Perceived work related stress, job performance, social support and intention to stay among immigrant nurses in a culturally diverse setting

This thesis measures and explores the perceived work related stress (WRS), job performance, social support and intention to stay among immigrant nurses in a multicultural nursing workforce in a diverse cultural setting at Sultan Bin Abdul-Aziz Humanitarian City (SBAHC), Riyadh region. The present research addresses gaps in the empirical literature by investigating the key work stressors experienced by immigrant nurses working in the Kingdom of Saudi Arabia (KSA) and by establishing nurses’ referent levels of work stress, social support, job performance and intention to stay in their current job. In addition, the research explores the complex relationships between work stress, social support, intention to stay and job performance. The job demand control-support (JDC-S) theory (Johnson and Hall 1988) provides the theoretical background for the thesis. This theory proposes that strain (i.e., work stress) occurs when demands (i.e., work stressors) exceed coping resources (e.g. social support). This research utilizes the case study mixed methodology approach incorporating a quantitative questionnaire survey and qualitative semi structured interviews. The eligible participants comprised 321 nurses 246 (76%) of whom returned their completed questionnaires. For the qualitative component of the study, a purposive sampling strategy was used; 20 nurses were interviewed using a semi-structured interview technique. The quantitative data revealed that nurses’ perception of WRS was occasional. The most common stressful event was Treatment” and “Death and Dying”. The reported mean for the overall job performance scale was high. The highest reported mean of the job performance subscale was for “Professional Development” and “Critical Care”, and the lowest mean was for “Leadership”. Moreover, male nurses reported higher level of stress than female nurses; the higher the number of patients, the higher the reported mean of stress by nurses. The reported mean of the Intention to Stay Scale [McCain Behavioural Commitment Scale (MBCS)] was moderate indicating that most nurses reported that they have a neutral perception of willingness to stay in their current placement. The qualitative phase indicated that the nurses within this environment were experiencing high levels of WRS and struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patient’s cultural and spiritual needs as well as maintaining a high standard of care. Importantly, there was inadequate support by the organisation or supervisor to manage WRS. Nurses perceived their job performance as high, and they intended to stay at work due to the financial benefits they get compared to their home country. Immigrant nurses felt discriminated due to the pay difference. In conclusion, the present research further contributes to our understanding of WRS, social support, job performance and intention to stay among immigrant nurses in KSA. The present study demonstrates that immigrant nurses in KSA are stressed; there was a significant difference between the qualitative and quantitative results

The effect of intentional nurse rounding and nurse prompt response time to Call system on patient satisfaction, patient complaints, and patient clinical outcome: An Audit trial

Background: Improving patient satisfaction and safety is a critical goal for hospitals around the world. Healthcare providers have increasingly recognized the importance of strategic initiatives and the impact they have on patient outcomes.Objectives: This study examines the effect of intentional nurse rounding and the call system's response times on patient satisfaction, patient complaints, falls, and hospital-acquired pressure injuries (HAPI).Methods: This descriptive study was conducted between December 2017 to August 2018 in a hospital in the United Arab Emirates. The Intentional Nurse Rounding (INR) and Prompt Response to Call System (PRTCS) were introduced in December 2017. It comprised of: (1) hourly nurses’ rounds between 07:00 hours to 23:59 hours and 2 hourly rounds between 24:00 hours to 06:59 hours daily, (2) measurement of nurses’ response time to call bells, (3) leadership rounds to assess patient satisfaction. The outcomes were patient satisfaction, patient complaints, fall rates, and HAPI rates. Baseline data were collected through retrospective reviews of the data on these outcomes in December 2017. The second period of data collection was conducted over eight months after the initiation of the system, from December 2017 to August 2018. The Chi-square test was used to detect significant differences in outcomes pre and post intervention.Results: The overall adherence to the “Intentional Nurse Rounding and Prompt Response Time to Call System” was 91% while the overall patient satisfaction rate was 97% in August 2018. The average response to call time was 1.2 minutes. Patient complaints decreased from 0.75/month to 0.125/month between December 2017 to August 2018. During the same period, the rates of patient falls and HAPI decreased from 1.17/month to 0.38/month and 0.35/month to 0.24/month respectively. Though the observed differences were not statistically significant, there was a promising difference in patient complaints pre and post intervention (P=0.08).Conclusion: Integrating nursing-led strategic initiatives such as intentional nurse rounding and reduced response time to the call bell system can positively impact patient satisfaction, complaints, and clinical outcome

Perceived work related stress, job performance, social support and intention to stay among immigrant nurses in a culturally diverse setting

This thesis measures and explores the perceived work related stress (WRS), job performance, social support and intention to stay among immigrant nurses in a multicultural nursing workforce in a diverse cultural setting at Sultan Bin Abdul-Aziz Humanitarian City (SBAHC), Riyadh region. The present research addresses gaps in the empirical literature by investigating the key work stressors experienced by immigrant nurses working in the Kingdom of Saudi Arabia (KSA) and by establishing nurses’ referent levels of work stress, social support, job performance and intention to stay in their current job. In addition, the research explores the complex relationships between work stress, social support, intention to stay and job performance. The job demand control-support (JDC-S) theory (Johnson and Hall 1988) provides the theoretical background for the thesis. This theory proposes that strain (i.e., work stress) occurs when demands (i.e., work stressors) exceed coping resources (e.g. social support). This research utilizes the case study mixed methodology approach incorporating a quantitative questionnaire survey and qualitative semi structured interviews. The eligible participants comprised 321 nurses 246 (76%) of whom returned their completed questionnaires. For the qualitative component of the study, a purposive sampling strategy was used; 20 nurses were interviewed using a semi-structured interview technique. The quantitative data revealed that nurses’ perception of WRS was occasional. The most common stressful event was Treatment” and “Death and Dying”. The reported mean for the overall job performance scale was high. The highest reported mean of the job performance subscale was for “Professional Development” and “Critical Care”, and the lowest mean was for “Leadership”. Moreover, male nurses reported higher level of stress than female nurses; the higher the number of patients, the higher the reported mean of stress by nurses. The reported mean of the Intention to Stay Scale [McCain Behavioural Commitment Scale (MBCS)] was moderate indicating that most nurses reported that they have a neutral perception of willingness to stay in their current placement. The qualitative phase indicated that the nurses within this environment were experiencing high levels of WRS and struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patient’s cultural and spiritual needs as well as maintaining a high standard of care. Importantly, there was inadequate support by the organisation or supervisor to manage WRS. Nurses perceived their job performance as high, and they intended to stay at work due to the financial benefits they get compared to their home country. Immigrant nurses felt discriminated due to the pay difference. In conclusion, the present research further contributes to our understanding of WRS, social support, job performance and intention to stay among immigrant nurses in KSA. The present study demonstrates that immigrant nurses in KSA are stressed; there was a significant difference between the qualitative and quantitative results