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  • Publication # 14-RA003

Improved hospital work environment linked to less nurse burnout and job dissatisfaction

Patient Safety and Quality of Care

One way to alleviate nursing shortages is to promote organizational efforts that will improve nurse recruitment and retention. A new study examining survey data on nurse outcomes at 137 Pennsylvania hospitals between 1999 and 2006 found nurses' situations improving, with fewer nurses reporting burnout (42.2 vs. 37.6 percent), intention to leave (22.4 vs. 14.2 percent), and job dissatisfaction (40.7 vs. 31.5 percent). 

Photograph of a nurse pressing her hands to her head as if she has a headache or is suffering a great deal of stress. These changes in nurse outcomes were related to improvements in the work environment. Over this same time period, four in 10 hospitals (39 percent) improved their nurse work environments while 33 percent worsened and 28 percent remained unchanged. 

The nurse work environment was measured using the Practice Environment Scale of the Nursing Work Index, a 31-item scale composed of five subscales: staffing and resource adequacy; nurse manager ability, leadership, and support of nurses; collegial nurse-physician relations; nurse participation in hospital affairs; and nursing foundations for quality of care. 

Nurses were surveyed on the degree to which each of 31 characteristics of better work environments was present in their current jobs. More than 42,000 nurses (52 percent response rate) responded to the survey in 1999, while over 25,000 nurses (39 percent response rate) responded in 2006. This study was supported by AHRQ (HS18534). 

See "Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data" by Ann Kutney-Lee, Ph.D., Evan S. Wu, B.S., Douglas M. Sloane, Ph.D., and Linda H. Aiken, Ph.D., in the International Journal of Nursing Studies 50, pp. 195-201, 2013.


Page last reviewed January 2014
Internet Citation: Improved hospital work environment linked to less nurse burnout and job dissatisfaction: Patient Safety and Quality of Care. January 2014. Agency for Healthcare Research and Quality, Rockville, MD.


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