This article's primary goal was to ascertain how the hospital's environment for patient and nurse treatment impacts outcomes. Numerous studies have been carried out to identify the variables that influence nurse and patient outcomes; however, none of these studies have concentrated solely on the contribution of the care environment to patient outcomes. Hospital staffing and education are two well-documented factors that influence patient mortality and nurse outcomes; as such, this study focused on determining the effects of the hospital care environment on nursing outcomes and patient mortality after accounting for hospital staffing and education (Aiken, 2008).
Research Elements: Design, Methods, Population, Strengths, Limitations: The research took up a descriptive research design since the researchers wanted to answer the question of the effects of hospital care environment on patient mortality and nurse outcomes. As such, data was collected from 10,184 nurses and 232,342 nurses from hospitals in Pennsylvania. The data was then analyzed to determine outcomes such as job satisfaction among nurses, the level of burnout among staff, intent to leave and reports of quality care. In addition, the researcher analyzed outcomes such as patient mortality rate and the failure of nurses to rescue patients. Practice environment scales of the nursing work index were used to measure care environments (Aiken, 2008).
Outcomes: The results suggested that nurses had better outcomes such as positive job experience and increased confidence in the quality of care in hospitals with better care environments. Also, patients had a decreased mortality rate and failure to rescue in such hospitals (Aiken, 2008).
Significance to Nursing and Patient Care: The results of the study show the nursing sector that they should optimize nurse staffing and education to achieve a high quality of care in their hospital.
Hessels, A., Flynn, L., Cimiotti, J. D., Bakken, S., & Gershon, R. (2015). The impact of health information technology on the quality of patient care. Journal of Health and Technology, 19, 230-280.
Summary of Article: Technology has not only revolutionized how people communicate but also the way healthcare services are provided. The following study focused on health information technology and how it has affected the quality of care experienced by the patient as well as the outcomes of that care (Hessels et al., 2015).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study was in the form of a cross-sectional research design where data from different healthcare organizations was collected and analyzed. Multiple regression analysis were used to estimate the effects of electronic health records on nursing care and patient outcomes (Hessels et al., 2015).
Outcomes: Electronic health records were associated with reduced rates of a prolonged stay at the hospital. As such, health information technology does indeed improve the quality of care and patient outcomes (Hessels et al., 2015).
Significance to Nursing and Patient Care: Hospitals should consider implementing advanced health information technologies in their facilities since this have been shown to improve the quality of care provided by nurses as well as the outcomes of patients treated using this technology (Hessels et al., 2015).
Kieft, R., Brouwer, B., & Francke, A. (2014). How nurses and their work environment affect patient experiences of quality care. Journal of Health Services Research, 14, 100-160.
Summary of Article: Nurses spend a lot of time with patients and hence they have the most influence on patient experiences in the hospital environment. However, most nurses are unaware of the huge influence they have on patient experiences. As such, hospitals should educate their nurses on factors within the nursing practice that influences patient outcomes. The following study focused on evaluating the perceptions nurses had about how their work contributes positively to patient experiences (Kieft et al., 2014).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study took up a descriptive research design; data was collected from 26 nurses from different focus groups including mental health care nurse, hospital care, nursing home care and home care. Interviews were recorded through audiotapes and later they were transcribed and analyzed (Kieft et al., 2014).
Outcomes: The nurses suggested several important elements they believed nurses needed to help them influence patient experiences positively. According to the results, clinically competent nurses who were collaborative positively impacted patient outcomes. In addition, the nurses mentioned autonomous nursing practice, adequate staffing and a patient-centered culture as some of the factors that help influence patient experiences positively. The nurses also pointed out factors that influence patient outcomes negatively; the major factor was a high workload among the nurses which led to poor patient experiences (Kieft et al., 2014).
Significance to Nursing and Patient Care: Nurses should incorporate practices that promote positive patient outcomes. For instance, the nurses can practice collaboration and clinical competence as this will improve patient experiences. Whatsoever, the nurses should take care so as not to overwork themselves as this would lead to poor patient experiences.
Kiwan, M., & Mathews, A. (2013). The impacts of work environment of nurses on patient safety outcomes. Journal of Nursing Studies, 50(2), 250-270.
Summary of Article: Serious concerns have been raised about the impact that restructuring hospitals have on patient safety outcomes and the nursing environment. However, few studies have been done to evaluate the nature of the relationship between patient safety outcomes and the nursing work environment. The following study was therefore conducted to identify the link between professional nursing practice conditions such as burnout to patient safety outcomes (Kiwan & Mathews, 2013).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study took up a descriptive study design where 8597 nurses completed the Maslach Burnout Inventory-Human service scale and the practice environment scale so as to determine their measures of burnout and work-life respectively. Reports of the occurrence of patient adverse effects were also recorded (Kiwan & Mathews, 2013).
Outcomes: The hospital environment affected the quality of work life expressed by the nurses; also, the adequacy of nurses affected their level of exhaustion. In turn, the quality of work life and the level of exhaustion portrayed by the nurses had a direct effect on patient outcomes (Kiwan & Mathews, 2013).
Significance to Nursing and Patient Care: The results showed that the outcomes of patient safety relied greatly on the nursing practice work environment. As such, nurses should ensure they put measures in place to decrease burnout among them.
Kussman, S. & Scheidenhelm, S. (2008). Nurses' perception of the impact of electronic health records on work and patient outcomes. Journal of Computer Information and Nursing, 26(2), 60-80.
Summary of Article: The main objective of the study was to evaluate the perceptions nurses had about the impact that electronic health records have on performance at work and patient outcomes (Kussman & Scheidenhelm, 2008).
Research Elements: Design, Methods, Population, Strengths, Limitations: The research made use of interviews, questionnaires and observational data from 46 nurses in two different hospitals. As such, the research was of a descriptive nature (Kussman & Scheidenhelm, 2008).
Outcomes: It was discovered that nurses preferred the use of electronic health records over paper records; the nurses cited decreased workload as one of the reasons why they preferred electronic medical records. Electronic recording increased information access hence improving efficiency in responding to situations. However, another percentage of the nurses believed that electronic records provided a safer means to provide care but it reduced the quality of care (Kussman & Scheidenhelm, 2008).
Significance to Nursing and Patient Care: Hospital administration should involve nurses while choosing the electronic record system to use. Also, nurses should be educated on the proper use of electronic medical recording to prevent misuse, therefore, increasing efficiency in providing care.
Laschinger, S., Finegan, H., & Shamian, J. (2001). The impacts of workplace empowerment, organizational trust on staff nurses' work satisfaction, and the organization commitment. Journal of Health Care Management, 23(3), 7-23.
Summary of Article: Kanter suggested that a work environment that encourages access to information, resources and support also promotes employee attitudes and productivity in the workplace. As such, a study was conducted to test this theory of work empowerment as suggested by Kanter (Laschinger et al., 2001).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study took up a predictive and non-experimental research design. 412 staff from the selected hospitals were interviewed for the purposes of the study (Laschinger et al., 2001).
Outcomes: The results showed that work environments that practiced empowerment also had positive effects on the staff as well as on the overall effectiveness of the organization (Laschinger et al., 2001).
Significance to Nursing and Patient Care: Hospitals should endeavor to provide work environments that empower their nurses since it will improve the care provided by the nurses to the patient.
Liu, K., You, L., Chen, S., Hao, Y., Zhu, X., Zhang, L., & Aiken, L. H. (2012, May). The relationship between hospital work environment and nurse outcomes in Guangdong, China: A nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476–1485.
Summary of Article: The nursing work environment is used to refer to staffing, work schedule, job demand and the general practice environment where nurses work. The study below aimed at examining the link between the nurses work environment and patient and nurse outcomes (Liu et al., 2012).
Research Elements: Design, Methods, Population, Strengths, Limitations: A survey was conducted on 1104 nurses in 89 hospitals. The study was in the form of a cross-sectional research design. Data was collected from patient quality and safety indicators (Liu et al., 2012).
Outcomes: A high rate of secondary infections among the patients was reported in hospitals where nurses reported higher job demands and workload (Liu et al., 2012).
Significance to Nursing and Patient Care: Hospitals should modify their work environments and work schedule to accommodate the needs of the nurses and hence improve the quality of care provided to patients. Such will enhance patient outcomes.
Midodzi, W., Estabrooks, C., Cummings, G., & Ricker, K. (2005). The impact of hospital nurse characteristics on 30-day mortality. Journal of Nursing Research, 54(2), 75-88.
Summary of Article: Evidence collected from various studies suggests that staffing of nurses has an impact on patient outcomes. However, very little attention has been given to other nursing characteristics such as nurse education, skill mix and quality of their work environment. The study, therefore, focused on assessing the effects of nursing education and skill mix on the mortality of patients (Midodzi et al., 2005).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study used a cross-sectional analysis where data from patients discharged from hospitals in Alberta was analyzed. Patient mortality data was then linked to nursing characteristics as derived from a survey of the registered nurses in the area (Midodzi et al., 2005).
Outcomes: A multi-level analysis was used to analyze the data; there was a less rate of mortality among patients where nurses exhibited higher education levels and a richer skill mix (Midodzi et al., 2005).
Significance to Nursing and Patient Care: The characteristics displayed by nurses are an important consideration when reducing the mortality among patients. Nurses should be more educated and have more skills in order to decrease the rates of mortality among patients.
Pundy, N. M. (2010). Effects of work environments on nursing and patient outcomes. Journal of Nursing Management, 18(8), 120-215.
Summary of Article: It is a common occurrence to find a nurse quit her job due to a general dissatisfaction with the current working conditions. The evidence is therefore needed to enable organizations to modify their environments to suit the needs of the nurses. As such, a study was conducted to determine the relationship between the nursing work environment and its effects on patient outcomes (Pundy, 2010).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study had a multi-level design where data from nurses and patients from different healthcare facilities was analyzed. The analysis was conducted using multi-level structural equation modeling (Pundy, 2010).
Outcomes: It was determined that empowering nurses does indeed affect their perception of the quality of care provided; this in turn positively affected their job satisfaction and the quality of care they provided in the hospital (Pundy, 2010).
Significance to Nursing and Patient Care: Hospital managers should create work environments that empower their nurses; this will, in turn, improve the quality of care provided.
Rosenstein, A. (2002). Impacts of nurse satisfaction and retention. American Journal of Nursing, 102(6), 26-34.
Summary of Article: The number of nurses has greatly reduced in many areas hence necessitating the need for new ways to effectively train and retain nurses. As such, this survey was conducted to assess relationships between the nurse and the physician and how this affects the nurse’s job satisfaction, morale, and retention (Rosenstein, 2002).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study was conducted on 1200 hospital executives including nurses and physicians. The survey was sent via email to various respondents hence the study had a qualitative research design (Rosenstein, 2002).
Outcomes: Most of the respondents agreed that the nurse-physician relationship does indeed have an effect on the nurse’s job satisfaction. Disruptive behavior from the physician was cited as the major reason why nurses quit their jobs (Rosenstein, 2002).
Significance to Nursing and Patient Care: The findings suggested that the quality of the relationship between the nurse and the physician should be addressed as a means to improve the nurse’s job satisfaction and hence retain them in the workplace.
Shammika, K., Admbarage, C., & Mudibanselage, H. (2015). The nursing shortage impact on job outcome. Journal of Competitiveness, 7(3), 75-95.
Summary of Article: The shortage of nurses is a common problem being experienced throughout the world. A study was therefore conducted to investigate the correlation between nurse shortage and the outcomes of jobs at the workplace (Shammika et al., 2015).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study used an exploratory research design where data was collected from random samples of nurses. Data was collected through the use of questionnaires; later, the questionnaires were analyzed (Shammika et al., 2015).
Outcomes: The shortage of nurses had an impact on the quality of care as well as the workload in hospitals. Hospitals with few nurses exhibited poor care quality and nurses often complained of burnout due to an excess workload (Shammika et al., 2015).
Significance to Nursing and Patient Care: Hospitals should find new ways train new nurses and retain them so as to curb the effects brought about by a shortage of nurses.
Smith, H., Fynn, L., Neff, D., & Sloane, D.. (2011). Effects of nurse training on patient mortality in hospital. Medical Care, 49(12), 1047-1053.
Summary of Article: Lower hospital mortality rates have often been linked with and adequate and well-trained workforce as well as a good nursing work environment. However, not much is known about how each variable affects patient mortality; as such, the following article was an appraisal of how nurse staffing, training, and environment affect patient mortality (Smith et al., 2011).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study was a descriptive research where 665 hospitals were studied; data from the hospitals discharge records was used and random samples of 39,038 nurses were interviewed (Smith et al., 2011).
Outcomes: There was a high mortality rate in hospitals where they had an inadequate nurse workforce. Hospitals that had more nurses had a decreased rate of patient mortality and failure to rescue (Smith et al., 2011).
Significance to Nursing and Patient Care: Increasing the number of nurses in a hospital has a positive outcome on patient outcomes. As a result, hospitals should ensure they have an adequate workforce to improve nursing and patient care.
Stone, P., Mooney, K., & Larson, E.. (2007). Nurse working conditions and patients safety outcomes. Journal of Nursing Administration, 45(6), 572-580.
Summary of Article: The effects that many working condition variables working interdependently have on patient outcomes have not been investigated. As such, the objective of the study was to examine the effects that a set of working condition variables has on the safety outcomes of patients in the ICU (Stone et al., 2007).
Research Elements: Design, Methods, Population, Strengths, Limitations: The research was in the form of an observational study. Variables such as staffing, overtimes, wages and hospital accreditation were measured. More than 15,000 patients and 1000 nurses were assessed (Stone et al., 2007).
Outcomes: Units with higher staffing showed lower rates of patient adverse reaction and mortality. On the other hand, increased overtime correlated with an increase in hospital-acquired urinary tract infections (Stone et al., 2007).
Significance to Nursing and Patient Care: Improving nursing working conditions will most definitely improve patient safety outcomes.
Tao, Y. & Zhu, X.W. (2012). The relationship between hospital environment and nurse outcomes. Journal of Clinical Nursing, 21(9-10), 1476-1485.
Summary of Article: There is a problem where hospitals are now experiencing a shortage of nurses. This study was conducted to examine the relationship between hospital work environment and job satisfaction and intent to leave among nurses (Tao & Zhu, 2012).
Research Elements: Design, Methods, Population, Strengths, Limitations: The study was in the form of a cross-sectional research design where data from 1104 nurses was collected and analyzed. Stratified convenience sampling was used to select subjects for study while scales such as the Maslach burnout inventory were used to determine nurse job satisfaction (Tao & Zhu, 2012).
Outcomes: There was a high percentage of nurses who admitted to experiencing burnouts while even a higher percentage of the nurses were dissatisfied with their job experience. What is more, it was determined that improving the work environment had a significant effect on burnouts and job satisfaction; improved work settings decreased the burnout and job dissatisfaction experienced by nurses (Tao & Zhu, 2012).
Significance to Nursing and Patient Care: Improving the working environment will help deal with the problem of nurse shortage by helping retain the nurses.
References
Aiken, L., Clarke S.P., & Sloane, D. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223-229.
Hessels, A., Flynn, L., Cimiotti, J. D., Bakken, S., & Gershon, R. (2015). The impact of health information technology on the quality of patient care. Journal of Health and Technology, 19, 230-280.
Kieft, R., Brouwer, B., & Francke, A. (2014). How nurses and their work environment affect patient experiences of quality care. Journal of Health Services Research, 14, 100-160.
Kiwan, M., Mathews, A. (2013). The impacts of work environment of nurses on patient safety outcomes. Journal of Nursing Studies, 50(2), 250-270.
Kussman, S. & Scheidenhelm, S. (2008). Nurses' perception of the impact of electronic health records on work and patient outcomes. Journal of Computer Information and Nursing, 26(2), 60-80.
Laschinger, S., Finegan, H., & Shamian, J. (2001). The impacts of workplace empowerment, organizational trust on staff nurses' work satisfaction, and the organization commitment. Journal of Health Care Management, 23(3), 7-23.
Liu, K., You, L., Chen, S., Hao, Y., Zhu, X., Zhang, L., & Aiken, L. H. (2012, May). The relationship between hospital work environment and nurse outcomes in Guangdong, China: A nurse questionnaire survey. Journal of Clinical Nursing, 21(9-10), 1476–1485.
Midodzi, W., Estabrooks, C., Cummings, G., & Ricker, K. (2005). The impact of hospital nurse characteristics on 30-day mortality. Journal of Nursing Research, 54(2), 75-88.
Pundy, N. M. (2010). Effects of work environments on nursing and patient outcomes. Journal of Nursing Management, 18(8), 120-215.
Rosenstein, A. (2002). Impacts of nurse satisfaction and retention. American Journal of Nursing, 102(6), 26-34.
Shammika, K., Admbarage, C., & Mudibanselage, H. (2015). The nursing shortage impact on job outcome. Journal of Competitiveness, 7(3), 75-95.
Smith, H., Fynn, L., Neff, D., & Sloane, D.. (2011). Effects of nurse training on patient mortality in hospital. Medical Care, 49(12), 1047-1053.
Stone, P., Mooney, K., & Larson, E.. (2007). Nurse working conditions and patients safety outcomes. Journal of Nursing Administration, 45(6), 572-580.
Tao, Y. & Zhu, X.W. (2012). The relationship between hospital environment and nurse outcomes. Journal of Clinical Nursing, 21(9-10), 1476-1485.
