Organizational climate and hospital nurses' caring practices: a mixed-methods study

Area of Science:

• Healthcare Management
• Nursing Practice
• Organizational Psychology

Background:

• Organizational climate significantly impacts patient outcomes in healthcare.
• The specific influence of organizational climate on nursing care delivery is not well understood.
• Understanding this relationship is crucial for optimizing nursing practice and patient care.

Purpose of the Study:

• To investigate the effect of organizational climate on the frequency of caring practices performed by registered nurses (RNs).
• To explore how organizational climate dimensions interact with nurse and patient characteristics to influence care delivery.
• To identify factors contributing to RNs delegating certain caring practices.

Main Methods:

• A mixed-methods approach was employed, combining quantitative nurse surveys (N=292) with qualitative case studies.
• The qualitative component involved 15 direct-care RNs, nursing personnel, and managers.
• Statistical analysis was used to determine the variation in caring practices explained by organizational climate.

Main Results:

• Organizational climate accounted for 11% of the variation in RNs' reported frequency of caring practices.
• Qualitative findings revealed that caring practices are influenced by the interaction between organizational climate, patient factors, and nurse characteristics.
• High workload intensity and role ambiguity prompted RNs to delegate caring tasks to practical nurses and assistive personnel.

Conclusions:

• Systemic interventions targeting organizational climate are necessary to enhance nursing care delivery.
• Supporting RNs' involvement in a comprehensive range of caring practices requires improvements in the healthcare work environment.
• Addressing workload and role clarity is essential for optimizing the role of RNs in patient care.