American Journal of Nursing Research
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American Journal of Nursing Research. 2013, 1(1), 10-19
DOI: 10.12691/ajnr-1-1-2
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Investing in Human Relations for Healthy Nursing Practice Environment, Nurses’ Job Satisfaction and Quality of Nursing Care

Nazlee Siddiqui1,

1School of Business, North South University, Bangladesh

Pub. Date: February 25, 2013

Cite this paper:
Nazlee Siddiqui. Investing in Human Relations for Healthy Nursing Practice Environment, Nurses’ Job Satisfaction and Quality of Nursing Care. American Journal of Nursing Research. 2013; 1(1):10-19. doi: 10.12691/ajnr-1-1-2


Relationship between the three domains of nursing practice environment, nurses’ job satisfaction and quality of nursing care have been studied for a way forward to superior healthcare delivery. However, the literature and management practices frequently viewed the relationship as one directional; which may have resulted to restructuring in the nursing practice environment that are insensitive to nurses’ need. This paper provides evidence of reciprocal relationship between the three domains in the context of interactions between nurses at NSW health organisations. Mixed methods of survey questionnaire and one-on-one semi-structured interview were used in this research in sequential design, with 136 survey respondents and 21 interviewees. The research result identified interactions between nurses as a vehicle through which the reciprocal relationship between the domains are kept in motion. While healthy interactions between nurses that generate trust and gratitude were seen to positively impact the domains, the opposite was noticed in case of unhealthy interactions. Therefore, management practices in nursing administration should invest for healthy human relations to achieve enhancements across the three domains.

interactions between nurses nursing practice environment job satisfaction quality of nursing care

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[1]  Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ: British Medical Journal. 2012;344.
[2]  McClure M, Poulin M, Sovie M, Wandelt M. Attraction and Retention of Professional Nurses Kansas City: American Academy of Nurses; 1983.
[3]  Patrician PA, Shang J, Lake ET. Organizational determinants of work outcomes and quality care ratings among Army Medical Department registered nurses. Research in Nursing & Health. 2010;33(2):99-110.
[4]  Schmalenberg C, Kramer M. Essentials of Productive Nurse Work Environment. Nursing Research. 2008;57(1):2-13.
[5]  Sermeus W, Aiken LH, Van den Heede K, Rafferty AM, Griffiths P, Moreno-Casbas MT, et al. Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology. BMC nursing. 2011;10(1):6.
[6]  Van Bogaert P, Clarke S, Roelant E, Meulemans H, Van de Heyning P. Impacts of unit-level nurse practice environment and burnout on nurse-reported outcomes: a multilevel modelling approach. Journal of Clinical Nursing. 2010;19(11-12):1664-74.
[7]  Donabedian A. Quality of care: problems of measurement. II. Some issues in evaluating the quality of nursing care. American Journal of Public Health 1969;59(10):4.
[8]  Hess R, Norman LD, Donelan K. Are Nurses Ready for Health Care Reform? A Decade of Survey Research. Nursing Economics. 2012;30(6):318.
[9]  Kramer M, Schmalenberg C. Development and Evaluation of Essentials of Magnetism Tool. Journal of Nursing Administration. 2004;34(7/8):365-78.
[10]  Lake ET. Development of the Practice Environment Scale of the Nursing Work Index Resarch in Nursing & Health 2002;25:176-88.
[11]  Warshawsky NE, Havens DS. Global use of the practice environment scale of the Nursing Work Index. Nursing Research. 2011;60(1):17.
[12]  Ravari ALI, Bazargan M, Vanaki Z, Mirzaei T. Job satisfaction among Iranian hospital-based practicing nurses: examining the influence of self-expectation, social interaction and organisational situations. Journal of Nursing Management. 2012;20(4):522-33.
[13]  Thompson ER, Phua FTT. A Brief Index of Affective Job Satisfaction. Group & Organization Management. 2012;37(3):275-307.
[14]  Weiss HM. Deconstructing job satisfaction: Separating evaluations, beliefs and affective experiences. Human Resource Management Review. 2002;12(2):173-94.
[15]  Locke EA. Waht is Job Satisfaction? Organizational Behaviour and Human Performance. 1969;4:309-36.
[16]  Hinshaw AS, Smeltzer CH, Atwood JR. Innovative retention strategies for nursing staff. The Journal of Nursing Administration. 1987;17(6):8-16.
[17]  Sauter MA, Boyle D, Wallace D, Andrews JL, Johnson MS, Bates M, et al. Psychometric Evaluation of the Organizational Job Satisfaction Scale. Journal of Nursing Measurement. 1997;5(1):53-69.
[18]  Hinshaw AS, Smeltzer C, Atwood JR. Innovative retention strategies for nursing staff. Journal of Nursing Administration. 1987;17(6).
[19]  Anne MW. The delivery of quality nursing care: a grounded theory study of the nurse's perspective. Journal of Advanced Nursing. 1998;27(4):808-16.
[20]  Lindgren M, Andersson IS. The Karen instruments for measuring quality of nursing care: construct validity and internal consistency. International Journal for Quality in Health Care. 2011;23(3):292-301.
[21]  Donabedian A. Evaluating the Quality of Medical Care. Milbank Quarterly. 2005;83(4):691-729.
[22]  Greenslade JH, Jimmieson NL. Distinguishing between task and contextual performance for nurses: development of a job performance scale. Journal of Advanced Nursing. 2007;58(6):602-11.
[23]  McClure M. Magnet Hospitals: Insights and Issues. Nursing Administration Quarterly. 2005;29(3):198-201.
[24]  American Nurses Credentialing Centre. Magnet Recognition Program. 2010.
[25]  Aiken LH, Buchan J, Ball J, Rafferty AM. Transformative impact of Magnet designation: England case study. Journal of Clinical Nursing. 2008;17(24):3330-7.
[26]  Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes. Journal of Nursing Administration. 2008;38(5):223-9 10.1097/01.NNA.0000312773.42352.d7.
[27]  Luzinski C, Lundmark V. State of the Science Related to Nurse Work Environments, Safe Practices, and Organizational Outcomes. Journal of Nursing Administration. 2012;42(10):S1-S2 10.1097/01.NNA.0000420388.10661.75.
[28]  Ulrich BT, Lavandero Rn, Hart KA, Woods D, Leggett J, Taylor D. Critical Care Nurses' Work Environments: A Baseline Status Report. Critical Care Nurse. 2006;26(5):46-57.
[29]  Johnson RB, Onwuegbuzie AJ, Turner LA. Toward a Definition of Mixed Methods Research. Journal of Mixed Methods Research. 2007;1(2):112-33.
[30]  Snyder C, Watson M, Jackson J, Cella D, Halyard M. Patient Reported Outcome Instrument Selection: DEsigning a Measurement Strategy. Value in Health. 2007;Vol. 10:S76-S85.
[31]  Dawis RV. Scale Construction. Journal of Counselling Psychology. 1987;34(4):481-9.
[32]  Joseph F. Hair J, William C. B, Barry J. B, Rolpf E. A. Mutlivariate Data Analysis. New Jersesy: Prentice Hall; 2009.
[33]  Malhotra N. Basic Marketing Research; a decision-making approach. New Jersey 07458: Prentice Hall; 2009.
[34]  Joseph F. Hair J, Black WC, Babin BJ, Andersom RE. Mulivariate Data Analysis. New Jersey: Pearson Prentice Hall; 2006.
[35]  Creswell JW, Plano Clark VL. Designing & constructing mixed methods research. Thousand Oaks, California 91320: Sage Publications, Inc.; 2007.
[36]  Fylan F. Chapter 6: Semi-structured interviewing. In J. Miles & P. Gilbert (Eds.), A Handbook of Research Methods for Clinical and Health Psychology New York, USA: Oxford University Press; 2005.
[37]  Baron RM, Kenny DA. The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51(6):1173-82.
[38]  MacKinnon DP, Fairchild AJ, Fritz MS. Mediation Analysis. Annual Review of Psychology. 2007;58(1):593-614.
[39]  Fiedler K, Schott M, Meiser T. What mediation analysis can (not) do. Journal of Experimental Social Psychology. 2011;47(6):1231-6.
[40]  Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Services Research. 2007;42(4):1758-72.
[41]  Zhao X, Lynch JG, Jr., Chen Q. Reconsidering Baron and Kenny: Myths and Truths About Mediation Analysis. Journal of Consumer Research, Vol 37, August 2010. 2010:p. 14.
[42]  Australian Council on Healthcare Standards. EQuIP 5 Guidelines. 2010.
[43]  Zittel B, Ezzeddine SH, Makatjane M, Graham I, Luangamornlert S, Pemo T. Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute. International Nursing Review. 2012;59(1):48-54.
[44]  Warelow P, Edward K-L, Vinek J. Care: What Nurses Say and What Nurses Do. Holistic Nursing Practice. 2008;22(3):146-53 10.1097/01.HNP.0000318023.53151.33.
[45]  Blau PM. Exchange and Power in Social life. New York: Wiley & Sons Inc.; 1986.
[46]  Mullarkey M, Duffy A, Timmins F. Trust between nursing management and staff in critical care: a literature review. Nursing in Critical Care. 2011;16(2):85-91.
[47]  Dillman DA. Mail and Internet Surveys: The Tailored Design Method. New Jersey: John Wiley & Sons,Inc.; 2007.