Tennessee's registered nurse vacancy rate is the highest in five years and the nursing shortage has dramatically impacted all portions of the state. The purpose of this study was to describe organizational attributes of exemplar Tennessee hospitals, as perceived by Chief Nurse Executives, which may influence the recruitment and retention of registered nurses. In this study, 52 Tennessee hospitals were identified as exemplars of quality patient care, organizational policy, and administration. Their Chief Nurse Executive's were surveyed utilizing a Hospital Characteristics Questionnaire and the Organizational Support Subscale from the Nursing Workforce Index Revised (NWI-R). The hospital characteristics and organizational attributes were then compared with those found in American Nurses Credentialing Center (ANCC) magnet hospitals, which have a reputation for retaining and recruiting nurses. The study demonstrated that the exemplar Tennessee hospitals were not comparable with the ANCC magnet hospitals and the findings suggest that Tennessee hospitals must develop strategies related to staffing, professional autonomy, respect for nursing, and positive work environments in order to recruit and retain nurses to preserve a nursing workforce now, and in the future.

De nombreux constats contemporains s’alarment du malaise récurrent des ressources humaines hospitalières, particulièrement à l’endroit des médecins et des soignants, et par conséquent du risque de mauvaise qualité de prise en charge des patients. Adoptant une approche plus optimiste, des chercheurs américains en soins infirmiers ont mis en évidence depuis le début des années 1980 l’existence d’hôpitaux dits magnétiques, parce qu’attractifs et fidélisateurs, et où il ferait bon travailler et se faire soigner. Cette thèse vise à approfondir le concept de Magnet Hospital, à éclairer sa définition et sa portée pour la gestion des ressources humaines hospitalières en France. Suivant une démarche hypothético-déductive, la conceptualisation, fondée sur un état de l’art, débute par une appropriation du modèle synthétique du Magnet Hospital. Empruntant une perspective psychosociale, notre modèle original de recherche se focalise sur la perception, à l’échelle des unités de soins, des attributs managériaux du magnétisme hospitalier (leadership transformationnel, empowerment perçu de la participation et climat relationnel collégial entre médecins et soignants) et ses conséquences attitudinales positives (satisfaction, implication, intention de rester, équilibre émotionnel travail/hors travail et efficacité collective perçue). Une méthodologie quantitative interroge au moyen de 8 échelles ad hoc un échantillon représentatif de 133 médecins, 361 infirmières et 362 aides-soignantes de 36 services de médecine polyvalente français. Une série de modélisations par équations structurelles, selon l’algorithme Partial Least Squares, teste la nature et l’intensité des relations directes et indirectes du magnétisme managérial perçu. Les résultats statistiques indiquent une bonne qualité des construits et d’ajustement des modèles. Un contexte managérial magnétique produit son principal effet positif sur l’efficacité collective perçue. Des différences catégorielles existent quant à la perception de sa composition et à la transmission de ses effets par la médiation de l’efficacité collective perçue, signalant le caractère contingent du magnétisme. Ces résultats ouvrent des perspectives managériales et scientifiques, en soulignant l’intérêt des approches positives de l’organisation hospitalière. / Many contemporary findings are alarmed of the recurring discomfort of hospital human resources, especially against doctors and nurses, and consequently against risk of poor quality of care for patients. Adopting a more optimistic approach, American nursing scholars have highlighted since the 1980s, some magnet hospitals, able to attract and retain, and with good working and care conditions. This thesis aims to explore Magnet Hospital concept, to inform its definition and scope for hospital human resource management in France. According to a hypothetico-deductive approach, based on a review of the literature, the conceptualization begins with appropriation of synthetic Magnet Hospital model. Under a psychosocial perspective, our original research model focuses on perception of managerial magnetic attributes (transformational leadership, perceived empowerment of participation, collegial climate between doctors and nurses) and their consequences on positive job attitudes (satisfaction, commitment, intent to rest, emotional equilibrium work/family, perceived collective efficacy), at wards level. A quantitative methodology proceeds by a questionnaire of 8 ad hoc scales and interviews 133 doctors, 361 nurses, 362, auxiliary nurses, in 36 French medicine units. A set of structural equations modeling, according to Partial Least Squares, tests nature and intensity of direct and indirect relationships of perceived managerial magnetism. The statistical results show a good validity of constructs and a good fit of models. The major positive effect of magnetic managerial context is on perceived collective efficacy. Some professional differences exist about perceptions of composition and transmission of magnetic effects (via mediation of perceived collective efficacy), indicating the contingency of magnetism. These findings open managerial and scientific opportunities, emphasizing the interest for positive organizational approach of hospital.

Summary: The aim of thi disertation was to enlighten the term magnet hospital. Introduction of this thesis describes personnel situation in health care systém in the Czech republic and globaly. It also shows predictions of the future critical nurse staff shortage on labour market all around the world and it's possible impact on quality of care. Magnet hospitals as the kind of organization that creates work enviroment which increases nurses work satisfaction, quality of care and patients outcomes, sees the author as one of the possible solution of nursing shortage in the Czech republic. Second part of this theses, rpresents the results of the qualitative and quantitative research, participant were 16 nurses at the management positions (structured intewies) and 250 nurses (questionare NWI-R autor's own translation). Results: It was obvious that still prevails the traditional hierarchy and medical model of care delivery. Also there is streotypical view of the role and position of the nurses in health care teams, nurses do not feel like they are involved in management of the hospital. According to the findings we cannot describe those organizations as magnet hospital. It's also clear that the nursing care managers play the key role in creating the good work environment. We should pay more attention to their...

The National Health Act aims to protect the health care users and workers by ensuring that their work environments are protected against injuries. Practice environment is described as a physical, social and psychological characteristic of a work setting in which policies, procedures and systems are designed so that employees can meet the organisational objectives and achieve personal satisfaction in their work environment. The aim of the study was to describe and analyze characteristics of the practice environment of nurses. A quantitative descriptive study was conducted in a public hospital in Gauteng Province. Practice Environment Scale-Nursing Working Index (PES-NWI) questionnaires were distributed to 207 nurses who were proportionately stratified. Data was analysed using the SPSS version 25. Findings identified gaps of the current characteristics of the practice environment and developed strategies that will assist managers to enhance practice environment. There was alignment and correlation between the means, standard deviation and the frequencies which were drawn from the findings. The overall Cronbach’s alpha was 89% which confirmed the internal consistency of the instrument. The majority of the variables demonstrated statistical significance which had a p value of 0.001. In conclusion, practice environment affects all health care professionals although the study only analyzed the practice environment of nurses. / Health Studies / M. P. H.