title: Wage, work environment, and staffing: effects on nurse outcomes.
abstract: Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes-less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes.
authors.affiliation: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA mchughm@nursing.upenn.edu.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: McHugh
authors.affiliation: National Database for Nursing Quality Indicators, Kansas City, MO, USA.
authors.forename: Chenjuan
authors.initials: C
authors.lastname: Ma
mesh_terms: D000328:Adult; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D010563:Personnel Turnover / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000458:organization & administration; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data*; D014481:United States; D019037:Urban Health Services / Q000458:organization & administration; D017132:Workplace
keywords: burnout; job satisfaction; outcomes; quality of work environment; staffing levels