Analysis of factors influencing innovative behaviors of intensive care unit nurses using a random forest model-a multicentre cross-sectional study

利用随机森林模型分析影响重症监护室护士创新行为的因素——一项多中心横断面研究

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Abstract

AIM: To identify and rank the key determinants-including sociodemographic factors, Spiritual Climate, Information Literacy, and Thriving at Work-of Innovative behaviours among intensive care nurses, and provide a theoretical basis for targeted interventions. BACKGROUND: Nurse innovation behavior is essential for the development of the nursing discipline; yet, significant progress in enhancing the innovation behavior of Intensive care nurses has been limited over the past few decades. Nurses must identify deficiencies and areas for improvement within the intensive medical care system while performing care practices. For nurses to identify solutions to these issues through an innovative approach, they must adopt innovative behaviors. METHODS: A multicentre cross-sectional study was conducted. We gathered data from a convenient sample of 587 Intensive care nurses from twenty-three hospitals of grade 2 A and above hospital in Anhui, China. The questionnaire included questions on participant demographic information, the Thriving at Work Scale, the Information Literacy Scale, the Spiritual Climate Scale, and the Innovative Behavior Inventory. Lasso-logistic regression was employed to identify influencing factors, and a random forest model was used to rank the importance of variables. RESULTS: The total score of innovative behavior of Intensive care nurses was 76.43 ± 14.67, and the results of LASSO analysis showed that the error was the smallest when the value of λ was 1.531. The number of influential factors corresponding to it was 6. The variables that ranked the top 6 in importance in the random forest model were included in the multifactorial logistic regression analysis. The results showed that spiritual climate, information literacy, thriving at work, the degree of love for nursing work, education level, and age were the main influences on the innovative behavior of Intensive care nurses (all P < 0.05), explaining a total of 55.7% of the variation, with spiritual climate being the primary influence. CONCLUSION: Intensive care nurses demonstrated moderately high levels of innovative behaviour. To further enhance innovation capacity, nursing managers should implement tiered information literacy training programs, improve the spiritual climate in Intensive Care Unit environments, facilitate nurse participation in multi-dimensional thriving at work interventions, and encourage highly educated and senior nurses to leverage their strengths.

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