growing interest in service to healthcare customers is causing
significant changes in the overall healthcare environment.
For this reason, nursing departments have engaged in
multilateral efforts to enhance the quality of nursing care, a
goal that can be achieved only through application of the
scientific nursing process (Brady & Cummings 2010).
Therefore, the fact that application of the nursing process
had the lowest mean score in both our study and that of
Ryu (2009) indicates that improvement in this activity
among nurses must be a priority to enhance their overall
professional performance.
The levels of outcomes of nursing performance with
respect to the general characteristics of nurses showed significant
differences between ages, between workplaces,
between total years of work experience, and between nurse
managers and general nurses. Similarly, in Bae’s (2007)
study, the levels of nursing performance outcomes showed
significant differences between ages and between total years
of work experience of nurses. The findings of both our
study and Bae’s can be explained by improvements in nursing
knowledge and skills related to increased work experience
over time. Based on these findings, enhancement of
nursing performance within nursing departments may
require development of special systems such as manpower
management programmes for long-term employees.
In our study, the factor most strongly affecting the outcomes
of nursing performance was knowledge-sharing culture,
followed by workplace, total years of work experience
and organisational learning. The levels of implementation
of the five core KM factors and the nursing performance
outcomes showed significant positive correlations among all
variables. However, only two core KM factors, knowledgesharing
culture and organisational learning, were identified
as affecting the outcomes of nursing performance. Choi’s
(2005) study, which investigated the factors affecting the
outcomes of nursing performance in healthcare organisations,
identified only organisational learning as a core KM
factor affecting the outcomes. But the importance of a
knowledge-sharing culture has been emphasised in the studies
of Shih-Hsiung and Gwo-Guang (2013) and of Thom
(2007), who investigated organisational cultures and concluded
that shared knowledge, experience and values are
critical enablers and success factors for KM implementation.
Mustapha (2012) indicated that the ultimate goal of
KM is to create a learning organisation in a knowledgesharing
atmosphere. A knowledge-sharing organisational
atmosphere has been found to make a large impact on the
organisation members’ propensity to create knowledge and
share it with other members (Ghosh & Scott 2007). Therefore,
nursing leaders have a responsibility to create a
knowledge- sharing environment by implementing personalisation
strategies such as incentive programmes because
knowledge creation and knowledge sharing are intangible
activities (Chang 2011). Development of strategies to
enhance knowledge-sharing culture could strengthen organisations’
competitiveness by reducing their nursing labour
costs and working hours.
Organisational learning, which was identified as a core factor
affecting the outcomes of nursing performance in our
study, was found to play a major role in KM by Choi (2005).
In addition, Guak (2011) and Noruzy et al. (2013) found
that among the five core KM factors, organisational learning
facilitated organisational innovation and consequently
improved organisational performance. Even though in our
study, the effects of organisational learning on the outcomes
of nursing performance were limited, organisational learning
could support achievement of sustained organisational
growth through promotion of continuous learning, field education
and job training. In this regard, nursing departments
should provide continuous support for the development of
nursing educational systems and programmes to encourage
nurses’ professional improvement, and individual nurses
should take advantage of these opportunities.
Based on these results, the practical implications of this
study would be of consideration to basic data in developing
the KM programme for enhancement of the outcome of
nursing performance, and it can also contribute to improving
both the productivity and competitiveness of healthcare
organisations.
Conclusion
Effective nursing requires many complex and knowledgeintensive
professional skills. For a healthcare organisation
to enhance its overall nursing performance, the knowledge
and experiences of its individual nurses should be identified
and shared throughout the organisation. Therefore, identifying
core KM factors that can be used to effectively manage
and share nursing knowledge is vital to improving the
outcomes of nursing performance.
This study identified the relationships between five core
KM factors and outcomes of nursing performance, and two
factors – knowledge-sharing culture and organisational
learning – were found to affect nursing performance outcomes.
Therefore, prioritising the adoption of a knowledgesharing
culture and organisational learning in KM systems
might be one method for organisations to more effectively
manage their knowledge resources and thus to enhance the
outcomes of nursing performance and achieve greater business
competitiveness.