Nurse Practice Environment, Job Satisfaction, Safety Climate, and Missed Nursing Care

Background: Nurse work environment can affect the nurse activities and can be associated with missed nursing care, also refered to as care left undone. Some reasons to explain missed care can include the practice environment, the safety climate and the job satisfaction.

Aims:

To investigate the impact of nurse practice environment factors on job satisfaction, safety climate and reasons for missed care.

Method:

A cross-sectional, descriptive and correlational study design with a convenience sample of 219 professional nurses from two teaching hospitals in São Paulo State, Brazil. The data coleta was conducted from April to October, 2017. The measure used were the Practice Environment Scale (PES), MISSCARE-BRASIL and the job satisfaction and safety climate subscales of the safety climate of the Safety Attitudes Questionnaire - Short Form 2006.

Results: The sample consisted of 35.6% of registered nurses and 64.4% of nursing technicians, with a mean age of 37 years and time of experience in the current unit of 5.5 years. Better work environment was associate to high level of job satisfaction, a better perception of the safety climate and less reasons for missed care.

The variable "safety climate" showed a strong positive correlation with the PES subscales: Nurse participation in hospital affairs, Nursing foundations for quality of care and Nurse manager ability leadership and, moderate positive correlation with Collegial nurse-physician relations and Staffing and Resource adequacy.

Job satisfaction resulted in a moderate positive correlation with PES subscales: Nurse participation in hospital affairs, Nursing foundations for quality of care and Nurse manager ability leadership and Collegial nurse-physician relations.

Regarding the variable "reasons for the omission of care", it was verified that the subscale Labor resources resulted in a moderate negative correlation with the subscales Nurse manager ability, leadership and the Staffing and Resource adequacy (PES). For the subscales Material resources and Communication, they showed a moderate negative correlation with the subscale Nurse manager ability, leadership (PES). On the other hand, the Management style resulted in moderate negative correlation with the Nursing foundations for quality of care and Nurse manager ability, leadership (PES).

Conclusion: Improving work environments can improve the nurses` perception of job satisfaction, safety climate and decrease missed nursing care.