Association of nurse work environment and safety climate on patient mortality: A cross-sectional study
There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes. To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality. Cross-sectional secondary...
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| Veröffentlicht in: | International journal of nursing studies 2017-09, Vol.74, p.155-161 |
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| container_title | International journal of nursing studies |
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| creator | Olds, Danielle M. Aiken, Linda H. Cimiotti, Jeannie P. Lake, Eileen T. |
| description | There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes.
To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.
Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.
Acute care hospitals in California, Florida, New Jersey, and Pennsylvania.
The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.
Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.
In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p |
| doi_str_mv | 10.1016/j.ijnurstu.2017.06.004 |
| format | Article |
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To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.
Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.
Acute care hospitals in California, Florida, New Jersey, and Pennsylvania.
The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.
Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.
In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316).
We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments.</description><identifier>ISSN: 0020-7489</identifier><identifier>EISSN: 1873-491X</identifier><identifier>DOI: 10.1016/j.ijnurstu.2017.06.004</identifier><identifier>PMID: 28709013</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute services ; Clinical outcomes ; Corporate culture ; Cross-Sectional Studies ; Discharge ; Hospital ; Hospital Mortality ; Hospitals ; Humans ; Mortality ; Nurses ; Nursing Staff ; Nursing Staff, Hospital ; Organizational climate ; Organizational culture ; Outcome assessment (health care) ; Patient Safety ; Polls & surveys ; Safety ; United States ; Work environment ; Workplace</subject><ispartof>International journal of nursing studies, 2017-09, Vol.74, p.155-161</ispartof><rights>2017 Elsevier Ltd</rights><rights>Copyright © 2017 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Sep 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-5e55f874ad7677346bd9d5d9e5cbaeed3a01e2064592ce89f1a55f27e7f82bc33</citedby><cites>FETCH-LOGICAL-c499t-5e55f874ad7677346bd9d5d9e5cbaeed3a01e2064592ce89f1a55f27e7f82bc33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijnurstu.2017.06.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,30999,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28709013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olds, Danielle M.</creatorcontrib><creatorcontrib>Aiken, Linda H.</creatorcontrib><creatorcontrib>Cimiotti, Jeannie P.</creatorcontrib><creatorcontrib>Lake, Eileen T.</creatorcontrib><title>Association of nurse work environment and safety climate on patient mortality: A cross-sectional study</title><title>International journal of nursing studies</title><addtitle>Int J Nurs Stud</addtitle><description>There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes.
To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.
Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.
Acute care hospitals in California, Florida, New Jersey, and Pennsylvania.
The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.
Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.
In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316).
We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments.</description><subject>Acute services</subject><subject>Clinical outcomes</subject><subject>Corporate culture</subject><subject>Cross-Sectional Studies</subject><subject>Discharge</subject><subject>Hospital</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Mortality</subject><subject>Nurses</subject><subject>Nursing Staff</subject><subject>Nursing Staff, Hospital</subject><subject>Organizational climate</subject><subject>Organizational culture</subject><subject>Outcome assessment (health care)</subject><subject>Patient Safety</subject><subject>Polls & surveys</subject><subject>Safety</subject><subject>United States</subject><subject>Work environment</subject><subject>Workplace</subject><issn>0020-7489</issn><issn>1873-491X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkU9v1DAQxS0EotvCV6gsceGSME7ifxwQqwoKUiUuIHGzvM4EHJJ4sZOt9tvjsG0FXDj5ML_3PPMeIZcMSgZMvOpL309LTPNSVsBkCaIEaB6RDVOyLhrNvj4mG4AKCtkofUbOU-oBgClQT8lZpSRoYPWGdNuUgvN29mGioaOrJ9LbEH9QnA4-hmnEaaZ2ammyHc5H6gY_2hlp5vdZtk7HEGc7-Pn4mm6piyGlIqFbLe1A84rt8Rl50tkh4fO794J8ef_u89WH4ubT9cer7U3hGq3ngiPnnZKNbaWQsm7ErtUtbzVyt7OIbW2BYQWi4bpyqHTHbBZUEmWnqp2r6wvy5uS7X3Yjti5vF-1g9jHvHI8mWG_-nkz-u_kWDoYLzZWCbPDyziCGnwum2Yw-ORwGO2FYkmE6x625UE1GX_yD9mGJ-eSVUiC0VDXPlDhRv3OJ2D0sw8CsVZre3Fdp1ioNCJOrzMLLP095kN13l4G3JwBzoAeP0SSX63DY-pjTN23w__vjF6tWtt4</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Olds, Danielle M.</creator><creator>Aiken, Linda H.</creator><creator>Cimiotti, Jeannie P.</creator><creator>Lake, Eileen T.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170901</creationdate><title>Association of nurse work environment and safety climate on patient mortality: A cross-sectional study</title><author>Olds, Danielle M. ; Aiken, Linda H. ; Cimiotti, Jeannie P. ; Lake, Eileen T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-5e55f874ad7677346bd9d5d9e5cbaeed3a01e2064592ce89f1a55f27e7f82bc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acute services</topic><topic>Clinical outcomes</topic><topic>Corporate culture</topic><topic>Cross-Sectional Studies</topic><topic>Discharge</topic><topic>Hospital</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Mortality</topic><topic>Nurses</topic><topic>Nursing Staff</topic><topic>Nursing Staff, Hospital</topic><topic>Organizational climate</topic><topic>Organizational culture</topic><topic>Outcome assessment (health care)</topic><topic>Patient Safety</topic><topic>Polls & surveys</topic><topic>Safety</topic><topic>United States</topic><topic>Work environment</topic><topic>Workplace</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olds, Danielle M.</creatorcontrib><creatorcontrib>Aiken, Linda H.</creatorcontrib><creatorcontrib>Cimiotti, Jeannie P.</creatorcontrib><creatorcontrib>Lake, Eileen T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of nursing studies</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olds, Danielle M.</au><au>Aiken, Linda H.</au><au>Cimiotti, Jeannie P.</au><au>Lake, Eileen T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of nurse work environment and safety climate on patient mortality: A cross-sectional study</atitle><jtitle>International journal of nursing studies</jtitle><addtitle>Int J Nurs Stud</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>74</volume><spage>155</spage><epage>161</epage><pages>155-161</pages><issn>0020-7489</issn><eissn>1873-491X</eissn><abstract>There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes.
To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.
Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.
Acute care hospitals in California, Florida, New Jersey, and Pennsylvania.
The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.
Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.
In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316).
We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28709013</pmid><doi>10.1016/j.ijnurstu.2017.06.004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); Access via ScienceDirect (Elsevier) |
| subjects | Acute services Clinical outcomes Corporate culture Cross-Sectional Studies Discharge Hospital Hospital Mortality Hospitals Humans Mortality Nurses Nursing Staff Nursing Staff, Hospital Organizational climate Organizational culture Outcome assessment (health care) Patient Safety Polls & surveys Safety United States Work environment Workplace |
| title | Association of nurse work environment and safety climate on patient mortality: A cross-sectional study |
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