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The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study.

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This study explored the link between the nursing practice environment and hospital complexity. A favorable environment, except for staffing, correlated with better quality of care and patient safety.

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Area of Science:

  • Nursing
  • Healthcare Management
  • Sociotechnical Systems

Background:

  • The nursing practice environment significantly impacts healthcare quality and patient safety.
  • Understanding sociotechnical complexity in hospitals is crucial for effective healthcare delivery.

Purpose of the Study:

  • To analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
  • To identify factors within the practice environment that influence perceived complexity.

Main Methods:

  • A sequential explanatory mixed-methods study was conducted with 132 nurses in a Brazilian hospital.
  • Quantitative data were collected using the Practice Environment Scale-Nursing Work Index and Complexity Characterization Questionnaire.
  • Qualitative data were gathered through semi-structured interviews with 18 nurses, followed by thematic analysis.

Main Results:

  • The nursing practice environment was generally favorable, with noted complexity in staffing and resource adequacy.
  • Three categories emerged, linking human and technical aspects to practice environment complexity, care quality, and patient safety.
  • Unexpected variability in care was inversely correlated with the practice environment.

Conclusions:

  • A significant relationship exists between the nursing practice environment and hospital sociotechnical complexity.
  • Findings have implications for improving the quality and safety of nursing care.
  • Addressing staffing and resource adequacy is key to mitigating complexity in the nursing practice environment.