title: Nursing work environment and quality of care: differences between units at the same hospital.
abstract: The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub-scales from the Nursing Work Index - Revised (NWI-R) to assess the nursing work environment and the performance of these sub-scales across different units in a hospital. Data were derived from a cross-sectional survey of 243 nurses from 13 units of a 300-bed university-affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five subscales were confirmed; three of the sub-scales had greater ability to discriminate between units. Using hierarchical regression models, "resource adequacy" was the sub-scale most strongly associated with the perceived quality of care at the last shift. The NWI-R sub-scales are potentially useful for comparison of work environments of different nursing units at the same hospital.
authors.affiliation: Department of Clinical Epidemiology and Community Studies and Quality Assessment Unit, St Mary's Hospital, Montreal, Canada.
authors.forename: Jane
authors.initials: J
authors.lastname: McCusker
authors.forename: Nandini
authors.initials: N
authors.lastname: Dendukuri
authors.forename: Linda
authors.initials: L
authors.lastname: Cardinal
authors.forename: Johanne
authors.initials: J
authors.lastname: Laplante
authors.forename: Linda
authors.initials: L
authors.lastname: Bambonye
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D019538:Health Care Surveys; D006272:Health Facility Environment / Q000145:classification; D006757:Hospital Units / Q000458:organization & administration / Q000592:standards*; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D009738:Nursing Service, Hospital / Q000458:organization & administration / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care; D011792:Quebec; D011795:Surveys and Questionnaires; D017749:Total Quality Management; D017132:Workplace / Q000145:classification* / Q000523:psychology