title: Nurse-perceived quality of care in intensive care units and associations with work environment characteristics: a multicentre survey study.
abstract: OBJECTIVE
  To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics.
  
  
  BACKGROUND
  Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality.
  
  
  METHODS
  A multicentre survey study was conducted in three Dutch intensive care units.
  
  
  METHODS
  The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 - June 2014.
  
  
  RESULTS
  The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction.
  
  
  CONCLUSIONS
  Factors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings.
authors.affiliation: Intensive Care Unit (ICU), St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Dewi
authors.identifier: http://orcid.org/0000-0002-5394-8028
authors.initials: D
authors.lastname: Stalpers
authors.affiliation: Institute of Psychology, Erasmus University, Rotterdam, The Netherlands.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Van Der Linden
authors.affiliation: Dutch Healthcare Authority, Utrecht, The Netherlands.
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Kaljouw
authors.affiliation: Department of Revalidation Nursing Science & Sports, University Medical Centre Utrecht, The Netherlands.|University of Applied Sciences, Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011787:Quality of Health Care; D017132:Workplace
keywords: intensive care units; job satisfaction; nurse-reported quality; nurses; perceptions; quality of health care; questionnaires; work environment