Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, United States.
International journal of nursing studies (Impact Factor: 2.9). 08/2012; 50(2). DOI: 10.1016/j.ijnurstu.2012.07.014
Source: PubMed


BACKGROUND: One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. OBJECTIVES: To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. METHODS: A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. RESULTS: In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, p<0.01) intention to leave (β=-4.10%, p<0.01), and job dissatisfaction (β=-8.00%, p<0.01). CONCLUSIONS: Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intention to leave current position, and job dissatisfaction.

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    • "Similarly Bartram et al. [32] found that perceived high performance work systems, which is a job resource for nurses, was the strongest predictor of intentions to leave the profession. Recent research by Kutney-Lee et al. [31] suggests that improvements in the working environments of nurses decreases not only burnout, but also their intentions to leave and their job dissatisfaction , while Van den Heede et al. [33] have found significant associations between staffing and work environment with intentions to leave the profession. A recent survey in Greece to investigate the impact of job stress on satisfaction among nurses has reported that heavy workload and conflicts were related to work stress which in turn affected negatively all job satisfaction dimensions [34]. "
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