Table 4

Summary of Evidence Related to Nurse Work Environment

SourceSafety Issue Related to Clinical PracticeDesign TypeStudy Design & Study Outcome Measure(s)Study Setting & Study PopulationStudy InterventionKey Finding(s)
Feldman 2001– 200556Adverse eventsProspective cohort studyObservational study with controls. Outcomes: team-attributable patient adverse events.51,560 patient care episodes from the largest U.S. home care agency with average age of patient 71 years86 home care teams Staff perception of work environment, especially aspects of organizational and team culture climate7% of the 51,560 episodes had an adverse event.
Adverse events were lower for teams with higher volume of patient care episodes (P ≤.05), higher concentration of visits among staff (P ≤.10), fewer weekend admissions (P ≤.01), more weekend visits (P .01), in noncongregate care setting (P ≤.10), and more care provided by nurses without bachelor’s or higher education (P ≤.10).
Adverse events were lower for teams with greater equity in distribution of incentives (P≤ .10), more teamwork (P ≤.10).
Kroposki and Alexander 200657Relationship of patient satisfaction, nurse perception of outcomes, and organizational characteristicsCross-sectional studyObservational study with controls. Outcomes: relationship of nurse perception of outcomes and organizational structure to patient satisfaction.Convenience sample of 325 patients and 205 nurses from 38 home care agencies in a southeastern StateEvaluation of patient satisfaction, nurse perception of patient outcomes, and organizational structureSignificant correlation between nurses’ ability to meet client’s psychosocial needs and patient satisfaction (P < .05). No other relationships existed between client satisfaction and outcome inventory components.
There was a significant positive relationship between organizational attributes and patient satisfaction in agencies with shared decisionmaking and open communication (P < .05) and formal rules and procedures (P < .05).

From: Chapter 13, Patient Safety and Quality in Home Health Care

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.