title: Nurse staffing and patient outcomes in Veterans Affairs hospitals.
abstract: OBJECTIVE
  To assess characteristics and perceptions of nurses working in the Veterans Health Administration (VHA), comparing types of nursing personnel, to benchmark to prior studies across healthcare systems.
  
  
  BACKGROUND
  Prior studies have shown relationships between positive registered nurse (RN) perceptions of the practice environment and patient outcomes. To date, no study has reported the comparison of RN perceptions of the practice environment in hospital nursing with those of non-RN nursing personnel. This study is the first to offer a more comprehensive look at perceptions of practice environment from the full range of the nursing work force and may shed light on issues such as the relationship of skill mix to nurse and patient outcomes.
  
  
  METHODS
  Cross-sectional observational study with a mailed survey administered to all nursing personnel in 125 VA Medical Centers between February and June 2003.
  
  
  RESULTS
  Compared with other types of nursing personnel in the VHA, RNs are generally less positive about their practice environments. However, compared with RNs in other countries and particularly with other RNs in the United States (Pennsylvania), VHA RNs are generally more positive about their practice environment and express more job satisfaction.
  
  
  CONCLUSIONS
  The nursing work force of the VHA has some unique characteristics. The practice environment for nurses in the VHA is relatively positive, and may indicate that the VHA, as a system, provides an environment that is more like magnet hospitals. This is significant for a public sector hospital system.
authors.affiliation: Health Service Research and Development, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA. ann.sales@med.va.gov
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sales
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Sharp
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Li
authors.forename: Gwendolyn T
authors.initials: GT
authors.lastname: Greiner
authors.forename: Elliott
authors.initials: E
authors.lastname: Lowy
authors.forename: Pamela
authors.initials: P
authors.lastname: Mitchell
authors.forename: Julie A
authors.initials: JA
authors.lastname: Sochalski
authors.forename: Paulette
authors.initials: P
authors.lastname: Cournoyer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006787:Hospitals, Veterans / Q000592:standards*; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D009720:Nurse Clinicians / Q000592:standards*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015401:Nursing Administration Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000592:standards*; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D017009:Professional Autonomy; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D017132:Workplace / Q000592:standards