Evaluation of the professional practice environment of nursing in health institutions

Abstract

Objective: To evaluate the hospital environment where nursing performs its practice comparing public and private hospitals and describing the characteristics that received unfavorable evaluation (≤ 2.5 points) in the professionals’ perception. Methods: A comparative and cross-sectional study was conducted in five hospitals (two public hospitals - A and B; and three private ones - C, D and E) from a city in the countryside of the state of São Paulo, with a total of 1773 nursing professionals. The instruments used were: data sheet for characterization of the sample and the Brazilian version of the Practice Environment Scale. In the data analysis, we used descriptive and inferential statistics. To compare the hospitals, we used the Kruskall Wallis test, followed by the Dunn post-test and the multinomial regression. Results: In the comparison of hospitals, D and E hospitals reached mean above the others and significant differences (p<0.0001) were obtained in relation to the five subscales of the instrument used. In the multinomial regression, hospital D obtained 5.8; hospital E 5.2; hospital C 3.0 and hospital A 2.7 chances of having a more favorable environment when compared to hospital B. Items with a score lower than 2.5 were associated, especially, lack of opportunity for development, recognition, participatory management and proper sizing. Conclusion: Private hospitals showed better performance when compared to the public ones, and the characteristics that received the worst evaluation were related to the participation of nurses in hospital affairs based on quality, support of the managers to the team and adequacy of resources.