الفهرس 
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Abstract
Health care organizations have recently focused more on organizational
climate due to the pressure of the health care sector reform. Healthcare
organizations are obliged to look for ways to be more flexible, adaptive, and
competitive in today’s volatile climate and fierce competition as they deal with
competitive challenges and quickly evolving markets. Healthcare facilities are
increasingly recognizing that their most significant resource is the human factor.
Success depends on the workforce’s capacity to come up with creative ideas and
operational strategies that exceed competitors.
Organizational climate has a beneficial influence on performance, therefore,
when nurses operate in a climate where they feel more liberated to carry out their
duties, have more control over their thoughts and work procedures, it leads to
higher productivity. Nurses’ involvement motivates them to give more effort, which
lowers conflicts and grievances and increases productivity. The ”backbone of good
organizational climate where people are diligent, ethical, and accountable” is said
to be involved nurses.
Aim of the study
The present study aims to assess nurses’ perception of organizational climate
and its relationship with their involvement in decision making and work
productivity.
Setting
The study was conducted in all medical and surgical care units at Alexandria
Main University Hospital, surgical care units (N=12) includes head and neck, gastrointestinal
tract, vascular, oncology, cosmetics, neurosurgery, nose and ear,
ophthalmology, liver and gallbladder, cardiothoracic, anal and colon and urology
unit, medical units (N=10) includes cardiology, gastroenterology, endocrinology, hematology, dermatology, gerontology, nephrology, rheumatology, liver diseases
and diabetes departments.
Subjects
The target population of this study included all nurses who provide direct
and indirect nursing care at the previously mentioned units and who were
available at the time of data collection(N=342). from this total target population,
nurses with more than one year of experience in the current working unit and
accepting to participate in this study (N=297) out of (N=342) were included in
this study. They were classified as 195 nurses in surgical care units and 102 nurses
in medical care units.
Tools
Three tools were utilized for data collection as follows:
Tool I: Organizational Climate Measure (OCM).
It was developed by Patterson (2005). It was adapted, validated and used by
Maus (2018) to examine organizational climate within hospitals as perceived by
nurses. The validated version of this tool (Maus 2018) was adopted by the
researcher. It consists of 34 items divided into seven domains classified as
follows, Welfare (4items), Autonomy (5items), Involvement (6items), Effort
(5items), Training (4items), Integration (5items), Supervisory support (5items).
Nurses’ responses were measured on a 4-point Likert scale ranging from (1)
Definitely false to (4) Definitely true. The overall score was ranging from (34-
136). The score ranged from (34-68) indicated poor organizational climate, score
ranged from (69-102) revealed good organizational climate, and score from (103-
136) indicated excellent organizational climate. Cronbach’s alpha coefficient for
internal consistency reliability of the tool was 0.762.
Tool II: The Decisional Involvement Scale.
It was developed by Havens &Vasey (2005) to assess the level of nurses’
involvement in decision-making. It was adopted by the researcher. It consists of
21 items classified into six domains classified as follows, Unit staffing(2items),
quality of professional practice (4items), professional recruitment (3items), unit
governance and leadership (6items), quality of support staff practice (3items),
collaboration or liaison activities (3items). Nurses’ responses were measured on
a 5-point Likert scale ranging from (1) Administration –management only to (5)
Staff nurses only. The overall score was ranging from (21-105). The score ranged
from (21-49) indicated low decisional involvement, score ranged from (50-77)
revealed moderate decisional involvement, and score ranged from (78-105)
indicated high decisional involvement. Cronbach’s alpha coefficient for internal
consistency reliability of the tool was 0.725.
Tool (III): Healthcare Productivity Survey (HPS)
It was developed by Gillespie et al., (2010) to measure work productivity as
perceived by nurses. It was adopted by the researcher. It consists of 29 items
classified into four domains as follows, cognitive demands (5items),
Handle/Manage Workload (6items), Support and Communication with Patients
and Visitors (7items), Safety and Competency (11items). Nurses’ responses were
measured on a 5-point Likert scale ranging from (-2) Decreased productivity to
(+2) Increased productivity. The overall score was ranging from (-58) to (+58).
The score ranged from (-58) to (-20) indicated low work productivity, score
ranged from (-19) to (+20) revealed moderate work productivity, and score ranged
from (+21) to (+58) indicated high work productivity. Cronbach’s alpha
coefficient for internal consistency reliability of the tool was 0.940.
In addition, personal and work-related characteristics data sheet was
developed by the researcher. It included items related to gender, age, marital
status, current working unit, educational qualification, years of experience in nursing profession, years of experience in this hospital, years of experience in the
current working unit.
Method
An approval for conducting the study was obtained from the Research Ethics
Committee of the Faculty of Nursing, Alexandria University.
Permission for carrying out the study was obtained from the Dean of Faculty
of Nursing, Alexandria University, and the hospital administrators to collect
the necessary data.
Study tools were translated into Arabic, back to back translation (Arabic-
English) was done. The study tools were tested for its content validity by a
jury consisted of five experts in the field of the study.
Internal consistency of the study tools was examined using Cronbach’s alpha
co-efficient test. The results of the three tools revealed that they are reliable.
A pilot study was conducted on 10 % of nurses (N=35) rather than study
subjects, to check and ensure the clarity of the tools, applicability, feasibility,
identify obstacles and problems that may be encountered during data
collection and no modification was done in the tools.
Data collection
Data were collected from the staff nurses through self -administered
questionnaire. It was hand delivered to the study subjects in the work setting after
explaining the aim of the study. The questionnaire was completed in the existence
of the researcher to ensure the objectivity of staff nurses’ responses, noncontamination
of their viewpoints, and to check that all items were answered
completely and accurately. For completion of the questionnaire, each study
subject consumed approximately from 15- 20 minutes. Data collection took a
period of two months starting from 3/12/2022 - 2/2/2023.
The following were the most important results of the present study:
The majority (88.2%) of studied nurses perceived their organizational
climate as good.
There was statistically significant relationship found between levels of
organizational climate and demographic characteristics of nurses regarding
age, sex, marital status, level of education and working unit.
Moreover, less than half (43.1%) of the studied nurses had a moderate level
of decision involvement.
There was statistically significant association between nurses’ demographic
characteristics and levels of their decision involvement regarding age,
marital status, level of education, working unit and years of experience.
Furthermore, more than three quarters of nurses (78.5%) had high level of
total health care productivity.
In addition, there was significant relation found between studied nurses’
basic characteristics and levels of their work productivity regarding marital
status and working unit only.
Furthermore, there was a high level of work productivity with excellent
organizational climate.
Moreover, a high level of decision involvement was associated with
excellent organizational climate.
In addition, there were statistically significant positive low relationships
between organizational climate, decision involvement and work
productivity.
Recommendations
Recommendations were given focused on the results of the current study to
address nurses’ organizational climate and improve nurses’ decision involvement
and work productivity. For nursing administrators: arrange for workshops and
training programs to nurses to explain importance of organizational climate in
decision making and work productivity, implement change strategies that will
enhance nurses’ organizational climate, such as flexible scheduling and clear
feedback, encourage open and transparent communication to improve nurses’
decision-making abilities and use interactive teaching strategies as brainstorming
to improve critical thinking skills and decision-making abilities. For first line
nurse manager: provide successful compensation plans such as flexible working
hours, hold regular meetings to get nurses’ feedback and to involve them in
decisions, encourage nurses to attend training programs and workshops to develop
decision making abilities and provide supportive organizational climate through
availability of adequate staff and resources. For staff nurses: attend regular
training programs, workshops and online training to enhance decision making
abilities and work productivity, attend courses about organizational climate and
work productivity to overcome possible obstacles to achieve better organizational
growth and participate in decision making and solve their problems at the unit.