tool - the Brazilian version

OBJECTIVES: the objective of this study was to evaluate the items contained in the Brazilian version of the Power as Knowing Participation in Change Tool (PKPCT). METHOD: investigation of the psychometric properties of the mentioned questionnaire through Rasch analysis. RESULTS: the data from 952 nursing assistants and 627 baccalaureate nurses were analyzed (average age 44.1 (SD=9.5); 13.0% men). The subscales Choices, Awareness, Freedom and Involvement were tested separately and presented unidimensionality; the categories of the responses given to the items were compiled from 7 to 3 levels and the items fit the model well, except for the following/leading item, in which the infit and outfit values were above 1.4; this item has also presented Differential Item Functioning (DIF) according to the participant's role. The reliability of the items was of 0.99 and the reliability of the participants ranged from 0.80 to 0.84 in the subscales. Items with extremely high levels of difficulty were not identified. CONCLUSIONS: the PKPCT should not be viewed as unidimensional, items with extremely high levels of difficulty in the scale need to be created and the differential functioning of some items has to be further investigated.

Study of stress, coping and psychosomatic health among would-be baccalaureate nurses

Stress is a risk factor that may endanger our quality of life and health. Certain occupational groups are particularly concerned, such as health care workers. Objective: The present study aimed to investigate the stress load and coping strategies of nurses as well as their psychosomatic health. Method: The questionnaire survey was performed at the University of Szeged. The sample consisted of 208 nursing students (136 part-time and 72 full-time students). The self-completed questionnaire included items of psychosomatic symptoms, coping strategies and stress load. Results: Persons characterized by high level of stress and more frequent psychosomatic symptoms tended to use inadaptive ways of coping more often; whereas those with a relatively lower stress level and fewer symptoms were not characterized by a more frequent use of active ways of coping but instead a lack of the inadaptive coping strategies. Conclusions: The authors concluded that vulnerability of the would-be baccalaureate nurses in this sample was especially high because they even used less effectively the ways of coping that otherwise aimed at both problem solving and maintaining their own health. Orv. Hetil., 2012, 153, 1225–1233.