Using Data to Strengthen Ambulatory Oncology Nursing Practice.
BACKGROUND
Efforts to measure quality of care do not capture the unique aspects of ambulatory oncology settings. To retain nurses, ensure a safe practice environment, and encourage behaviors that support high-quality care, there is a need to identify factors associated with job satisfaction and turnover with measures that reflect the ambulatory setting.


OBJECTIVE
The objective of this study was to examine the patterns and correlates of the work environment for nurses and nurse practitioners working in a National Cancer Institute-designated Comprehensive Cancer Center.


METHODS
Web-based questionnaires were disseminated to employees with a registered nurse license in ambulatory settings and related support services and included 3 affiliated satellite locations. Participants completed the Practice Environment Scale of the Nursing Work Index, revised for ambulatory oncology settings, the Safety Organizing Scale, and items to assess job satisfaction, perceived quality of care, and intention to leave their current position. Logistic and linear regression models were used to examine factors associated with these outcomes.


RESULTS
From 403 individuals, 319 (79.2%) participated. The majority of respondents endorsed excellent quality of care (57.7%), job satisfaction (69.3%), and intention to stay in current position (77.4%). Endorsement of favorable collegial nurse-physician relationships was significantly associated with all 3 outcomes and increased performance of safety organizing behaviors. Nurses reported variations in practice environments and safety organizing behaviors across units.


CONCLUSIONS
Work environment assessments are useful to retain experienced nurses and support the delivery of high-quality patient care.


CONCLUSIONS
Routine assessment of the work environment for registered nurses and advanced practice nurses is feasible and informative.
Author Affiliations: University of Michigan School of Nursing, Ann Arbor, Michigan (Dr. Friese); Dana-Farber Cancer Institute (Drs. Siefert and Ponte) and Simmons College Department of Nursing Family Nurse Practitioner Program, Boston, Massachusetts (Mss Thomas-Frost and Walker).
Christopher R
CR
Friese
Mary Lou
ML
Siefert
Kaitlin
K
Thomas-Frost
Stacy
S
Walker
Patricia Reid
PR
Ponte
D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D006801:Humans; D033182:Intention; D007588:Job Satisfaction; D008875:Middle Aged; D054547:National Cancer Institute (U.S.) / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D009740:Nursing Staff / Q000523:psychology* / Q000706:statistics & numerical data; D009859:Oncology Nursing / Q000458:organization & administration*; D010563:Personnel Turnover; D019555:Physician-Nurse Relations; D011787:Quality of Health Care; D017751:Safety Management / Q000458:organization & administration; D011795:Surveys and Questionnaires; D014481:United States; D017132:Workplace / Q000458:organization & administration*