الفهرس | Only 14 pages are availabe for public view |
Abstract Nursing is a sensitive career that plays an important role in society. Nurses are the main persons responsible about a patient life or the patient at risk for suffering. Motivated nurses work under conditions that promote retention and thwart turnover tend to produce outcomes that are satisfactory. Thus the hospitals have to understand the factors affecting nurses’ motivation and retention in their work to empower all personnel to be more and more productive and increase quality of patient care and reduce turnover rate. The study was conducted to assess the relationship between motivating work factors and nurses’ retention at Menoufia University Hospital and Shebin El-Kom Teaching Hospital. This was achieved through assessing the motivating work factors among nurses, assessing the factors affecting nurses’ retention and determining the relationship between motivating work factors & nurses’ retention at the study settings. Research design: A descriptive correlational research design was used in conducting this study. Setting: This study was conducted at selected departments in two different hospitals in Shebin El-Kom, Menoufia Governorate, namely: Menoufia University Hospital and Shebin El-Kom teaching hospital. The study settings were divided into three categories which include the following: •Critical care departments which include the following: Emergency, O.R, adult ICU, pediatric ICU, neonate, Burn, & Hemodialysis department. •Inpatient departments which include the following: medical, surgical, pediatrics, obstetrics & Gynecology, neurological, cardiology, chest, Orthopedics, & Oncology departments. •Nursing administration department. Subjects: The subjects of this study included : A convenient sample of 315 nurses were recruited from Menoufia University hospital (159) and Shebin El-Kom Teaching hospital (156). The inclusion criteria: They have at least two years of experience working in the hospital and accepted to participate in the study. Tools of data collection: Two tools were utilized by the investigator to collect data. These tools were: 1. Motivational Level Questionnaire was used to assess the motivating work factors among nurses at Menoufia University hospital and Shebin El-Kom teaching hospital. The questionnaire consisted of three parts which included first part to assess sociodemographic data, second part to assess ranking of desired motivating work factors according to their importance and third part to assess the extent to which hospitals provide motivating work factors. Summary 106 2. Nurses’ Retention Questionnaire was used to assess factors leading to nurses’ retention at Menoufia University Hospital and Shebin El-Kom Teaching Hospital. The questionnaire consisted of three parts which included first part to assess contributing factors of retention, second part to assess ranking of contributing factors of turnover and third part to assess the level of intention to leave hospitals. These tools were tested for reliability by the internal consistency coefficient alpha that was (0.96 & 0.97 respectively). Pilot study:- A pilot study was carried out before starting the actual data collection. The purpose of the pilot study was to ascertain clarity, relevance, applicability of the study tools and to determine obstacles that may be encountered during data collection. It also helped to estimate the time needed to fill the questionnaire tools. The pilot study was carried on 32 nurses which presented (10%) of sample size and excluded from the main study sample to fill out the questionnaire. Field work: Data was collected upon four months started from 10th of March 2016 to 10th of July 2016. It was collected in the morning, afternoon, and night shifts and subjects fill in the questionnaire in the presence of the investigator to ascertain all questions were answered. The time required for each nurse to fill the questionnaire was estimated to be 15-20 minutes. Statistical methodology: The data collected was tabulated and analyzed by SPSS (statistical package for social science) version 18 on IBM compatible computer. Results: The main findings of the present study revealed the following: •There was a very highly statistical significant positive correlation between total motivating work factors and total retention factors. •The desired motivating work factors ranked as the top five factors were: recognition and appreciation, salary, rewards, advancement and growth, training and development. •There was no difference in ranking of the 1st motivating work factor in both hospitals (Teaching Hospital &University Hospital) by the studied subjects which were recognition and appreciation, and salary. •The actual provided motivating work factors by the studied settings were arranged as the following: job characteristics, working conditions, feedback, training and development, job responsibility, leadership, goal-setting, job security, rewards, salary, advancement and growth, recognition and appreciation, & performance appraisal. •The majority of the studied subjects at both hospitals (Teaching Hospital & University Hospital) were moderately motivated (55.80% & 57.62% respectively). •Moreover, total retention factors at University Hospital and Teaching Hospital were moderate (41.32%& 39.97% respectively). •The majority of studied subjects reported that the 1st three categories (salary and incentives, job contents, work environment) of contributing factors of retention were provided by the study settings at semi-equal percentage (40.73%, 41.1%, and 41.02% respectively). While organizational factors were provided at the lowest percentage (36%). •The potential contributing factors of turnover as reported by the studied subjects ranked as the top five factors were: work overload, bad working relation with nursing supervisors, scheduling system, unsatisfactory salary, and tenure problems. •There was no difference in ranking of the 1st potential contributing factors of turnover in both hospitals (Teaching Hospital &University Hospital) by the studied subjects. •Most of the studied subjects (61.9%) had intention to leave hospitals. Also, there was no statistically significant difference between the two hospitals regarding intention to leave. •The studied subjects had intention to remain in hospitals in spite of the moderately motivated nursing staff and moderate retention factors provided by the study settings. •The highest percentage of the studied subjects’ age is less than 35years (37.1%). This finding indicated that nurses are mostly young, accordingly they will have long year to work. •The studied subjects’ more than or equal 45 years are motivated (65.56%) and retained (45.98%) compared to other age groups of the studied nurses. •There were statistical significant differences between age and total motivating work factors and total retention factors as P-value <.05. Recommendations: Based on the findings of this study and the review of the literature, the following recommendations are proposed: At practical level: •Disseminate the study results to the important key persons (hospital administrators) to be considered when dealing with nurses to decrease the liability of de-motivation and increase the retention rate of nurses at hospitals. •Recognition and appreciation of the good work done by staff nurses is the key issue that should be tackled seriously by health managers in hospitals. Staff will appreciate basic motivation schemes such as nurse of the month award. •Improve the compensation system of basic salary, incentives and bonuses that are competitive. •Update the hospital policies related to nursing vacations, nursing work hours, and inventory to aid in retention of nurses. •Provide an adequate number of nurses and ensure an appropriate distribution of the current nursing workforce to reduce work load and keep nurses retained in their work. •The job description should be reviewed and updated to reduce workloads and any non-nursing duties, which in turn reduce turnover and improve retention rate of nurses. •Nursing assistants and other supportive staffs should be recruited in accordance with the number of the patients. •Provide 24-hours nursery for the children of nurses during work shifts to provide motivating work climate and aid in retention of nurses. •Holding workshops with staff to discuss the strategies to motivate and retain nurses. At educational level: •Provide nurse managers/supervisors with training programs in the art of management, leadership and communication skills. •Provide newly employed nurses with well-prepared orientation program which aid in retaining nurses. •Opportunities to attend national and international nursing conferences should be organized for staff to update their knowledge in contemporary medical practice. •Nurses should be included in hospital committees to facilitate professional development through the expansion of their knowledge and sharing in decision making. •Management of hospitals should conduct annual assessment of the motivation and retention level of nurses and take proactive actions to decrease turnover of nurses. At research level: •Replication of the study on large sample size and different settings. •Further research is also needed to assess the impact of retention strategies on quality of patient care. |