Changes to nurses' practice environment over time.

Area of Science:

• Nursing Practice Environment
• Healthcare Workforce Dynamics
• Patient Care Quality

Background:

• Positive nurse practice environments are associated with improved nurse retention and patient care outcomes.
• Understanding changes in these environments is vital for healthcare quality.

Purpose of the Study:

• To analyze shifts in the nursing practice environment, nurse retention factors, unit stability, and patient care task completion.
• To compare these factors across two time periods (2004-2013).

Main Methods:

• Utilized the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability, and delayed/undone tasks.
• Data collected from six acute-care hospitals across three Australian states in two waves (2004, 2013).

Main Results:

• Slight decline in average practice environment scores observed.
• Increased difficulty in finding new positions, lower intent to leave, and greater job instability reported by nurses.
• Rates of delayed patient care tasks rose, while rates of undone tasks decreased.

Conclusions:

• Deterioration in perceived nursing practice environment quality is concerning, especially during persistent workforce shortages.
• Organizational restructuring and nurse executive turnover may have contributed to the decline.
• Nursing management must implement evidence-based strategies to enhance practice environments and mitigate instability.