Nursing Work Environment and Patient Outcomes in a Hospital Context

Abstract

OBJECTIVE The aims of this study were to summarize the current state of knowledge regarding the relationship between nursing work environment (NWE) and patient outcomes and to identify gaps in the literature. BACKGROUND There was an increased awareness of the impact of NWE on patient outcomes, in particular, related to safety and quality of care. METHOD Scoping review was conducted. Studies published between 2002 and the 1st quarter of 2018 were included to provide an overview of the research on the associations between NWE and patient outcomes. RESULTS Of 2238 titles and abstracts identified, 35 studies were included, and publication ranged from 2005 to 2018. All studies included were observational, 4 had a longitudinal design, and the remaining studies were cross-sectional. Evidence indicates that better NWE decreases the risk of patient adverse events and increases the quality of care. CONCLUSIONS The associations between different dimensions of NWE and patient outcomes should be explored.

An Examination of the Factors Associated With Implementation of Evidence‐Based Management Practices for Improving Nurse Work Environments

“…To address the gap in research, we examined individual, evidence, and contextual factors associated with implementation of EBMPs by nurse managers. We studied five EBMPs for improving NWEs because of the robust research linking better NWE and patient outcomes (Nascimento & Jesus, 2020) and nurse managers’ instrumental role in managing both NWE and nurse‐sensitive patient outcomes. We found that each of the five EBMPs studied had a unique profile of predictors associated with its implementation.…”

“…To address the identified knowledge gap, the primary purpose of this study was to examine individual, evidence, and contextual factors associated with nurse manager‐reported implementation of EBMPs for improving NWEs across 10 public health system hospitals in New York City (NYC) using the Integrated Promoting Action on Research Implementation in Health Services (PARIHS) implementation science framework (Harvey & Kitson, 2016). The study results can inform the development of effective organizational and policy interventions to support nurse managers in implementing EBMPs to improve NWEs and, consequently, patient outcomes associated with better NWEs (Nascimento & Jesus, 2020).…”

“…EBM has been associated with higher quality of care for acute myocardial infarction, congestive heart failure, and pneumonia (Tsai et al, 2015). In nursing, robust research has linked five EBM practices (EBMPs) for nurse work environment (NWE) improvement to improve nurse‐sensitive patient outcomes, including mortality, failure to rescue, pressure ulcers, falls, medication errors, and 30‐day readmission after hip or knee surgery (Nascimento & Jesus, 2020). The five EBMPs for NWE improvement are (1) promoting nurse participation in hospital affairs; (2) creating foundations for quality of care; (3) providing leadership and support for staff nurses; (4) ensuring staffing and resource adequacy; and (5) promoting collegial nurse–physician relations.…”

“…The five EBMPs for NWE improvement are (1) promoting nurse participation in hospital affairs; (2) creating foundations for quality of care; (3) providing leadership and support for staff nurses; (4) ensuring staffing and resource adequacy; and (5) promoting collegial nurse–physician relations. Nurse managers have a major responsibility for implementing these EBMPs in order to create high‐quality NWEs as a precursor to achieving high‐quality nurse‐sensitive performance metrics (Lake, 2002; Nascimento & Jesus, 2020). While nurse managers’ implementation of the five EBMPs could serve as an important strategy for boosting overall quality of health care, it is currently unknown to what extent nurse managers’ implement the EBMPs for NWE improvement and what factors facilitate their implementation of the EBMPs.…”

Leadership, adequate staffing and material resources, and collegial nurse–physician relationships promote better patients, professionals and institutions outcomes

“…A large number of researchers worldwide have been studying the relationship between the perception of the nursing practice environment and patients, nursing professionals and institution outcomes (Aiken et al, 2018; Balsanelli & Cunha, 2013; Gasparino et al, 2019; Nascimento & Jesus, 2020).…”