Staff Perceptions of the Professional Practice Environment 2006 Values Philosophy Standards of Practice Collaborative Decisionmaking Professional Development Patient Care Delivery Models Privileges, Credentialing, Peer Review Research Descriptive Care Theory Models Massachusetts General Hospital Patient Care Services Nursing Department The General Hospital Corporation, 1999 1
Introduction: This survey should take about 30 minutes to complete. All survey answers will be kept completely confidential. Your answers will never be linked to your name and will never be used in a way that could identify you. The survey does contain a randomly generated ID number. Since the survey will be delivered two ways (paper and online), the ID number will be used by the Institute for Health Policy to track completed surveys to avoid any duplication of mailings and to ensure that each clinician only completes the survey once. Also, the ID number will enable you to complete the online survey over multiple sessions, should you not want to complete it during one session. The ID number will not be shared with anyone in MGH Patient Care Services. Survey responses will never be linked to your name. Please do not write your name on the questionnaire or the return envelope. The initial data analysis will report responses from all services within Patient Care Services. Secondary analysis will focus on unit data and data groupings (e.g. surgical services or physical therapy). Content analysis will be completed on the open-ended question across all Patient Care Services to identify themes. If permission is given, written comments for individual services will be presented as part of data reporting to each service. We are electronically reading responses from the surveys. Please answer all questions by filling in the circle completely. See the example below for how the circle should be filled in. The survey should be filled out in blue or black ink. Please do not write in the margins or make any errant marks outside of the circles on the survey since this may affect the electronic reading of survey responses. There is space at the end of the survey for written comments. Yes No Thank you for your willingness to participate in this survey. If you have any questions about the survey, please don t hesitate to contact Eric Campbell, Ph.D. at the Institute for Health Policy at 617-726-5213 or via email at ecampbell@partners.org. 2
A. CLINICAL PRACTICE: In this section, statements refer to factors related to practice on your primary unit. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about clinical practice on your primary unit. 1. Leadership is supportive of nursing. 2. Nursing controls its own practice on my unit. 3. I have freedom to make important patient care and work decisions. 4. There is a lot of teamwork between nurses and doctors. 5. On my unit, patient care assignments foster continuity of care. 6. I have adequate support services to allow me to spend time with my patients. 7. I have enough time and opportunity to discuss patient care problems with other nurses. 8. On my unit, there are enough nurses on staff to provide quality patient care. 9. The nurse manager on my unit is a good manager and leader. 10. We have enough staff to get the work done. 11. There are opportunities to work on a highly specialized patient care unit. 3
A. CLINICAL PRACTICE (continued): Statements refer to factors related to practice on your primary unit. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about clinical practice on your primary unit. 12. My nurse manager supports the nursing staff in decision-making, even if the conflict is with a doctor. 13. Physicians and nurses have good working relationships. 14. On my unit, I am asked to do things against my professional judgment. 15. Overall, how dissatisfied or satisfied are you with your CLINICAL PRACTICE on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied B. GENERAL RELATIONSHIPS AND COMMUNICATION: In this section, statements refer to factors related to general relationships and communication on your primary unit. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about general relationships and communication on your primary unit. 16. Information on the status of patients is available when I need it. 17. I receive information quickly when a patient's status changes. 18. Information regarding patient care is relayed without major delays. 4
19. Overall, how dissatisfied or satisfied are you with GENERAL RELATIONSHIPS AND COMMUNICATION on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied C. TEAMWORK AND LEADERSHIP: In this section, statements refer to factors related to teamwork and leadership on your primary unit and other hospital units. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about teamwork and leadership on your primary unit. 20. My unit has constructive work relationships with other hospital units. 21. My unit does not receive the cooperation it needs from other hospital units. 22. Other hospital units seem to have a low opinion of my primary unit. 23. Inadequate working relationships with other hospital units limit the effectiveness of work within my primary unit. 24. Overall, how dissatisfied or satisfied are you with TEAMWORK AND LEADERSHIP on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied 5
D. DISAGREEMENT/CONFLICT: In this section, statements refer to what happens when there is a disagreement or conflict on your primary unit. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about disagreement or conflict on your primary unit. 25. When staff on my unit disagree, they ignore the issue, pretending it will "go away." 26. Most conflicts occur with members from my own discipline. 27. Staff on my unit withdraw from conflict. 28. On my unit, all points of view are carefully considered in arriving at the best solution for the problem. 29. All staff on my unit work hard to arrive at the best possible solution. 30. On my unit, staff involved in a disagreement or conflict do not settle the dispute until all are satisfied with the decision. 31. Most conflicts occur with members from other disciplines. 32. Everyone on my unit contributes from their experience and expertise to produce a high quality solution for a conflict. 33. On my unit, disagreements between staff are ignored or avoided. 34. Staff involved in a disagreement or conflict settle the dispute by consensus. 6
35. Overall, how dissatisfied or satisfied are you with the way DISAGREEMENTS OR CONFLICTS are addressed on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied E. INTERNAL WORK MOTIVATION: In this section, statements refer to your feelings about work. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about your work motivation on your primary unit. 36. My opinion of myself goes up when I work on my primary unit. 37. I feel bad and unhappy when I discover that I have performed less well than I should. 38. I feel a high degree of personal responsibility for the work I do. 39. I feel a great sense of personal satisfaction when I do my work well. 40. I have challenging work that motivates me to do the best I can. 41. Working on my primary unit gives me the opportunity to gain new knowledge and skills. 42. I am motivated to do well because I am empowered by my work environment. 43. Working in this environment increases my sense of professional growth. 7
44. Overall, how dissatisfied or satisfied are you with your WORK MOTIVATION on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied F. CULTURAL SENSITIVITY: In this section, statements refer to cultural sensitivity on your primary unit. Think of your primary unit as the work area, department, or clinical area of the hospital where you spend most of your work time. Please fill in the ONE circle that best reflects your level of disagreement or agreement with the following statements about cultural sensitivity on your primary unit. 45. Staff on my unit have access to the necessary resources to provide culturally competent care. 46. Staff on my unit are sensitive to the diverse patient population for whom they care. 47. Staff respect the diversity of their unit's health care team. 48. Overall, how dissatisfied or satisfied are you with CULTURAL SENSITIVITY on your primary unit? (Please fill in ONE circle only) O O Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied G. OVERALL SATISFACTION Please fill in the ONE circle that best reflects your level of dissatisfaction or satisfaction with the following statement about your primary unit. Very Dissatisfied Dissatisfied Satisfied Very Satisfied 49. Overall, how satisfied are you working on your primary unit? 8
H. DEMOGRAPHICS: Please tell us a little about yourself. Fill in the blanks or fill in the circle that corresponds with your response. 50. What is your age? 51. Please indicate your gender. O Female O Male 52. What is your current work status? (Fill in ONE circle only) O Full time O Part time O Per diem 53. What is the highest level of education you have received? O Diploma O Master s degree not in your profession O Associate degree O Doctoral degree in your profession O Bachelors degree in your profession O Doctoral degree not in your profession O Bachelors degree not in your profession O Other (Please Specify: ) O Master s degree in your profession 54. Please indicate the year this degree was received: 55. How many years have you worked in your current profession? (# of years) 56. Which of the following best describes your current work setting? (Fill in the circle for all that apply) O O O Inpatient Outpatient Other (Please specify: ) 57. How many years have you worked at MGH? (# of years) 9
58. Have you attended the 8-hour Culturally Competent Care program offered by the Center for Clinical and Professional Development? (Fill in ONE circle only) O O Yes No I. Common Patient Problems: Below is a list of common patient problems encountered during the nurse/patient interaction. For each problem, please select how frequently you are exposed to the problem on your primary unit and also how prepared you are to address the problem? PATIENT PROBLEMS How frequently do you see this problem on your primary unit? (Fill in ONE circle only) Never Sometimes Often All of the time Not prepared at all How prepared are you to address this problem? (Fill in ONE circle only) 59. Risk for infection O O 60. Management of infection O O 61. Anxiety O O 62. Skin breakdown O O 63. Incontinence O O 64. Self-care deficit (Unable to complete ADLs) Very well prepared O O 65. Sleep disturbance O O 66. Obesity O O 67. Malnutrition O O 68. Falls O O 69. Risk for injury O O 70. Immobility O O 10
How frequently do you see this problem on your primary unit? (Fill in ONE circle only) PATIENT PROBLEMS Never Sometimes Often All of the time Not prepared at all How prepared are you to address this problem? (Fill in ONE circle only) 71. Violence O O 72. Anger O O 73. Confusion O O 74. Ineffective pain management O O 75. Family conflict O O 76. Fear O O 77. End of life ethical dilemmas O O 78. Substance abuse O O Very well prepared 79. Non-invasive mechanical ventilation O O 80. Invasive mechanical ventilation O O 81. Wound O O 82. Ostomy O O 83. Airway management O O 84. Ineffective code status conflict O O 85. Risk for knowledge deficit O O 11
I. Other Common Patient Problems: If you encounter other common patient problems please list them below. For each problem, please select how frequently you are exposed to the problem on your primary unit and also how prepared you are to address the problem? PATIENT PROBLEMS Other (please specify below) How frequently do you see this problem on your primary unit? (Fill in ONE circle only) Never Sometimes Often All of the time Not prepared at all How prepared are you to address this problem? (Fill in ONE circle only) Very well prepared 86. O O 87. O O 88. O O 89. O O YOUR COMMENTS: Please feel free to write any comments you have in regards to any of the topics in this survey as well as topics not covered in this survey that pertain to the professional practice environment. I give permission for any comments above to be included in a list of general responses to be shared with my Associate Chief Nurse. (Please fill in ONE circle only) O Yes, release my comments O No, do not release my comments THANK YOU FOR YOUR TIME AND EFFORT IN COMPLETING THIS SURVEY. PLEASE RETURN THIS SURVEY IN THE ENCLOSED ENVELOPE BY September 25, 2006 2006 Staff Perceptions of the Professional Practice Environment The Institute for Health Policy Massachusetts General Hospital 50 Staniford St., 9 th Floor Boston, MA 02114 The General Hospital Corporation, 1999 12