Job Resources and Core Self-Evaluation as Predictors of Nurse Engagement and Patient-Safety Outcomes: A Longitudinal Study

Abstract

Background: Work engagement and patient-safety outcomes in nursing practice are critically significant. However, most previous studies evaluating antecedents of work engagement and patient-safety outcomes have used cross-sectional designs.

Aims: To investigate the effects of job resources (organizational support and leader empowerment) and core self-evaluation on nurses' work engagement and patient-safety outcomes.

Methods: This longitudinal study surveyed 2,618 registered nurses from 17 public hospitals in XuZhou, China. Participants completed self-report questionnaires on organizational support, leader empowerment, and core self-evaluation at baseline. Work engagement and patient-safety outcomes were collected 18 months after the baseline. The mixed linear regression and Johnson-Neyman statistical analysis were used to analyze data.

Results: Organizational support was an outsize predictor of nurses' work engagement, followed by core self-evaluation and leader empowerment. Organizational support and core self-evaluation were equally crucial for predicting patient-safety outcomes. Moreover, the positive impact of leader empowerment on patient-safety outcomes became significant when the core self-evaluation score was below 51.

Conclusions: This study demonstrated that organizational support, leader empowerment, and core self-evaluation are important determinants of nurses' work engagement and patient-safety outcomes. Implications for Nursing Management. Hospital managers and nurse leaders should consider providing multiple supports to motivate staff nurses to engage in work. When nurses' core self-evaluation is low, empowering training for nurse leaders should be essential to reduce adverse patient events.

Figure 1

The theoretical framework of the relationship between job resources, core-evaluation, engagement, and patient-safety outcomes. A solid line indicates that the findings from the previous studies support the demonstrated relationships. A broken line indicates that no research evidence in nursing studies has demonstrated the relationships yet.

Figure 2

Estimated effect of leader empowerment on patient-safety outcomes moderated by core self-evaluation with Johnson–Neyman confidence bands.