The nursing practice environment, staff retention, and quality of care

Abstract

The effects of key factors in the nursing practice environment--management style, group cohesion, job stress, organizational job satisfaction, and professional job satisfaction--on staff nurse retention and process aspects of quality of care were examined. Hinshaw and Atwood's (1985) anticipated turnover model was modified and expanded to include relevant antecedent and outcome variables. The four-stage theoretical model was tested using data from 50 nursing units at four acute care hospitals in the southeast. The model explained 49% of the variance in staff nurse retention and 39% of the variance in process aspects of quality of nursing care. Study findings warrant careful consideration in light of recent practice environment changes: experience on the unit and professional job satisfaction were predictors of staff nurse retention; job stress and clinical service were predictors of quality of care. The variable contributing the most to indirect, and in turn, total model effects, was that of management style. These results substantiate the belief that aspects of the practice environment affect staff nurse retention, and most importantly, the quality of care delivered on hospital nursing units.

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

“…This result is not unique to South Africa as evidence shows that health system reforms in the Africa region [76] or elsewhere [77] tend to expand or extend the roles of health workers, but are often imposed on health workers without their inputs or with insufficient discussion, thereby affecting job satisfaction and/or health service delivery. Existing evidence suggests that shared governance and leadership and health worker inclusion in the development of policies and strategies is an important aspect that positively influences job satisfaction and retention of nursing managers [78]. …”

Special Features: Health Policy: Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy

“…Simultaneously, this approach takes advantage of the daily cost-effective and quality-of-care benefits of adequate nurse staffing (Rothberg, Abraham, Lindenauer, & Rose, 2005). The call for hospitals to act has been in place since the Institute of Medicine’s (1983) report Nursing and Nursing Education: Public Policies and Private Actions , and the subsequent research that has demonstrated the relationships among poor staffing and poor work environments, nurse burnout, turnover, and professional attrition (Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Leveck & Jones, 1996; Stone et al, 2007). Evidence supports programs like Magnet Hospital designation, which is given to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing, including adequate staffing.…”

Turnover of nursing employees in a Gauteng hospital group

“…There is indeed mounting evidence that the adverse working conditions and low satisfaction of nurses are associated with increased nursing turnover (Davidson, Folcarelli, Crawford, Duprat & Clifford, 1997;Irvine & Evans, 1995;Leveck & Jones, 1996). It is the high-risk groups that are more likely to exhibit turnover behaviour if the work environment is not perceived as positive in terms of various outcomes.…”