{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:20:07Z","timestamp":1760239207019,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:00:00Z","timestamp":1602720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.<\/jats:p>","DOI":"10.3390\/ijerph17207520","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T21:42:21Z","timestamp":1602798141000},"page":"7520","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4926-6622","authenticated-orcid":false,"given":"Jos\u00e9 Ram\u00f3n","family":"Mart\u00ednez-Riera","sequence":"first","affiliation":[{"name":"Departamento Enfermer\u00eda Comunitaria, Medicina Preventiva y Salud P\u00fablica e Historia de la Ciencia, Universidad de Alicante, E-03080 Alicante, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-2048","authenticated-orcid":false,"given":"Ra\u00fal","family":"Ju\u00e1rez-Vela","sequence":"additional","affiliation":[{"name":"Department of Nursing, University of La Rioja, 26006 Logro\u00f1o, La Rioja, Spain"},{"name":"Research Group BMP Idi-Paz. Hospital La- Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6014-2180","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"D\u00edaz-Herrera","sequence":"additional","affiliation":[{"name":"Primary Care Costa Ponent, Catalan Health Institute, Hospital Universitari General de Catalunya, Avda, De la Gran V\u00eda de l\u00b4Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Hospital Universitari General de Catalunya, Carrer Pedro i Pons, 1, 08195 Sant Cugat del Vall\u00e8s, Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6548-8025","authenticated-orcid":false,"given":"Raimunda","family":"Montejano-Lozoya","sequence":"additional","affiliation":[{"name":"Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain"},{"name":"Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabell\u00f3n docente Torre H, Hospital La Fe, 46016 Valencia, Spain"}]},{"given":"Vicente","family":"Dom\u00e9nech-Briz","sequence":"additional","affiliation":[{"name":"Hospital Universitario de la Ribera, km 1, Ctra. Corbera, 46600 Alzira, Valencia, Spain"}]},{"given":"Jos\u00e9 Vicente","family":"Benavent-Cervera","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, VIU Valencia International University, Calle del Pintor Sorolla 21, 46002 Valencia, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-3117","authenticated-orcid":false,"given":"Ana Cristina","family":"Cabellos-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabell\u00f3n docente Torre H, Hospital La Fe, 46016 Valencia, Spain"},{"name":"Hospital Universitari i Polit\u00e8cnic La Fe, Avda. Fernando Abril Martorell, 106. Pabell\u00f3n docente Torre H, Hospital La Fe, PC, 46016 Valencia, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0005-6384","authenticated-orcid":false,"given":"Pedro","family":"Melo","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa, Institute of Health Sciences\/School of Nursing (Porto)\/Centre for interdisciplinary research in Health, 4200-450 Porto, Portugal"}]},{"given":"Tam H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"William F. Connell School of Nursing, Boston College, Newton, MA 02467, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8607-3195","authenticated-orcid":false,"given":"Vicente","family":"Gea-Caballero","sequence":"additional","affiliation":[{"name":"Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain"},{"name":"Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabell\u00f3n docente Torre H, Hospital La Fe, 46016 Valencia, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"ref_1","unstructured":"McClure, M.L., Poulin, M.J., Sovie, M., and Wandelt, M. (2018, July 15). Magnet hospitals. Attraction and retention of professional nurses. Task Force on Nursing Practice in Hospitals. Available online: http:\/\/citeseerx.ist.psu.edu\/viewdoc\/download;jsessionid=1C7787038D1F9066F62B5E1146FEF479?doi=10.1.1.487.3161&rep=rep1&type=pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"172","DOI":"10.12968\/bjon.2017.26.3.172","article-title":"Effects of work environment on patient and nurse outcomes","volume":"26","author":"Copanitsanou","year":"2017","journal-title":"Br. J. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1016\/S0140-6736(13)62631-8","article-title":"Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study","volume":"383","author":"Aiken","year":"2014","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/NNA.0b013e31828eebc9","article-title":"New nurses\u2019 perceptions of hostility and job satisfaction","volume":"43","author":"Hickson","year":"2013","journal-title":"J. Nurs. Admin"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/MLR.0000000000000355","article-title":"Changes in patient and nurse outcomes associated with magnet hospital recognition","volume":"53","author":"Stimpfel","year":"2015","journal-title":"Med. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1002\/nur.10032","article-title":"Development of the practice environment scale of the Nursing Work Index","volume":"25","author":"Lake","year":"2002","journal-title":"Res. Nurs. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/j.1365-2648.2011.05730.x","article-title":"Psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index in a primary healthcare context","volume":"68","year":"2012","journal-title":"J. Adv. Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/01.NNA.0000269742.40137.a6","article-title":"The essentials of magnetism for home health","volume":"37","author":"Mensik","year":"2007","journal-title":"JONA J. Nurs. Adm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e7369","DOI":"10.7717\/peerj.7369","article-title":"Development of a short questionnaire based on the Practice Environment Scale-Nursing Work Index in primary health care","volume":"7","year":"2019","journal-title":"Peer J."},{"key":"ref_10","first-page":"27","article-title":"Elementos esenciales de los entornos profesionales enfermeros en Atenci\u00f3n Primaria y su influencia en la calidad del cuidado","volume":"28","year":"2017","journal-title":"Enfermer\u00eda Cl\u00ednica"},{"key":"ref_11","first-page":"1","article-title":"The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014","volume":"28","year":"2014","journal-title":"Gac. Sanit."},{"key":"ref_12","unstructured":"RNAO Registered Nurses Association Ontario (2018, October 30). Developing and sustaining Nursing Leadership. Available online: http:\/\/rnao.ca\/bpg\/guidelines\/developing-and-sustaining-nursing-leadership."},{"key":"ref_13","first-page":"655","article-title":"How to use the nominal group and Delphi techniques","volume":"38","author":"McMillan","year":"2016","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_14","unstructured":"Tashakkori, A., and Teddlie, C. (2003). Handbook of Mixed Methods in Social and Behavioural Research, Sage."},{"key":"ref_15","unstructured":"Schmidt, R.C. (2008). Managing Delphi surveys using non parametric statistical techniques. Int. Abstr. Oper. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.enfi.2013.06.001","article-title":"Entorno laboral, satisfacci\u00f3n y burnout de las enfermeras de unidades de cuidados cr\u00edticos y unidades de hospitalizaci\u00f3n. Proyecto RN4CAST-Espa\u00f1a","volume":"24","year":"2013","journal-title":"Enfermer\u00eda Intensiva"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.aprim.2012.12.015","article-title":"Influence of socio-demographic, labour and professional factors on nursing perception concerning practice environment in Primary Health Care","volume":"45","author":"Moreno","year":"2013","journal-title":"Atenci\u00f3n Primaria"},{"key":"ref_18","first-page":"271","article-title":"Assessment of the professional practice environment by Spanish nurses who participate in Internet forums","volume":"23","year":"2013","journal-title":"Enfermer\u00eda cl\u00ednica"},{"key":"ref_19","unstructured":"Generalitat de Catalunya (2018, October 30). Health Plan of Catalonia 2011\u20132015. [Internet]. Available online: http:\/\/www.google.es\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB8QFjAA&url=http%3A%2F%2Fsalutweb.gencat.cat%2Fweb%2F.content%2Fhome%2Fel_departament%2Fpla_de_salut%2Fdocuments%2Farxius%2Fplan_de_salud_catalunya_es.pdf&ei=tIyiVLe6J8rrUoyRgqgO&usg=AFQjCNEejdMc_24tAeIwpXf6LlLmEbYH-A&sig2=itAq-OEphsu-kCHc-5qHdw."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/00005110-200407000-00010","article-title":"Development and evaluation of essentials of magnetism tool","volume":"34","author":"Kramer","year":"2004","journal-title":"JONA J. Nurs. Admin"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ijnurstu.2011.12.001","article-title":"Effective strategies for nurse retention in acute hospitals: A mixed method study","volume":"50","author":"Heede","year":"2013","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006199-200601000-00001","article-title":"Variations in nursing practice environments: Relation to staffing and hospital characteristics","volume":"55","author":"Lake","year":"2006","journal-title":"Nurs. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.ijnurstu.2012.08.001","article-title":"Validation of the Spanish version of the questionnaire Practice Environment Scale of the Nursing Work Index","volume":"50","year":"2013","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_24","first-page":"191","article-title":"Nursing practice settings and competence to incorporate evidence into decisions: Analysis of the situation in the Balearic Islands (Spain)","volume":"25","author":"Bennasar","year":"2011","journal-title":"Gac. Sanit."},{"key":"ref_25","first-page":"20","article-title":"Principales problemas de los recursos humanos sanitarios en la Uni\u00f3n Europea y Espa\u00f1a","volume":"97","year":"2012","journal-title":"Enfermer\u00eda Docente"},{"key":"ref_26","unstructured":"Consejo General de Enfermer\u00eda (2018, October 20). Informe sobre recursos humanos sanitarios en Espa\u00f1a y la Uni\u00f3n Europea 2014. An\u00e1lisis comparativo de la situaci\u00f3n de m\u00e9dicos y enfermeras. Available online: https:\/\/www.consejogeneralenfermeria.org\/docs_revista\/InformeRRHHSanitarios2014.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.enfcli.2018.08.005","article-title":"Enfermer\u00eda de Pr\u00e1ctica Avanzada y gesti\u00f3n de casos: Elementos imprescindibles en el nuevo modelo de atenci\u00f3n a la cronicidad compleja en Espa\u00f1a","volume":"29","year":"2019","journal-title":"Enfermer\u00eda Cl\u00ednica"},{"key":"ref_28","first-page":"4","article-title":"La promoci\u00f3n colectiva de la salud comunitaria. A prop\u00f3sito del informe SESPAS 2018","volume":"11","year":"2018","journal-title":"Revista Iberoamericana de Enfermer\u00eda Comunitaria"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7520\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:22:06Z","timestamp":1760178126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,15]]},"references-count":28,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17207520"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17207520","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2020,10,15]]}}}