الفهرس 
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Abstract
SUMMARY
Innovative behavior can be defined as nurses’ ability to promote and seek new
ideas, and attempts to build support for implementation of these ideas. Nurses’
innovative behavior acts as preemptive resource for organizational sustenance and
development. So, health care organization requires a range of behaviors to make
sure that both nurses and organization will succeed in the future as; work
discretion, time availability, management support and reward/reinforcement.
Aim of the study:
Examine the relationship between health care organizational characteristics
and nurses’ innovative behavior at Kafr El-Dawar General Hospital, Fever
Hospital and Damanhour Chest Hospital.
Research question:
What is the relationship between health care organizational characteristics
and nurses’ innovative behavior at Kafr El-Dawar General Hospital, Fever
Hospital and Damanhour Chest Hospital?
Research Design:
A descriptive, correlational research design was used in this study
Setting:
The study was conducted at all Intensive and critical Care Units (ICUs) at
Kafr El-Dawar General Hospital, Fever Hospital and Damanhour Chest Hospitals
(n=11). These hospitals are affiliated to the Ministry of Health and Population
(MOHP); containing the largest general ICUs.
It is located at El-Beheira Governorate, with bed capacity (n=278,105
and160), respectively. Kafr El-Dawar General Hospital included all Intensive Care
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Units (ICUs) (n=9), namely: general, coronary care unit, neonatal, kidney-dialysis,
pediatric, neuro-surgery, toxicology, eclampsia, and burn. General ICU at Fever
Hospital (n=1); and at Damanhour Chest Hospital (n=1).
Subjects:
All staff nurses, who are working in the previously mentioned settings and
who were available at the time of data collection, with at least one year of
experience, were included in the study (N=220).
Tools of the study:
In order to collect the required data, the following two tools were used in this
study:
Tool I: Organizational characteristics Scale:
This scale consisted of two parts:
Part 1: demographic characteristics data sheet:
It was developed by the researcher, and included data, namely: gender, age,
educational qualification, working unit, years of nursing and unit experiences, and
marital status. (Appendix I)
Part 2: Organizational characteristics Scale:
It was developed and adapted by the researcher based on Hornsby et al. and
Buamann (176, 10) to measure health care organizational characteristics. It consisted
of 20 items, classified into four dimensions, namely: (1) work discretion (7-item);
(2) time availability (5-item); (3) management support (5-item); and (4)
rewards/reinforcement (3-item). Responses were measured using 5-point Likert
rating scale ranging from (1) strongly disagree to (5) strongly agree. The highest
score indicates higher level of organizational characteristics. The total scores for
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health care organizational characteristics were generated by summing up the scores
from all subscales and ranges from 20 to 100; where from 20 to less than 47
indicate low score, from 47 to less than 74 indicate moderate score and from 74 to
100 indicate high score. (Appendix II)
Tool II: Nurses Innovation Behavior Scale:
It was developed by Janssen (2005), (105) to measure nurses’ innovative
behavior. It consists of 9 items divided into three subscales, as follows: (1) idea
generation (3-item); (2) idea implementation (3-item); and (3) idea realization (3-
item). Responses were measured on a 7-point Likert rating scale ranging from (1)
never to (7) always. Scores ranged from 9 to 63, where from 9 to less than 27
indicate low score, from 27 to less than 45 indicate moderate score and from 45 to
63 indicate high score. (Appendix III)
Methods
1. An official permission was obtained from the Dean of Faculty of Nursing,
Damanhour University and the administrators of the identified hospitals to
obtain an approval for collecting the necessary data from the selected units.
2. The two tools were translated into Arabic language and were tested for its
content validity and translation by five experts in the field of the study.
Accordingly, some modifications were done. (Appendix IV)
3. Reliability test was conducted using Cronbach’s alpha test, as follows:
tool I: Organizational characteristics Scale :( α = 0.774) and tool II: Nurses
innovation behavior scale: (α = 0.826), indicating adequate and good
reliability.
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4. A pilot study was carried out on (10%) of total sample size; staff nurses
(n=22), who were not included in the study sample; in order to check and to
ensure the clarity and feasibility of the tool and to identify obstacles and
problems that may be encountered during data collection. Then, no
modification was done.
5. Data collection for this study was conducted by the researcher through
hand-delivered, self-administered questionnaire. An individualized interview
with each staff nurse was conducted to explain the aim of the study and the
needed instructions were given before the distribution of the questionnaire in
their settings.
6. The questionnaire was completed by staff nurses at their work setting; It
took about 20-30 minutes to fill out the two tools. The data was collected in
a period of three months, starting from the first of January 2020 to the end of
March 2020.
Ethical considerations:
1. The research approval was obtained from the ethical committee at the
Faculty of Nursing-Damanhour University, prior to the start of the study.
2. An informed written consent was obtained from the study subjects after
explanation of the aim of the study.
3. Privacy and right to refuse to participate or withdraw from the study was
assured during the study.
4. Confidentiality and anonymity regarding data collected was maintained.
The following were the core results of the present study:
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The result revealed that there were highly statistical significant differences
between staff nurses working at the three hospitals (Fever, Chest and Kafr
El-Dawar General Hospitals) and total health care organizational
characteristics and management support dimension. However, no statistical
significant differences were found between the three hospitals and the other
dimensions.
The first dimension was management support at Fever, Chest and Kafr El-
Dawar General Hospitals; compared to time, which was the last dimension
at Fever, Chest and Kafr El-Dawar General Hospitals.
The result indicated that the highest percentage of staff nurses, working at
Fever, Chest and Kafr El-Dawar General Hospitals got moderate level of
total health care organizational characteristics.
There were highly statistical significant differences between staff nurses
working at three hospitals (Fever, Chest and Kafr El-Dawar General
Hospitals) and total nurses’ innovative behavior. Whereas, a statistically
significant difference was found between the three hospitals and idea
generation subscale.
The first subscale was idea generation at Fever, Chest and Kafr El-Dawar
General Hospitals. Whereas, the last subscale was idea realization at Fever
Hospital. However, idea implementation was last subscale at chest hospital.
The highest percentage of staff nurses, working at Fever, Chest and Kafr
El-Dawar General Hospitals got high level of total nurses’ innovative
behavior.
At Fever Hospital, there was highly statistical significant relationship
between total health care organizational characteristics and staff nurses’
educational
qualification,
while
there
were
statistical
significant
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relationships between total health care organizational characteristics and
both years of nursing and unit experiences.
Moreover, there were statistical significant relationships between nurses’
innovative behavior and gender, educational qualification, and both years of
nursing and unit experiences.
At Chest Hospital, there were highly statistical significant relationships
between total health care organizational characteristics and staff nurses’
educational qualification and, between total nurses’ innovative behavior and
years of nursing experience. Moreover, there were statistical significant
relationships between total health care organizational characteristics and
both gender and years of unit experience. Additionally, there were statistical
significant relationship between total nurses’ innovative behavior and age
and years of unit experience.
At Kafr El-Dawar General Hospital, there were highly statistical significant
relationships between total organizational characteristics and educational
qualification, years of unit experience and marital status. Additionally, there
were highly statistical significant relationships between total nurses’
innovative behavior and both years of nursing and unit experiences.
Furthermore, there were statistical significant relationships between total
health care organizational characteristics and years of nursing experience
and between total nurses’ innovative behavior and age and educational
qualification.
There was statistical significant correlation between total health care
organizational characteristics and total nurses’ innovative behavior at the
three hospitals.
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Nursing and unit experience and nurses’ innovative behavior were highly
significant predictors whereas; age and educational qualification were
significant predictors of health care organizational characteristics.
Educational qualification, unit experience and health care organizational
characteristics were highly significant predictors whereas; age and nursing
experience were significant predictors of nurses’ innovative behavior.
Conclusion and Recommendations:
There were highly statistical significant differences between staff nurses
working at the three hospitals and total health care organizational characteristics
and nurses’ innovative behavior. Moreover, there were highly statistical significant
correlations between total health care organizational characteristics and its related
dimensions; except work discretion dimension; and between total nurses’
innovative behavior and its related subscales.
Based
on
the
findings
of
the
present
study,
the
following
recommendations are suggested:
1. Hospital administrators should:
Conduct workshops on innovative thinking and design strategies to improve and
facilitate innovative behavior among staff nurses.
Introduce reward programs that motivate staff nurses to continuously share
knowledge to improve the quality of patient care and that encourage innovation
as a job requirement and reward for good work.
2. Head nurses should:
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React positively to the innovative efforts of staff nurses by providing them time,
support and resources to carry out innovative ideas and give more attention to
their needs and how to satisfy and reward them.
Conduct regular meeting with staff nurses to discuss ways of improvement of
quality of work life, fairness of rewards, give authority and responsibility to
take decisions.
3. Staff nurses should:
Communicate openly with their head nurses to discuss their problem and their
ideas and opinions.
Attend training program to become aware of organizational policies, resources,
rules and regulation, to improve their abilities and skills to work effectively and