The analysis by the University of Pennsylvania’s school of nursing looked at the findings from 17 studies from around the world to assess the link between working environments and key outcomes including the wellbeing of patients and nurses.
The research evidence analysed by the Penn Nursing team comprised data from more than 2,600 hospitals, 165,000 nurses and 1.3 million patients.
The researchers focused on four sets of outcomes – nurse job satisfaction, nurse assessments of quality and safety, patient health and patient satisfaction.
They found “consistent” and “significant” links between work environments for nurses and all four categories with better working conditions associated with a reduced risk of negative outcomes including patient deaths.
“Our quantitative synthesis of the results of many studies revealed that better work environments were associated with lower odds of negative outcomes ranging from patient and nurse job dissatisfaction to patient mortality,” said nurse and lead investigator Eileen Lake.
Better working conditions – assessed using a tool called the Practice Environment Scale of the Nursing Work Index – were linked with lower odds of nurses feeling unhappy at work or reporting safety and quality concerns.
On average nurses in a good working environment were 29% less likely to be dissatisfied in their job and 35% less likely to rate safety and quality as poor.
The findings, published in the journal Medical Care, show negative outcomes for patients were 7% less likely in settings where nurses’ working conditions were good.
Meanwhile, patients were 16% more likely to be satisfied with the care they received.
The researchers said their findings highlighted the need to look at ways to improve working conditions to help ensure the best care.
“Our results support the unique status of the nurse work environment as a foundation for both patient and provider wellbeing that warrants the resources and attention of healthcare administrators,” said Ms Lake.