Nurse Work Environment and Stress Biomarkers: Possible Implications for Patient Outcomes

Abstract

Objective: To examine associations between nurse work environment, serum biomarkers, and patient outcomes in a large hospital.

Methods: A work environment questionnaire was administered in 2017 to the total sample of nurses in a Midwestern hospital. A subsample of nurses (n = 83) provided blood samples. Correlation analyses examined associations between work environment ratings, biomarkers (dehydroepiandrosterone-sulphate [DHEA-S] and interleukin-6 [IL-6]), and unit-level patient outcomes.

Results: Work stress was negatively correlated with DHEA-S (r = -0.23) and positively correlated with IL-6 (r = 0.31; P < 0.05). Psychological safety (r = 0.22) and competence development (r = 0.25) were both positively correlated with DHEA-S (P < 0.05). DHEA-S was negatively correlated with central line-associated bloodstream infections (rho = -0.61; P < 0.05).

Conclusions: Work environment-associated physiological mechanisms might adversely impact patient safety, in addition to nurse health.