Introduction. The implementation of structured pathways for the placement of newly hired nurses has shown to increase both their job satisfaction and the quality of the assistance provided. However, although context-specific monitoring of variables influencing the organizational climate is often recommended, there are no studies in the literature that investigate the descriptive information of these constructs in the cohort of newly hired nurses. The objectives of this study are: (1) to describe the level of elements influencing the organizational climate in the newly recruited nurses of the Seven Lakes ASST, (2) to describe the predictive capabilities of these error awareness constructs in clinical practice, and (3) to link study variables to a CWB-related proximity variable to establish a hypothetical behavioral safety cut-off. Materials and Methods. This pilot descriptive observational study refers to a sample of 41 newly recruited nurses in the year 2019. The procedure included the compilation of an online questionnaire containing 50 items related to validated scales on variables to be analyzed (Unit Nursing Climate Scale, Leader-Member Social Exchange Scale, Utrecht Work Engagement Scale, Affective Commitment Scale) more than the variables related to Error Awareness and a typical example of CWB in the health context. All scores were standardized in a 0-100 metric. Results. The sample consisted of subjects with 26 years of median age. All the constructs were stable for internal consistency (α>0,80), the response values saw the Group Work (UNCS) have the highest score (62/100, IQR 58-81), while the Affective Commitment the lowest (37/100, IQR 27-65). The multiple linear regression model has seen Professional Development (UNCS) and Dedication (UWES) predict more than 75% of Error Awareness variance. The parameter with the best sensitivity and specificity ratio of the scores of the investigated constructs concerning the proximity of adequacy of behavior under the ROC curve gave a value of 64.8. Conclusions. This pilot study further confirms the impact of the organizational climate on the quality of care. The approach and results presented provide nursing managers with interesting insights and reading keys in the increasingly important perspective of monitoring the path of newly employed nurses and in the reduction of CWB, using behavioral safety cut-offs. Keywords. newly employed nurse, organizational climate, error awareness, CWB.
Introduzione. L’implementazione di percorsi strutturati per l’inserimento degli infermieri neoassunti ha mostrato aumentare sia la loro Job Satisfaction che la qualità dell’assistenza erogata. Tuttavia, sebbene siano spesso raccomandati monitoraggi contesto-specifici delle variabili influenzanti il clima organizzativo, nella letteratura non vi sono studi che indaghino le informazioni descrittive di questi costrutti nella coorte di infermieri neoassunti. Gli obiettivi di questo studio sono quindi: (1) descrivere il livello degli elementi influenzanti il clima organizzativo negli infermieri neoassunti dell’ASST dei Sette Laghi, (2) descrivere le capacità predittive di questi costrutti sulla consapevolezza degli errori nella pratica clinica e (3) mettere in relazione le variabili dello studio con una variabile di prossimità relativa ai CWB, per stabilire un ipotetico cut-off di sicurezza comportamentale. Materiali e Metodi. Questo studio osservazionale descrittivo di natura pilota si riferisce ad un campione di 41 infermieri neoassunti nell’anno 2019. La procedura ha previsto la compilazione di un questionario online contenente 50 item relativi a delle scale validate sulle variabili da analizzare (Unit Nursing Climate Scale, Leader-Member Social Exchange Scale, Utrecht Work Engagement Scale, Affective Commitment Scale) più delle variabili riferite alla Consapevolezza degli Errori e ad un tipico esempio di CWB nel contesto sanitario. Tutti gli score sono stati standardizzati in una metrica 0-100. Risultati. Il campione era composto da soggetti con 26 anni di età mediana. Tutti i costrutti si sono presentati stabili dal punto di vista della consistenza interna (α>0,80), i valori di risposta hanno visto il Lavoro di Gruppo (UNCS) avere lo score più alto (62/100, IQR 58-81), mentre l’Affective Commitment quello più basso (37/100, IQR 27-65). Il modello di regressione lineare multipla ha visto lo Sviluppo Professionale (UNCS) e la Dedizione (UWES) predirre più del 75% della varianza della Consapevolezza degli Errori. Il parametro con miglior rapporto di sensibilità e specificità degli score dei costrutti indagati in relazione alla prossimità di adeguatezza di comportamento sotto curva di ROC ha dato valore di 64,8. Conclusioni. Questo studio pilota conferma ulteriormente l’impatto del clima organizzativo sulla qualità dell’assistenza. L’approccio e i risultati presentati forniscono ai manager infermieristici degli spunti e delle chiavi di lettura interessanti nella sempre più importante ottica di monitoraggio del percorso dei neoassunti e nella riduzione dei CWB, attraverso l’utilizzo di cut-off di sicurezza comportamentale. Parole Chiave. infermieri neoassunti, clima organizzativo, consapevolezza errori, CWB.
Clima Organizzativo e Counterproductive Work Behavior nell’implementazione di un percorso per infermieri neoassunti: uno studio Pilota presso l'ASST Sette-Laghi
TORRE, MARCELLO
2019/2020
Abstract
Introduction. The implementation of structured pathways for the placement of newly hired nurses has shown to increase both their job satisfaction and the quality of the assistance provided. However, although context-specific monitoring of variables influencing the organizational climate is often recommended, there are no studies in the literature that investigate the descriptive information of these constructs in the cohort of newly hired nurses. The objectives of this study are: (1) to describe the level of elements influencing the organizational climate in the newly recruited nurses of the Seven Lakes ASST, (2) to describe the predictive capabilities of these error awareness constructs in clinical practice, and (3) to link study variables to a CWB-related proximity variable to establish a hypothetical behavioral safety cut-off. Materials and Methods. This pilot descriptive observational study refers to a sample of 41 newly recruited nurses in the year 2019. The procedure included the compilation of an online questionnaire containing 50 items related to validated scales on variables to be analyzed (Unit Nursing Climate Scale, Leader-Member Social Exchange Scale, Utrecht Work Engagement Scale, Affective Commitment Scale) more than the variables related to Error Awareness and a typical example of CWB in the health context. All scores were standardized in a 0-100 metric. Results. The sample consisted of subjects with 26 years of median age. All the constructs were stable for internal consistency (α>0,80), the response values saw the Group Work (UNCS) have the highest score (62/100, IQR 58-81), while the Affective Commitment the lowest (37/100, IQR 27-65). The multiple linear regression model has seen Professional Development (UNCS) and Dedication (UWES) predict more than 75% of Error Awareness variance. The parameter with the best sensitivity and specificity ratio of the scores of the investigated constructs concerning the proximity of adequacy of behavior under the ROC curve gave a value of 64.8. Conclusions. This pilot study further confirms the impact of the organizational climate on the quality of care. The approach and results presented provide nursing managers with interesting insights and reading keys in the increasingly important perspective of monitoring the path of newly employed nurses and in the reduction of CWB, using behavioral safety cut-offs. Keywords. newly employed nurse, organizational climate, error awareness, CWB.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/12206