Improving easy-to-change factors of an RN's work environment may significantly improve the quality of care they deliver, according to a study in Health Care Management Review.
Previous studies have identified nurse-to-patient ratios as an important determinant of patient care quality; however, amending ratios may be difficult without significant cost and resource investment. In addition, a projected nursing shortage may make it even more difficult to increase nurse staffing levels.
For the study, New York University (NYU) researchers and colleagues examined results from a 98-question survey of 1,226 RNs that is part of a 10-year longitudinal study that began in 2006. In the surveys, RNs identified various environmental factors that influence quality of care. In order of importance, those factors include:
- Physician work environment;
- Workgroup cohesion;
- Nurse-physician relations;
- Procedural justice; and
- Job satisfaction.
The results also showed that nurses' patient care quality ratings are higher at Magnet hospitals and lower in facilities experiencing organizational constraints, such as supply shortages.
According to the study authors, hospital officials to can make several strategic changes to improve nursing care. For example, they note that Magnet recognition and workgroup cohesion have a nearly equal impact on patient care quality ratings. However, it is significantly less expensive to invest in workgroup cohesion than to strive for Magnet recognition.
According to study author and NYU nursing professor Christine Kovner, hospital leaders "need to examine their resources and determine which changes are possible and which will have the most impact on improving patient care" (NurseWeek, 11/21; Robert Wood Johnson Foundation release, 11/21).
