Staff Perceptions

of the
Professional Practice
Environment
2006
Values Philosophy S tandards
of
Practice

Professional
Development Patient Care
Collaborative
Delivery
Decision-
Models
making

Privileges, Descriptive
Research
Credentialing, Care Theory
Peer Review Models

Massachusetts General Hospital

Patient Care Services
Nursing Department
©The General Hospital Corporation, 1999

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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.

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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.

UNIT
Strongly Disagree Disagree Agree Strongly Agree

1. Leadership is supportive of nursing. O O O O

2. Nursing controls its own practice on my unit. O O O O

3. I have freedom to make important patient care and work decisions. O O O O

4. There is a lot of teamwork between nurses and doctors. O O O O

5. On my unit, patient care assignments foster continuity of care. O O O O

6. I have adequate support services to allow me to spend time with my patients. O O O O

7. I have enough time and opportunity to discuss patient care problems with other
nurses.
O O O O

8. On my unit, there are enough nurses on staff to provide quality patient care. O O O O

9. The nurse manager on my unit is a good manager and leader. O O O O

10. We have enough staff to get the work done. O O O O

11. There are opportunities to work on a highly specialized patient care unit. O O O O

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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.
UNIT
Strongly Disagree Disagree Agree Strongly Agree
12. My nurse manager supports the nursing staff in decision-making, even if the
conflict is with a doctor. O O O O

13. Physicians and nurses have good working relationships. O O O O

14. On my unit, I am asked to do things against my professional judgment. O O O O

15. Overall, how dissatisfied or satisfied are you with your CLINICAL PRACTICE on your primary unit? (Please fill in ONE circle only)

O O O O 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.
UNIT
Strongly Disagree Disagree Agree Strongly Agree

16. Information on the status of patients is available when I need it. O O O O

17. I receive information quickly when a patient's status changes. O O O O

18. Information regarding patient care is relayed without major delays. O O O O

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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 O O 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.
UNIT
Strongly Disagree Disagree Agree Strongly Agree

20. My unit has constructive work relationships with other hospital units. O O O O

21. My unit does not receive the cooperation it needs from other hospital units. O O O O

22. Other hospital units seem to have a low opinion of my primary unit. O O O O
23. Inadequate working relationships with other hospital units limit the effectiveness
of work within my primary unit.
O O O O

24. Overall, how dissatisfied or satisfied are you with TEAMWORK AND LEADERSHIP on your primary unit? (Please fill in ONE circle only)

O O O O O O
Very Dissatisfied Moderately Dissatisfied A Little Dissatisfied A Little Satisfied Moderately Satisfied Very Satisfied

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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.

UNIT
Strongly Disagree Disagree Agree Strongly Agree

25. When staff on my unit disagree, they ignore the issue, pretending it will "go away." O O O O

26. Most conflicts occur with members from my own discipline. O O O O

27. Staff on my unit withdraw from conflict. O O O O

28. On my unit, all points of view are carefully considered in arriving at the best
solution for the problem. O O O O

29. All staff on my unit work hard to arrive at the best possible solution. O O O O
30. On my unit, staff involved in a disagreement or conflict do not settle the dispute
until all are satisfied with the decision. O O O O

31. Most conflicts occur with members from other disciplines. O O O O

32. Everyone on my unit contributes from their experience and expertise to produce a
high quality solution for a conflict. O O O O

33. On my unit, disagreements between staff are ignored or avoided. O O O O

34. Staff involved in a disagreement or conflict settle the dispute by consensus. O O O O

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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 O O 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.
UNIT
Strongly Disagree Disagree Agree Strongly Agree

36. My opinion of myself goes up when I work on my primary unit. O O O O

37. I feel bad and unhappy when I discover that I have performed less well than I
should.
O O O O

38. I feel a high degree of personal responsibility for the work I do. O O O O

39. I feel a great sense of personal satisfaction when I do my work well. O O O O

40. I have challenging work that motivates me to do the best I can. O O O O

41. Working on my primary unit gives me the opportunity to gain new knowledge and
skills.
O O O O

42. I am motivated to do well because I am empowered by my work environment. O O O O

43. Working in this environment increases my sense of professional growth. O O O O

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44. Overall, how dissatisfied or satisfied are you with your WORK MOTIVATION on your primary unit? (Please fill in ONE circle only)

O O O O 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.

UNIT
Strongly Disagree Disagree Agree Strongly Agree
45. Staff on my unit have access to the necessary resources to provide culturally
competent care. O O O O

46. Staff on my unit are sensitive to the diverse patient population for whom they care. O O O O

47. Staff respect the diversity of their unit's health care team. O O O O

48. Overall, how dissatisfied or satisfied are you with CULTURAL SENSITIVITY on your primary unit? (Please fill in ONE circle only)

O O O O 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.

UNIT
Very Dissatisfied Dissatisfied Satisfied Very Satisfied

49. Overall, how satisfied are you working on your primary unit? O O O O

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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 Inpatient
O Outpatient
O Other (Please specify: ___________________)

57. How many years have you worked at MGH? ________ (# of years)

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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 Yes
O 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?

How frequently do you see this problem on How prepared are you to address this problem?
your primary unit? (Fill in ONE circle only)
PATIENT PROBLEMS (Fill in ONE circle only)
Never Sometimes Often All of Not prepared Very well
the time at all prepared
59. Risk for infection O O O O O O O O O O
60. Management of infection O O O O O O O O O O
61. Anxiety O O O O O O O O O O
62. Skin breakdown O O O O O O O O O O
63. Incontinence O O O O O O O O O O
64. Self-care deficit (Unable to
complete ADLs) O O O O O O O O O O
65. Sleep disturbance O O O O O O O O O O
66. Obesity O O O O O O O O O O
67. Malnutrition O O O O O O O O O O
68. Falls O O O O O O O O O O
69. Risk for injury O O O O O O O O O O
70. Immobility O O O O O O O O O O

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 How frequently do you see this problem on How prepared are you to address this problem?
your primary unit? (Fill in ONE circle only)
(Fill in ONE circle only)
PATIENT PROBLEMS Never Sometimes Often All of Not prepared Very well
the time at all prepared
71. Violence O O O O O O O O O O
72. Anger O O O O O O O O O O
73. Confusion O O O O O O O O O O
74. Ineffective pain management O O O O O O O O O O
75. Family conflict O O O O O O O O O O
76. Fear O O O O O O O O O O
77. End of life ethical dilemmas O O O O O O O O O O
78. Substance abuse O O O O O O O O O O
79. Non-invasive mechanical
ventilation O O O O O O O O O O

80. Invasive mechanical ventilation O O O O O O O O O O

81. Wound O O O O O O O O O O
82. Ostomy O O O O O O O O O O
83. Airway management O O O O O O O O O O
84. Ineffective code status conflict O O O O O O O O O O
85. Risk for knowledge deficit O O O O O O O O O O

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 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?

How frequently do you see this problem on How prepared are you to address this problem?
your primary unit? (Fill in ONE circle only)
PATIENT PROBLEMS (Fill in ONE circle only)
Never Sometimes Often All of Not prepared Very well
the time at all prepared
Other (please specify below)
86. O O O O O O O O O O
87. O O O O O O O O O O
88. O O O O O O O O O O
89. O O O O O O O O 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., 9th Floor
Boston, MA 02114
©The General Hospital Corporation, 1999

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