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OBJECTIVE The aim of this study was to explore the influence of nurse work characteristics, resiliency, and burnout on retention, and patient quality and safety. BACKGROUND With an ongoing nursing shortage, maintaining qualified nursing staff is critical. We explored the direct and indirect effects of practice environment, nurse work characteristics, and burnout on retention, and perceived quality and safety. METHODS Responses from 507 RNs were collected via an anonymous online survey. Theorized relationships were explored via path analysis and invariance testing. RESULTS Positive practice environment and favorable work characteristics lowered burnout and improved outcomes. The indirect effects of work characteristics and burnout were dependent upon individual level of resilience. Social capital minimized the effects of burnout for participants reporting below-average resilience. CONCLUSIONS Leader support was critical in shaping positive perception of the practice environment. A nurse leader's visibility and actions impact intent to stay. Results of this study may inform healthcare systems struggling to retain a robust, engaged nursing workforce.

Restraint use has been linked to longer lengths of stay and other undesirable outcomes. This evidence-based project explored the impact of a restraint management bundle on restraint use, quality, and safety outcomes. Results indicated that the proportion of intensive care unit patients restrained decreased significantly (24.3% vs 20.9%) following program implementation. Project results suggest that the restraint management bundle may provide a framework for guiding the process to reduce restraint use, minimize harm, and improve patient safety.