Nursing practice environment, job outcomes and safety climate: a structural equation modelling analysis

J Nurs Manag. 2017 Jan;25(1):46-55. doi: 10.1111/jonm.12427. Epub 2016 Oct 11.

Abstract

Aim: To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate.

Background: The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units.

Methods: A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used.

Results: Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors.

Conclusions: Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive.

Implications for nursing management: Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses.

Keywords: burnout; health facility environment; job satisfaction; nurses; patient safety; professional.

MeSH terms

  • Adult
  • Brazil
  • Burnout, Professional / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Job Satisfaction*
  • Male
  • Middle Aged
  • Nurses / psychology*
  • Nurses / statistics & numerical data
  • Patient Safety / standards*
  • Patient Safety / statistics & numerical data
  • Personnel Turnover / statistics & numerical data
  • Statistics as Topic
  • Surveys and Questionnaires
  • Workplace / psychology
  • Workplace / standards*
  • Workplace / statistics & numerical data