Design: A comparative, cross-sectional study based on a self-administered survey questionnaire. It is a secondary analysis.

Population, Sample, Setting, Years: The sample consisted of 3,086 registered nurses working in seven specialties (med/surg, ICU, obstetrics, operation/recovery room, pediatrics, psychiatry, rehabilitation) within acute care hospitals in Alberta, Canada. It represents a subset of the Alberta Registered Nurse Survey, which is part of the international multidisciplinary research project “International Study of Hospital Staffing and Organization on Patient Outcomes” conducted by the Center of International Hospital Outcomes Research Consortium in 1998.

Concepts/Variables: Registered nurses reported on variables included quality of care, job satisfaction, emotional exhaustion, autonomy, control over practice, nurse-physician relationships, nursing and non-nursing activities, workload, and adverse events.

Method: Selected nurse and patient outcomes were compared between medical-surgical and other nurse units using descriptive statistics.

Findings: In medical-surgical units, first, nurses have poor autonomy, control over practice, and relationships with physicians; routinely perform non-nursing activities and leave undone more nursing activities than the other specialties; and have the lowest level of job satisfaction and autonomy, and highest level of emotional exhaustion. Second, patients have the highest percentage of adverse events and the lowest quality of care among all the other units.

Conclusion: Medical-surgical nurses practice in poor working-condition environments that result in poor outcomes in quality of care and adverse patient events.

Implication: Nurses contribute to quality of care through several mechanisms included nurse staffing, workload, emotional exhaustion, and job satisfaction. The effects of medical-surgical nurse practice environment have largely been ignored as important variable influencing outcomes, even though they are significant, since the majority of patients receive healthcare in these units.

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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004