A comprehensive study has confirmed that across the world, the environment in which nurses’ work influences the quality of nursing care, nurses’ job outcomes and patient well-being. These findings should convince health administrators to give more attention to working environments, according to the researchers.
“Our results support the unique status of the nurse work environment as a foundation for both patient and provider well-being that warrants the resources and attention of health care administrators,” said Eileen Lake, the lead investigator. Lake is the Associate Director of the Center for Health Outcomes and Policy Research of the University of Pennsylvania School of Nursing.
Nurses’ work environment compared to outcomes
The research was an extensive meta-analysis of previous studies where measurements of nursing work environments were statistically compared to four outcomes. The first was nurse job outcomes in terms of burnout, job dissatisfaction and intention to leave. The second was nurses’ reports on the quality and safety of patient care and conditions in the unit.
Patient outcomes were analyzed based on 30-day inpatient mortality and adverse events. The final result included in the analysis was patient satisfaction, measured on patients’ ratings of the hospital.
The findings showed that in better working environments nurses were 28%-32% less likely to experience job dissatisfaction, burnout and intention to leave. The chances of poor quality and safety ratings were reduced by 23%-51%.
At the same time, the odds that patients were satisfied increased by 16% and the possibility of inpatient deaths and adverse events was reduced by 8% – nearly 1 in 10.
Rigorous study design
The value and strength of the above conclusions lie in the fact that they are a summary of extensive previous research, using a quantitative meta-analysis. Out of a possible 308 studies, 17 qualified for inclusion and they spanned 16 years. The studies represented research undertaken in 22 different countries across the world – in the US, UK, Canada, Europe, and Asia. Data from more than 2,600 hospitals, 165,000 nurses and 1.3 million patients were subjected to rigorous statistical analysis.
Only studies using the Practice Environment Scale of Nursing Work Index (PES-NWI) as a measurement were included in the research. This the most accepted tool for assessing nursing work environments. It covers quality care, nurse manager ability, adequacy of staffing and resources, and the relationships between colleagues. The tool is supported globally by quality, health professional and accreditation organizations.
Nurses’ work environments need attention
The researchers believed that the study provides conclusive evidence that nurses’ work environment is related to a wide range of outcomes both for the service provider and the patient. The findings are relevant not only for policymakers and health care administrators but also for nurses, patients, and their families.