The impact of nurse work environment on nurse outcomes, nurse-perceived quality of care and patient safety in Saudi Arabia

Abstract

Background: The current shortage of nurses jeopardizes the quality and safety of patient care globally, and is particularly serious in Saudi Arabia. There is ample evidence that nurse work environments are important to nurses’ job satisfaction, burnout, and retention, and the quality and safety of patient care. However, most of this research has been conducted in the United States and Europe with very little emanating from Saudi Arabia or the Middle East. Purpose: This study investigated relationships between components of nurse work environment and nurse outcomes and nurse-perceived quality of care and patient safety. Methods: This correlational study was conducted using cross-sectional data collected from 496 registered nurses working in a large tertiary hospital in Riyadh, Saudi Arabia. Participants completed an online survey similar to that used in RN4Cast studies. Nurse-reported measures were used to assess nurses’ perceptions of their work environments, nurse-outcomes (i.e., job satisfaction, burnout, and intent to leave), and nurses’ perceptions of quality of care and patient safety. Hierarchical logistic regression was conducted to examine the relationships between components of nurse work environment and nurse and patient outcomes, after controlling for nurse and patient characteristics. Findings: Nurses’ perceptions of staffing and resource adequacy was predictive of all nurse outcomes except for intent to leave whereas nurse manager ability and leadership was found to be predictive only of job satisfaction. In terms of patient outcomes, staffing and resources adequacy and nursing foundation for quality of care were found to be the only independent predictors of quality of care and patient safety. Implications for Nurse Leaders: Nurse leaders in Saudi Arabia should give special attention to staffing and resources adequacy, nursing management and leadership, and nursing foundation for care delivery at the unit level. Hospitals in Saudi Arabia should strive for magnet-like qualities as they play a critical role in the recruitment and retention of nurses and contribute to better quality and safe care delivery. Conclusion: Magnet-like work environments that are culturally sensitive are critical to attracting and retaining Saudi nurses and nurses from other countries who are currently vital to alleviating the nursing shortage in Saudi Arabia.