Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention

Int J Nurs Stud. 2007 Jul;44(5):723-35. doi: 10.1016/j.ijnurstu.2006.01.012. Epub 2006 Mar 24.


Background: Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction.

Objectives: The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction.

Design: The study was a prospective, non-randomized, controlled intervention.

Participants and settings: Nursing staff in two municipal elderly care organizations in western Sweden.

Methods: In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced.

Results: Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality.

Conclusions: Compared to a reference municipality, nursing staff ratings of their competence and the psychosocial work environment improved in the municipality where the toolbox was introduced.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Clinical Competence / standards*
  • Education, Nursing, Continuing / organization & administration*
  • Geriatric Nursing / education*
  • Health Facility Environment / organization & administration
  • Home Care Services / organization & administration
  • Humans
  • Job Satisfaction
  • Leadership
  • Middle Aged
  • Multivariate Analysis
  • Needs Assessment
  • Nursing Education Research
  • Nursing Homes / organization & administration
  • Nursing Staff* / education
  • Nursing Staff* / psychology
  • Personnel Turnover
  • Program Development
  • Program Evaluation
  • Prospective Studies
  • Self Efficacy
  • Surveys and Questionnaires
  • Sweden
  • Workplace / organization & administration
  • Workplace / psychology*