LMRJ Volume 2 Issue 1 17 | P a g e Effect of Environmental Factors on Job Performance among Nurses of Tertiary Health Care Sector Tehseena Akram1, Hafiza Ummara Rasheed2, Abida Asghar3, Noreen Fatima4 1University of Lahore, Nursing Instructor at (College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore). 2College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore. 3University of Lahore, Nursing Instructor at (College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore). 4College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore. Correspondence: Tehseena Akram University of Lahore, Nursing College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore. E-mail: tehseenaakram@gmail.com LMRJ.2020:2(1): DOI: 10.3810/LMRJ.2020.2.1.04 Received: 10 December 2019 Revised: 4 January 2020 Accepted for publication 8 January 2020 Abstract This study was designed to assess effects of environmental factors on job performance among nurses of tertiary health care sector. A cross- sectional study was conducted. A total of 200 nurses were selected from Services Hospital Lahore, Pakistan. This study reveals that the physical environment plays the important role on job performance which is already cited in literature and also affects retention of the staff. Materialistic facilities, surroundings, a physical condition, worry capability affects tremendously on the performance of the workers. This study suggests that performance may be improved by addressing safety, infection control measures, and environment temperatures and supplies availability. Keywords: Environmental Factors, Job Performance, Nurses. Introduction Career routine is an extremely important aspect argumentative winner of an organization 1. Disorganized career routine is associated with lesser efficiency which leads to less cost-effectiveness and weakening of general managerial effectiveness2-3. Healthy occupational routine as actions to be completed towards accomplishing the organization’s aims and intents4. Healthier job routine is the fundamental concept of today’s work place for patient centered care 5 and for business success and employee satisfaction 6. Nurses are significant part of health structures thereafter better performance is expected from them, and performance of nurses is closely linked to the output and worth of concern conditions surrounded by wellbeing of the concern organizations. For this motive, it was significant on the way to identify factors influencing appropriate delivery of the system 7. Nurses’ performance in the health care system can potentially be dependent on the familiarity, skills, motivation and favorable environment 8. Although there are many factors which can affect the performance, such as a superior profitable location, a stiff employment promote, and aged personnel. However, in many studies it is hypothesized that good environmental factors act as a buffer against low satisfaction levels that can lead to poor performance9. Moreover, environmental factors also influence the place of work by increasing professional pressure Research article mailto:tehseenaakram@gmail.com LMRJ Volume 2 Issue 1 18 | P a g e which is the leading cause of burnout and poor performance hence, more attention has to be given to the conducive environment for the high productivity of the employees, patient satisfaction, and low turnout and can even increase the revenue of the organization 10. Thus it’s the employer responsibility to give proper working environment so that the routine of workers meet the preferred values. Unfortunately nurse are still struggling with the lower two levels defined by the Maslow framework11. It is also stated that the work place incivility is the major cause of the staff leaving their present position12. The objective of the study was to assess the effects of environmental factors on the job performance among nurses of tertiary health care sector. This study will help nurses to know about contact of job green factors on nurses’ employment routine. Secondly, this study will help the organization to aware about the study result, which it will helpful to overcome weakness. Methodology A cross-sectional study was adopt to reply the investigate inquiry. Logical, traverse-sectional learn aim was be deployed used for this study. The study was conduct in the Services hospital, Lahore, Pakistan. Inclusion criteria are those staff nurses in all departments in services hospital who show willingness to participate in study and those who are present during the time of data collection. Participants who concur to contribute in the study and indication the learned assent form and Willingness to fill the self- administered questionnaire. The exclusion criteria, the Students Nurses, and Head nurses or nurses in the administration department. A number of research studies use the Slovin’s formula for obtaining the sample size. Denoting by n, the sample size, was given as n=N/1+ (N) (E) 2 where N is the population size and e is the margin of error 13-14. Sample size of the study was calculated as 200. The convenient sampling strategy was adopted for this study. From Beomcheol, (2006) study, questionnaire variables were chosen 15. Moreover in the independent variable data was collected against age, gender, mother tongue, level of education, years of experience. Instrument of workplace environment was adopted from AWASES, (2006) which contains 8 items as independent variables. The instrument was about the physical environment and the availability of the supplies in the work place environment e.g., safe environment, necessary instruments are available, equipment’s are working condition, contamination control plan procedures were accessible and that sterilized solution for security of employees and patients are available. The data compilation procedure was in progress after receiving the consent from the University of Lahore, and from the management of Services hospital. Pre-testing of the survey on 15 % of the participant was carried out. Involvement in the study was life form unpaid; no reimbursement, aid or monetary incentive was obtainable. Data entry was done in SPSS. The data was stored in hard and soft copies. Out of 200 participants age distribution was given as 18-25 years, 25-35 years, 35- 50 years and above 50 years, reside in union (Less than 1 year, 1-5 years, 6-10 years, and above 10 years), married category (married, single), and requirement (Nursing diploma, specialization, Post RN and others). Result The Around 70% (n= 140) of the respondents were single and rest of them were married. In the age group of above 50 years only 23 (11.5%) of the participants lie. Only 12.5 percent of the participants (n=21) were having work experience more than 10 years. A summary is given in Table 1. The overall mean score of the work place environment tool was 4.1 and its standard deviation was 1. Moreover the overall mean score of the job performance was 4 (SD ±0.7). LMRJ Volume 2 Issue 1 19 | P a g e The work environment tool was on likert scale. It had 8 items, each have the five values for the participants to score on. Around 54 percent of the participants were agree that their workplace is really safe. Only 8 % individuals do feel that they are not secure at their workplace. A summary is presented in Table 2. Regarding the layout of the workplace around 90 (45%) agree and 32 (n=16) strongly agreed that it is good. A total of 73(36.5%) of the participants agreed that they have the comfortable temperatures at work place and 39% of the participants said that the instruments provided at their workplace were most of the time in working condition. On the subject of availability of the supplies 4.5% and 11% of participants were strongly disagree and disagree respectively. Surprisingly 9% of the nurses revealed that they are not even privileged to have antiseptic solution at their workplace. Only 36.5% participants stated that they have well defined infection control strategy. 31% of the participants showed their neutral response on being the top performer. Majority of the nurses agreed 75(37.5%) that they are among the top 10 percent of the frontline performer. Where 30(15%) are well aware about operational system than others. A summary of the results is presented in Table 3. In this study the correlation coefficient (r) equals to 0.987, indicating a strong positive relationship (p< 0.001). Multivariate linear regression is summarized in Table 4, persons who reported to have better work place environment have significantly (p= .001) better performance as the β is positive 0.48. Frequency Percent Gender Female 200 100.0 Age 18-25 50 25 25-35 74 37 35-50 53 26.5 Above 50 23 11.5 Stay in organization Less than 1Year 50 25 1-5Years 59 29.5 6-10Years 66 33 Above 10Years 25 12.5 Marital Status Married 60 30 Single 140 70 Qualification Nursing diploma 145 72.5 Specialization 25 12.5 Post RN 14 07 Other 16 08 Variables My work environment is safe and Free from hazards. Strongly Disagree 16(8) Disagree 18(9) Neutral 51(25.5) Agree 73(36.5) Strongly Agree 42(21) My work place has Good workplace layout. 15(7.5) 23(11.5) 40(20.0) 90(45) 32(16) My work place has Comfortable temperature. 15(7.5) 26(13.0) 51(25.5) 73(36.5) 35(17.5) Necessary instruments are available at my work place. 10(5) 22(11) 56(28) 59(29.5) 53(26.5) Instruments available at my work place in working conditions. 10(5) 19(9.5) 52(26) 78(39) 41(20.5) Materials and supplies sufficient at my work place. 9(4.5) 22(11) 48(24) 75(37.5) 46(23) Antiseptic hand solution for safety of team and patients is obtainable at my work place. 9(4.5) 18(9) 54(27) 67(33.5) 52(26) Infection control strategy guidelines are Available at my work place. 10(5) 14(7) 52(26) 73(36.5) 51(25.5) Table 1: Demographic characteristics of study population Table 2: Work Environment related variables LMRJ Volume 2 Issue 1 20 | P a g e Table 3: Job Performance variables Table 4: Regression for Work Place Environment Factors Associated with Job Performance Variables I am a top performer. Strongly Disagree 12(6) Disagree 13 (6.5) Neutral 62 (31) Agree 62 (31) Strongly Agree 51(25.5) I am in the top 10 percent of frontline employees here. 12(6) 16(8) 61 (30.5) 75(37.5) 36(18) I am very dedicated to satisfying the needs of customers. 13(6.5) 12(6) 61 (30.5) 81(40.5) 33(16.5) I know what customers expect better than others. 11(5.5) 17 (8.5) 43(21.5) 97(48.5) 32 (16) I know more about menu items than others. 11(5.5) 18 (9) 58 (29) 78 (39) 35 (17.5) I know more about operational system than others. 16 (8) 19 (9.5) 55 (25) 85(42.5) 30(15) Variables Standard Error T P value Constant 2.178 .177 12.286 .001* Work place environment 0.480 0.042 11.491 .001* Discussion This is the first study in Pakistan on the green factor and its effects on career routine among nurses in Lahore, Pakistan to best of author’s knowledge. Thus the study presents first information of factor which affect job act. Job presentation is a very important factor in growth of any organization 1-3,16 . Moreover, this study reveals that good working conditions pursue the nurses to be dedicated towards patients needs. This is in agreement with other studies which says that better job environment is the core build of today’s labor rest for patient centered care 6-7 . The direct and positive relationship between conducive environment and high productivity by the employees is also coherent to other studies which further relate it with more patient satisfaction, and low turnout and can even increase the revenue of the organization 9-11, 18. The present study showed that safety among all the working conditions is necessary which is also discussed extensively in other studies 2, 10, 14, 18 . These studies reveal that the physical environment plays the important role on job performance which is already cited in literature the retention of the staff 7,9,14 . The significant factors in the physical settings were the accessibility of the equipment’s and the co- operation of the staff. It is consequently imperative for employer to supply inappropriate working environment to make sure that the performance of staff meet the much loved values. Moreover, majority of the nurses provide this information that they do not have the availability of the hand wash solution whereas. Pittet et al., (2000) also shared that compliance to hand washing can only increase if recourses like soap and water are available15. Proper temperature of the work place is as important as food and water13, which is quite evident in the present study also, nurses who are satisfied with the indoor temperature were more perceptive to patient need than others. In the last we can conclude that for the LMRJ Volume 2 Issue 1 21 | P a g e nurses there is evidence that better workplace environmental is strongly related to better work place environment. References 1. Allison E. Aiello, Rebecca M. Coulborn, Vanessa Perez, and Elaine L. Larson. 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