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. 2024 Dec 16;77(6):e20230315.
doi: 10.1590/0034-7167-2023-0315. eCollection 2024.

The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study

[Article in English, Portuguese]
Caren de Oliveira Riboldi  1 , Renata Cristina Gasparino  2 , Wiliam Wegner  3 , Eder Henriqson  4 , Tarcísio Abreu Saurin  3 , Ana Maria Müller de Magalhães  3
Affiliations

The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study

[Article in English, Portuguese]
Caren de Oliveira Riboldi et al. Rev Bras Enferm. .

Abstract
in English, Spanish

Objectives: to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.

Methods: a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.

Results: the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.

Conclusions: the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.

Objetivos:: analizar la relación entre el entorno de práctica profesional de enfermería y la complejidad sociotécnica hospitalaria desde la percepción de los enfermeros.

Métodos:: estudio explicativo secuencial de métodos mixtos realizado en un hospital del sur de Brasil. Se aplicaron la versión brasileña de la Practice Environment Scale-Nursing Work Index y el Cuestionario de Caracterización de la Complejidad a 132 enfermeros. Posteriormente, se realizaron entrevistas semiestructuradas con 18 participantes, sometidas a análisis temático. La integración de los datos se llevó a cabo mediante conexión.

Resultados:: el entorno de práctica se mostró favorable, excepto en la subescala de Adecuación de personal y recursos, donde se observó complejidad en las actividades. Las tres categorías emergentes explicaron aspectos humanos y técnicos relacionados con la complejidad en el entorno de práctica, la calidad del cuidado y la seguridad del paciente. La variabilidad inesperada se correlacionó inversamente con el entorno de práctica.

Conclusiones:: los resultados del estudio indican una relación entre estos constructos, con implicaciones para la calidad y la seguridad del cuidado.

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Figures

Figure 1
Figure 1. Integration of quantitative and qualitative results, Porto Alegre, Rio Grande do Sul, Brazil, 2021
Figura 1
Figura 1. Integração dos resultados quantitativos e qualitativos, Porto Alegre, Rio Grande do Sul, Brasil, 2021
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