title: Improving work environment perceptions for nurses employed in a rural setting.
abstract: BACKGROUND
  Effective recruitment and retention of professional nurses is a survival strategy for health care facilities, especially in rural areas.
  
  
  OBJECTIVE
  This study examines the use of the Individual Workload Perception Scale to measure nurse satisfaction by a small rural hospital in order to make positive changes in the work environment for nurses.
  
  
  METHODS
  Baseline work environment perceptions of nurses employed in a rural Kentucky hospital were assessed using the Individual Workload Perception Scale, a validated 38-item instrument. Nurses reviewed the results and brainstormed on potential interventions to address areas of concern. The 4 interventions selected for implementation by the nursing staff included (1) implementation of a shared decision making or governance model; (2) enhanced role of licensed practical nurses within the organization; (3) augmentation of administrative support on night and weekend shifts; and (4) utilization of wireless communication devices. After implementation of the interventions, staff nurse perceptions were reassessed using the same tool.
  
  
  RESULTS
  The follow-up survey revealed improvements in all areas measured by the Individual Workload Perception Scale, with the greatest improvement in the perception of the work environment noted among night nurses. The increase in positive work environment perception among these nurses, with greater than or equal to 11 years of professional experience, was statistically significant.
  
  
  CONCLUSIONS
  Tools exist to support the development and evaluation of interventions to improve the work environment for nurses practicing in rural health care settings. By addressing issues of specific concern, both job satisfaction and retention of this talented pool of professionals can be enhanced.
authors.affiliation: Patient Care Services, Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Teasley
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sexton
authors.forename: Cathryn A
authors.initials: CA
authors.lastname: Carroll
authors.forename: Karen S
authors.initials: KS
authors.lastname: Cox
authors.forename: Michele
authors.initials: M
authors.lastname: Riley
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ferriell
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003625:Data Collection; D003659:Decision Making, Organizational; D006272:Health Facility Environment / Q000592:standards*; D006780:Hospitals, Rural / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D007629:Kentucky; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000600:supply & distribution; D016272:Occupational Health; D010560:Personnel Selection; D011365:Professional Practice Location; D011594:Psychometrics; D000078329:Workforce; D017132:Workplace / Q000523:psychology / Q000592:standards*