• Doris C Vahey, Linda H Aiken, Douglas M Sloane, Sean P Clarke, and Delfino Vargas.
• Mount Sinai Medical Center, Department of Nursing, New York, NY, USA. dvahey@nursing.upenn.edu
• Med Care. 2004 Feb 1; 42 (2 Suppl): II57-66.

BackgroundAmid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes.ObjectivesThis study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. RESEARCH DESIGN/SUBJECTS: We conducted cross-sectional surveys of nurses (N=820) and patients (N=621) from 40 units in 20 urban hospitals across the United States.MeasuresNurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS).ResultsPatients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction.ConclusionsImprovements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care.

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