To understand how to create a stabile workforce achieving excellent
quality of care and patient safety, associations between practice environments
and nurse and patient outcomes have been widely studied in acute and
psychiatric care hospitals. Knowing residential aged care services are challenged
to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a
cross-sectional survey, a sample of 709 registered nurses, licensed practical
nurses and nurse aides employed in 25 residential aged care services completed
a structured questionnaire composed of various validated instruments measuring
nurse practice environment factors, nurse work characteristics, burnout, nurse
reported job outcomes, quality and patient adverse events. Associations between
variables across residential aged care services were examined using multilevel
modelling techniques. Associations were identified between practice environment
factors, work characteristics, burnout dimensions, and reported outcome
variables across residential aged care services. Multiple multilevel models
showed independent variables (nursing management at the unit level, workload,
decision latitude, social capital, emotional exhaustion and depersonalization)
as important predictors of nurse reported outcome (job satisfaction, turnover
intensions), quality of care (at the unit, the last shift, and in the service within
the last year) and patient adverse events (patient and family complaints, patient
falls, pulmonary and urinary tract infections, and medications errors). Results
suggested the importance of nurse practice environment factors, nurse work
characteristics and perception of burnout on nurse and patient outcomes across their
nurse practice environment. Challenging the complex care of a vulnerable and
frail population executives, physicians, nursing leaders as well as nurses in
their nurse practice environment shared responsibility to create working conditions
achieving excellent quality and patient safety.