Table 3 Labeling of factors and corresponding items
Factor 1, Staffing and resource adequacy |
Adequate support services allow me to spend time with my patients |
Enough time and opportunity to discuss patient care with other nurses |
Enough registered nurses on staff to provide quality patient care |
Enough staff to get the work done |
Management that listens and responds to employee concerns |
Patient care assignments that foster continuity of care (i.e. the same nurse care for the same patient from 1 day to the next) |
Factor 2, Nurse–doctor relations |
Doctors and nurses have good working relationships |
Doctors value nurses’ observations and judgments |
Doctors recognize nurses’ contributions to patient care |
A lot of team work between nurses and doctors |
Doctors respect nurses as professionals |
Collaboration between nurses and doctors |
Doctors hold nurses in high esteem |
Factor 3, Nursing policy |
Opportunities for advancement |
An active quality assurance program |
Registered nurses are involved in the internal governance of the hospital (e.g. practice and policy committees) |
Nursing care is based on a nursing rather than a medical model |
RNs have the opportunity to serve on hospital and nursing committees |
Written, up-to-date care plans for all patients |
A preceptor program for newly hired nurses |
Factor 4, Nursing management and development |
A supervisory staff that is supportive of nurses |
Active staff development or continuing education programs for nurses |
Career development/clinical ladder opportunity |
Opportunity for registered nurses to participate in policy decisions |
A nurse manager who is a good manager and leader |
A chief nursing officer who is highly visible and accessible to staff |
Praise and recognition for a job well done |
A nurse manager who backs up the nursing staff in decision making, even if the conflict is with a doctor |
Factor 5, Nursing competency |
High standards of nursing care are expected by the management |
A chief nursing officer is equal in power and authority to other top level hospital executives |
A clear philosophy of nursing that pervades patient care environment |
Working with nurses who are clinically competent |