Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Linda Flynn, PhD, RN, Nursing, Rutgers, The State University of New Jersey, 75 Halsey Street, Newark, NJ 07102, 973-353-1307, lflynn@rutgers.edu

Purpose: Although two decades of research have investigated the impact of the hospital work environment on staff and inpatient outcomes, little is known regarding the relationship between work environment and outcomes in home healthcare agencies. The purpose of this study, funded by an intramural grant, was to explore the impact of work environment traits on key nurse and patient outcomes in home care.

Theoretical Framework: Sociological theories posit that nurse work environments in hospitals and other health care organizations characterized by interdisciplinary collaboration, nurse autonomy, adequate resources, and administrative support will experience higher levels of staff satisfaction and superior patient outcomes.

Methods: This descriptive correlational study utilized Dillman mail survey methods to obtain a 52% response rate from randomly selected subscribers to a professional nursing journal. Data analyses for this study were delimited to 137 respondents indicating current employment as staff nurses in home care agencies; the sample represented nurses from 38 states. Survey packets contained the Nursing Work Index-R as a measure of the nursing work environment, as well as items measuring job satisfaction, quality of care, workload, and frequencies of key adverse patient events. Bivariate correlation and logistic regression techniques were used to analyze data.

Findings: As anticipated, organizational support for nursing, as a measure of the work environment, was positively associated with job satisfaction and nurse-assessed quality of care, and negatively associated with reported frequencies of patient-administered medication errors, uncontrolled acute or chronic pain, and the inability of patients/family members to manage care upon discharge from home health care services. Importantly, nurses who rated their work environment as the least supportive were four times as likely to indicate intentions to leave their jobs.

Conclusions: As in hospitals, creation of a magnetic work environment in home care agencies that support clinicians and their practice appears to be important in reducing key adverse patient events. Moreover, work environment appears to be an important determinant of job satisfaction and retention among home care nurses.

Learning Objectives: At the end of the presentation, participants will be able to

• Summarize empirical evidence linking the nursing work environment to inpatient outcomes in hospitals.
• Describe the evolution of nursing work environment research in home healthcare.
• Identify 3 key home health outcomes influenced by the nursing work environment in home health agencies.

Keywords: Home Care, Outcomes Research

Presenting author's disclosure statement:

Any relevant financial relationships? No