Effects of hospital care environment on patient mortality and nurse outcomes

Linda H. Aiken, Sean Clarke, Douglas M. Sloane, Eileen T. Lake, Timothy Cheney

Research output: Contribution to journalArticle

Abstract

The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Background: Staffing and education have welldocumented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Methods: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Results: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Conclusion: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

Original languageEnglish (US)
JournalJournal of Nursing Administration
Volume39
Issue number7-8 SUPPL.
DOIs
StatePublished - Jul 1 2009

Fingerprint

Nurses
Mortality
Quality of Health Care
Education
Job Satisfaction
Patient Care
Nursing

ASJC Scopus subject areas

  • Leadership and Management

Cite this

Effects of hospital care environment on patient mortality and nurse outcomes. / Aiken, Linda H.; Clarke, Sean; Sloane, Douglas M.; Lake, Eileen T.; Cheney, Timothy.

In: Journal of Nursing Administration, Vol. 39, No. 7-8 SUPPL., 01.07.2009.

Research output: Contribution to journalArticle

Aiken, Linda H. ; Clarke, Sean ; Sloane, Douglas M. ; Lake, Eileen T. ; Cheney, Timothy. / Effects of hospital care environment on patient mortality and nurse outcomes. In: Journal of Nursing Administration. 2009 ; Vol. 39, No. 7-8 SUPPL.
@article{652dcf0d895f4099b03f71d32b21c2a9,
title = "Effects of hospital care environment on patient mortality and nurse outcomes",
abstract = "The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Background: Staffing and education have welldocumented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Methods: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Results: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Conclusion: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.",
author = "Aiken, {Linda H.} and Sean Clarke and Sloane, {Douglas M.} and Lake, {Eileen T.} and Timothy Cheney",
year = "2009",
month = "7",
day = "1",
doi = "10.1097/NNA.0b013e3181aeb4cf",
language = "English (US)",
volume = "39",
journal = "Journal of Nursing Administration",
issn = "0002-0443",
publisher = "Lippincott Williams and Wilkins",
number = "7-8 SUPPL.",

}

TY - JOUR

T1 - Effects of hospital care environment on patient mortality and nurse outcomes

AU - Aiken, Linda H.

AU - Clarke, Sean

AU - Sloane, Douglas M.

AU - Lake, Eileen T.

AU - Cheney, Timothy

PY - 2009/7/1

Y1 - 2009/7/1

N2 - The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Background: Staffing and education have welldocumented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Methods: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Results: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Conclusion: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

AB - The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Background: Staffing and education have welldocumented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Methods: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Results: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Conclusion: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

UR - http://www.scopus.com/inward/record.url?scp=68949149325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68949149325&partnerID=8YFLogxK

U2 - 10.1097/NNA.0b013e3181aeb4cf

DO - 10.1097/NNA.0b013e3181aeb4cf

M3 - Article

C2 - 19641438

AN - SCOPUS:68949149325

VL - 39

JO - Journal of Nursing Administration

JF - Journal of Nursing Administration

SN - 0002-0443

IS - 7-8 SUPPL.

ER -