{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:48:51Z","timestamp":1773640131758,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":73,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The nursing practice environment is widely recognized as a key factor in promoting care quality and safety. It is associated with greater professional satisfaction, improved nurse retention, and reduced adverse events. Despite its importance being broadly acknowledged in the literature, there are few structured interventions aimed at promoting the nursing practice environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of the Positive Nursing Practice Environment Promotion Program (PPAPEP) in improving primary care nurses\u2019 perceptions of their work environment and attitudes toward patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A randomized, controlled, parallel\u2010group, double\u2010blind clinical trial was conducted in primary healthcare units in Northern Portugal between September 2024 and April 2025. A total of 48 nurses participated, allocated by stratified randomization into intervention and control groups. The instruments Scale for the Environments Evaluation of Professional Nursing Practice\u2010Shortened Version and the Safety Attitudes Questionnaire\u2010Short Form were applied at three time points: preintervention, postintervention, and three\u2010month follow\u2010up. Statistical analysis included paired and independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, repeated\u2010measures ANOVA, and correlation analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The PPAPEP produced modest improvements in overall perceptions of the nursing practice environment in the intervention group, with small significative changes in the structure and process subscales. No statistically significant changes were observed in the safety climate. Follow\u2010up analyses showed an inverted U\u2010shaped pattern, indicating that the immediate positive effects slightly decreased over time. Perceptions of the practice environment and safety climate were strongly correlated at all time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PPAPEP has demonstrated effectiveness in improving the nursing practice environment. Effects on the safety climate were limited, suggesting that sustained changes require continuous interventions, periodic reinforcement, and institutional involvement. The strong association between nurses\u2019 perceptions of the work environment and the safety climate highlights the need for integrated strategies that simultaneously promote good working conditions and patient safety.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov.identifier: NCT06762015\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/4139767","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T04:49:04Z","timestamp":1773636544000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Promoting Positive Nursing Practice Environments: Outcomes of a Randomized Trial in Primary Care"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8011-378X","authenticated-orcid":false,"given":"Soraia Cristina de Abreu","family":"Pereira","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0557-2377","authenticated-orcid":false,"given":"Eduardo Jos\u00e9 Ferreira dos","family":"Santos","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7274-8753","authenticated-orcid":false,"given":"Rosilene Alves","family":"Ferreira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6089-9670","authenticated-orcid":false,"given":"Cintia Silva","family":"Fassarella","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-9537","authenticated-orcid":false,"given":"Olga Maria Pimenta Lopes","family":"Ribeiro","sequence":"additional","affiliation":[]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mnl.2021.08.009"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0000000000000932"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/NURSREP15070224"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgpo.2023.0062"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2023.0032"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01358-x"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9111578"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/IJERPH20105909"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2165079920901533"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/HEALTHCARE12171748"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.36401\/JQSH-22-12"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01395-6"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.70034"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/S12912-025-02905-4"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.OUTLOOK.2019.06.018"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/NURSREP14040222\/S1"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2020.08.007"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/INR.12826"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.4102\/HSAG.V27I0.1788"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14462"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2025.0025"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijn.13291"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.15640\/ijn.v2n1a11"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.70127"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOQ-2023-002506"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/S12909-018-1255-6\/TABLES\/3"},{"key":"e_1_2_12_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/IJERPH182212057"},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13617"},{"key":"e_1_2_12_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2024.102516"},{"key":"e_1_2_12_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/S12912-023-01571-8"}],"container-title":["Journal 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