The association of the emergency department work environment on patient care and nurse job outcomes
Abstract Objective To determine the association between emergency nurses’ work environments and patient care quality and safety, and nurse burnout, intent to leave, and job dissatisfaction. Methods Cross‐sectional study of 221 hospitals in New York and Illinois informed by surveys from 746 emergency...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.13040 |
| _version_ | 1797650183350124544 |
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| author | K. Jane Muir Douglas M. Sloane Linda H. Aiken Vaneh Hovsepian Matthew D. McHugh |
| author_facet | K. Jane Muir Douglas M. Sloane Linda H. Aiken Vaneh Hovsepian Matthew D. McHugh |
| author_sort | K. Jane Muir |
| collection | DOAJ |
| description | Abstract Objective To determine the association between emergency nurses’ work environments and patient care quality and safety, and nurse burnout, intent to leave, and job dissatisfaction. Methods Cross‐sectional study of 221 hospitals in New York and Illinois informed by surveys from 746 emergency nurses and 6932 inpatient nurses with linked data on hospital characteristics from American Hospital Association Annual Hospital Survey. The RN4CAST‐NY/IL study surveyed all registered nurses in New York and Illinois between April and June 2021 about patient safety, care quality, burnout, intent to leave, and job dissatisfaction and aggregated their responses to specific hospitals where they practiced. Work environment quality was measured using the abbreviated Practice Environment Scale of the Nursing Work Index. Generalized estimating equations were used to determine the relationship between emergency nurses’ work environments on patient care and nurse job outcomes. Results A total of 58% of emergency nurses reported high burnout, 39% reported job dissatisfaction, and 27% indicated intent to leave their job in the next year. Nurses in hospitals with good (vs mixed) or mixed (vs poor) emergency work environments were less likely to report unfavorable patient care quality and hospital safety grades, and were less likely to experience high burnout, job dissatisfaction, and intentions to leave the job, by factors ranging from odds ratio (OR) 0.21 (95% confidence interval [CI], 0.16–0.29) to OR 0.46 (95% CI, 0.34–0.61). Conclusions Given the complex and high stakes nature of emergency nursing care, leaders should place a high priority on organizational solutions targeting improved nurse staffing and work environments to advance better patient and clinician outcomes. |
| first_indexed | 2024-03-11T15:57:33Z |
| format | Article |
| id | doaj.art-14b0ab9cdbba4659bfdd6cf3bb1f5431 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-03-11T15:57:33Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-14b0ab9cdbba4659bfdd6cf3bb1f54312023-10-25T08:50:36ZengWileyJournal of the American College of Emergency Physicians Open2688-11522023-10-0145n/an/a10.1002/emp2.13040The association of the emergency department work environment on patient care and nurse job outcomesK. Jane Muir0Douglas M. Sloane1Linda H. Aiken2Vaneh Hovsepian3Matthew D. McHugh4National Clinician Scholars Program University of Pennsylvania Philadelphia Pennsylvania USACenter for Health Outcomes and Policy Research School of Nursing University of Pennsylvania Philadelphia Pennsylvania USACenter for Health Outcomes and Policy Research School of Nursing University of Pennsylvania Philadelphia Pennsylvania USACenter for Health Outcomes and Policy Research School of Nursing University of Pennsylvania Philadelphia Pennsylvania USACenter for Health Outcomes and Policy Research School of Nursing University of Pennsylvania Philadelphia Pennsylvania USAAbstract Objective To determine the association between emergency nurses’ work environments and patient care quality and safety, and nurse burnout, intent to leave, and job dissatisfaction. Methods Cross‐sectional study of 221 hospitals in New York and Illinois informed by surveys from 746 emergency nurses and 6932 inpatient nurses with linked data on hospital characteristics from American Hospital Association Annual Hospital Survey. The RN4CAST‐NY/IL study surveyed all registered nurses in New York and Illinois between April and June 2021 about patient safety, care quality, burnout, intent to leave, and job dissatisfaction and aggregated their responses to specific hospitals where they practiced. Work environment quality was measured using the abbreviated Practice Environment Scale of the Nursing Work Index. Generalized estimating equations were used to determine the relationship between emergency nurses’ work environments on patient care and nurse job outcomes. Results A total of 58% of emergency nurses reported high burnout, 39% reported job dissatisfaction, and 27% indicated intent to leave their job in the next year. Nurses in hospitals with good (vs mixed) or mixed (vs poor) emergency work environments were less likely to report unfavorable patient care quality and hospital safety grades, and were less likely to experience high burnout, job dissatisfaction, and intentions to leave the job, by factors ranging from odds ratio (OR) 0.21 (95% confidence interval [CI], 0.16–0.29) to OR 0.46 (95% CI, 0.34–0.61). Conclusions Given the complex and high stakes nature of emergency nursing care, leaders should place a high priority on organizational solutions targeting improved nurse staffing and work environments to advance better patient and clinician outcomes.https://doi.org/10.1002/emp2.13040burnoutemergency departmentnurseturnoverwork environment |
| spellingShingle | K. Jane Muir Douglas M. Sloane Linda H. Aiken Vaneh Hovsepian Matthew D. McHugh The association of the emergency department work environment on patient care and nurse job outcomes Journal of the American College of Emergency Physicians Open burnout emergency department nurse turnover work environment |
| title | The association of the emergency department work environment on patient care and nurse job outcomes |
| title_full | The association of the emergency department work environment on patient care and nurse job outcomes |
| title_fullStr | The association of the emergency department work environment on patient care and nurse job outcomes |
| title_full_unstemmed | The association of the emergency department work environment on patient care and nurse job outcomes |
| title_short | The association of the emergency department work environment on patient care and nurse job outcomes |
| title_sort | association of the emergency department work environment on patient care and nurse job outcomes |
| topic | burnout emergency department nurse turnover work environment |
| url | https://doi.org/10.1002/emp2.13040 |
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