Nurse Practice Environment and Burnout as Predictors of Safety Climate, Teamwork Climate and Job Satisfaction

Purpose: Analyze the effects of nursing work environment and burnout in the safety climate, teamwork climate and job satisfaction from the perspective of the nursing professionals.

Methods: A cross sectional study with a convenience sample of 580 professional nurses from three teaching hospital in São Paulo State, Brazil. It was proposed a theoretical model with the dimensions of the nurse practice environment, burnout and outcome variables (safety climate, teamwork climate and job satisfaction). The measures used were Nursing Work Index-Revised, Maslach Burnout Inventory, and the Safety Attitude Questionnaire-Short Form 2006 (subscales: safety climate, teamwork climate and job satisfaction). For data analysis, the Structural Equation Modelling through the Partial Least Squares (PLS-PM) approach was used.

Results: At first it was considered the measures related to the convergent and discriminant validities, and to ensure the model fit fourteen variables were excluded. In the evaluation of the structural model it was found that all constructs contributed to the accuracy of the model (Q² > 0). The outcome variables in the model showed Pearson` coefficient values (R²) ranging from medium to large effect. The adjusted model explained 28% of safety climate, 33% of teamwork climate and 23% of job satisfaction variables. Another indicator that demonstrates the quality of the adjusted model is the observed effect size for the variables that constitute the theoretical model, in which the values of the size effect varied from moderate to large effect (f²= 0.19 to 0.51). All the relations among the variables in the model were significant (p < 0.0001). The path coefficients indicates that increasing the nursing work environment by one, the job satisfaction increases by 0.21, the safety climate increases by 0.52 and the teamwork climate increases by 0.48. In the other hand, if the burnout decrease by one, the teamwork climate increases by 15% and the job satisfaction increases by 33%. The path coefficient between burnout and safety climate was not significant.

Conclusion: The perception of nurse professionals in relation to nursing practice work environment and burnout were predictors of safety climate, teamwork climate and job satisfaction. The final model was fitted to explain the effect of the nurse work environment and burnout in the outcome variables.