Influence of governance strategies, organizational climate and individual behaviors towards nurses performance

Abstract

Nursing services have been acknowledged to have direct effects on ensuring the success of initiatives to increase the quality and value of healthcare. Performance-related issues among nurses in the context of Malaysian public hospitals have brought interest to the researcher to examine and assess the constituents of nurses’ performance. The objectives of this research are to determine constituents of nurses’ performance based on availability, competence, responsiveness, and productivity as well as to examine the influence of contextual factor namely organizational governance strategies, organizational climate, and individual behavior towards nurses’ performance. Prior to the field study, Nurse Performance Scale (NPS) was developed, and validation of the questionnaire was done using lay expert review, research expert review and exploratory factor analysis. Using probability and proportionate sampling, a survey was distributed to 938 nurses in three levels of care in public hospitals, namely district hospitals, major specialist hospital, and tertiary hospital in the state of Terengganu. A total of 792 (84.4%) responses was analyzed. The results of ANOVA indicated that the differences in dimensions of performance level among nurses between levels of care were statistically significant. Two types of structural models were established to test the hypothesized relationships. The results showed that six hypothesized direct paths were found to be statistically significant in the district hospitals model. Governance strategies, shared governance, performance management, professional development, organizational climate, and individual behavior were found to be significantly influence the level of nurses’ performance. The findings of the study also demonstrated dynamic relationships in different levels of care in relation to organizational governance strategies, organizational climate, and individual nurse behaviors towards their performance. This research proposed a Nursing Workforce Performance Framework (NWPF) which outlined a set of strategies, action plans and policy recommendations to manage key determinants to nurses’ performance. This framework is beneficial to Ministry of Health as guidelines in enhancing nursing workforce performance. Nursing practices in public and private sectors may benefit from the research outcomes as guidelines for managing key determinants to nurses’ performance.