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. 2024 Mar;46(3):210-218.
doi: 10.1177/01939459241230369. Epub 2024 Feb 11.

Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis

Caroline Boudreau  1 , Ann Rhéaume  1
Affiliations

Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis

Caroline Boudreau et al. West J Nurs Res. 2024 Mar.

Abstract

Background: The nursing workforce remains in a vulnerable state post pandemic as working conditions are difficult and exacerbated by a global nursing shortage. Identifying factors leading to turnover intentions are thus critical for health care system recovery.

Purpose: The purpose of this study was to examine the impact of nurses' work environment and the pandemic on missed nursing care, scope of practice, emotional exhaustion, and intent to leave.

Methods: This study was a cross-sectional, self-reporting online survey, sent to hospital-based nurses in a Canadian province (n = 419). Mediation analysis was used to examine both direct and indirect effects of work environment and COVID-19 impact on nurse outcomes (emotional exhaustion and intent to leave) through missed care and scope of practice.

Results: The results showed that 73% of nurses were considering leaving the profession. Several direct and indirect pathways predicted emotional exhaustion and intent to leave. A better work environment was related to both decreased emotional exhaustion and intent to leave. Nurses' scope of practice partially mediated the relationship between work environment and intent to leave. On the other hand, missed care did not mediate emotional exhaustion or intent to leave.

Conclusions: While considering the global nursing shortage, it is imperative to implement strategies to promote nurses' well-being and their retention within the health care system.

Keywords: COVID; emotional exhaustion; missed nursing care; nurses; scope of practice; turnover intentions; work environment.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Final model. ---- Indicates non-significant path. *p < .05. **p < .001.
See this image and copyright information in PMC

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