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Relationships among organizational characteristics, occupational fatigue, and missed care in registered nurses working at night in NJ acute care hospitals
Descriptive
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Title
Relationships among organizational characteristics, occupational fatigue, and missed care in registered nurses working at night in NJ acute care hospitals
Name
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Crincoli
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Suzanne
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Suzanne Crincoli
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author
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de Cordova
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Pamela
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Advisory Committee
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chair
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Thomas-Hawkins
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Charlotte
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Charlotte Thomas-Hawkins
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Advisory Committee
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member
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Flynn
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Linda
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Linda Flynn
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Advisory Committee
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member
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Sagherian
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Knar
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Knar Sagherian
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Advisory Committee
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Rutgers University
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Graduate School - Newark
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theses
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2023
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2022-10
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2021
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English
Abstract
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Background: The Agency for Healthcare Quality and Safety has recognized missed care as a significant threat to healthcare quality and patient safety. The incidence of Missed Care is high internationally. The effect of the synergistic relationships among organizational (i.e., practice environment support, RN workload, patient-to-RN staffing ratios) and nurse characteristics, (i.e., experience level, education level, sleep hours, consecutive work shifts) and occupational fatigue types (i.e., chronic fatigue, acute fatigue, and inter-shift recovery) on the incidence of missed care at night is not well known. Objectives: Guided by the Integrated Model of Abnormal Work Schedules, Organizational and Nurse Characteristics, Occupational Fatigue, and Missed Care the aims of this study were to examine (1) the individual, and independent effects of organizational characteristics, and occupational fatigue types on the incidence of missed care in registered nurses (RN) working in acute care hospitals at night; and (2) the moderating effects of organizational characteristics, and nurse characteristics on the relationship between occupational fatigue types and missed care at night.
Methods: This dissertation employed a quantitative, cross-sectional Design. A publicly available roster of registered nurses was used to recruit participants for this study. The data were analyzed using SPSS software. The Tasks Undone-12 (TU-12) scale, the Practice Environment Scale of Nurse Work Index (PES-NWI), the Individualized Workload Perception Scale-Revised (IPWS_R) subscale, a single-item staffing question, and the Occupational Fatigue and Exhaustion Recovery Scale (OFER-15) were used in this study.
Results: Descriptive statistics, Pearson’s correlation, multiple linear regression, and simple moderation analysis were employed. Individual predictors of missed care at night were practice environment support, RN workload, patient-to-RN staffing ratios, chronic fatigue, and inter-shift recovery. Acute fatigue did not individually predict missed care. Multiple regression analysis revealed patient-to-RN staffing ratios and chronic fatigue to be predictors of missed care at night. Moderation analysis revealed that (1) acute fatigue and missed care were dependent on a nurse's experience level, (2) inter-shift recovery and missed care were dependent on a nurse's experience level, and sleep hours between shifts.
Conclusion: Implications of this study inform policies for safe nursing practice and patient safety at night.
Methods: This dissertation employed a quantitative, cross-sectional Design. A publicly available roster of registered nurses was used to recruit participants for this study. The data were analyzed using SPSS software. The Tasks Undone-12 (TU-12) scale, the Practice Environment Scale of Nurse Work Index (PES-NWI), the Individualized Workload Perception Scale-Revised (IPWS_R) subscale, a single-item staffing question, and the Occupational Fatigue and Exhaustion Recovery Scale (OFER-15) were used in this study.
Results: Descriptive statistics, Pearson’s correlation, multiple linear regression, and simple moderation analysis were employed. Individual predictors of missed care at night were practice environment support, RN workload, patient-to-RN staffing ratios, chronic fatigue, and inter-shift recovery. Acute fatigue did not individually predict missed care. Multiple regression analysis revealed patient-to-RN staffing ratios and chronic fatigue to be predictors of missed care at night. Moderation analysis revealed that (1) acute fatigue and missed care were dependent on a nurse's experience level, (2) inter-shift recovery and missed care were dependent on a nurse's experience level, and sleep hours between shifts.
Conclusion: Implications of this study inform policies for safe nursing practice and patient safety at night.
Subject
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Topic
Nursing
Subject
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Topic
Health care management
Subject
(authority = RUETD)
Topic
Occupational safety
Subject
(authority = local)
Topic
Fatigue
Subject
(authority = local)
Topic
Missed care
Subject
(authority = local)
Topic
Practice environment support
Subject
(authority = local)
Topic
Staffing
Subject
(authority = local)
Topic
Workload
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Rutgers University Electronic Theses and Dissertations
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http://dissertations.umi.com/gsn.newark.rutgers:10258
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169 pages
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Ph.D.
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Includes bibliographical references
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Graduate School - Newark Electronic Theses and Dissertations
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doi:10.7282/t3-bsfq-2s23
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The author owns the copyright to this work.
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Crincoli
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Suzanne
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Permission or license
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2023-04-27T15:03:59
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Suzanne Crincoli
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Rutgers University. Graduate School - Newark
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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2023-04-27
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2025-04-13
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Access to this PDF has been restricted at the author's request. It will be publicly available after April 13, 2025.
Copyright
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Copyright protected
Availability
Status
Open
Reason
Permission or license
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