Relationship Between Work Environments, Nurse Outcomes, and Quality of Care in ICUs: Mediating Role of Nursing Care Left Undone.

BACKGROUND: The mechanism of how work environments affect nurse outcomes and quality of care has not been studied in intensive care unit (ICU) settings.

PURPOSE: The purpose was to investigate the effects of work environment on nurse outcomes and quality of care in ICUs, through the mediating effects of nursing care left undone.

METHODS: This study used survey data from 459 nurses from 22 ICUs in 22 hospitals in China. Hierarchical logistic regression modeling was used to analyze the relationships and the mediating effects.

RESULTS: Positive work environments were associated with lower nurse job dissatisfaction, less burnout, higher quality of care, and safer care. Adding nursing care left undone could reduce the effects of work environments, showing partial mediating effects of nursing care left undone.

CONCLUSIONS: Cultivating supportive work environments serves as a strategy to reduce nursing care left undone, and to improve nurse outcomes and quality of care in ICUs.