• Deirdre McCaughey, Gwen McGhan, Erin M Walsh, Cheryl Rathert, and Rhonda Belue.
• Deirdre McCaughey, MBA, PhD, is Assistant Professor, Department of Health Policy and Administration and Department of Public Health Sciences, The Pennsylvania State University, University Park, Pennsylvania. E-mail: mccaughey@psu.edu. Gwen McGhan, RN, MN, is Jonas/Hartford Doctoral Student, School of Nursing, The Pennsylvania State University, University Park. E-mail: gem18@psu.edu. Erin M. Walsh, BS, BA, is Project Manager, Department of Health Policy and Administration, The Pennsylvania State University, University Park. E-mail: erin.walsh9@gmail.com. Cheryl Rathert, PhD, is Assistant Professor, Health Services Management, Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia. E-mail: rathertc@health.missouri.edu. Rhonda Belue, PhD, is Associate Professor, Department of Health Policy and Administration, The Pennsylvania State University, University Park. E-mail: rzb10@psu.edu.
• Health Care Manage Rev. 2014 Jan 1;39(1):75-88.

BackgroundWith estimates of a 51% growth in the number of nursing assistants needed by 2016, there is a critical need to examine workplace factors that negatively contribute to the recruitment and retention of nursing assistants. Studies have shown that high demands, physical stress, and chronic workforce shortages contribute to a working environment that fosters one of the highest workforce injury rates in the United States.PurposesThe aim of this study was to explore the relationship between nursing assistant injury rates and key outcomes, such as job satisfaction and turnover intent, while exploring workplace environment factors, such as injury prevention training, supervisor support, and employee engagement, that can decrease the rates of workplace injury.Methodology/ApproachData from the 2004 National Nursing Assistant Survey were used to examine the negative effects of workplace injury on nursing assistants and the workplace environment factors that are related to the rate of worker injury.FindingsNursing assistants who experience job-related injuries have lower levels of job satisfaction, increased turnover intentions, and are less likely to recommend their facility as a place to work or seek care services. It was also found that nursing assistant injury rates are related to employee ratings of injury prevention training, supervisor support, and employee engagement. NAs with multiple injuries (>2) were 1.3-1.6 times more likely to report being injured at work than NAs who had not been injured when supervisor support, employee engagement, and training ratings were low.Practice ImplicationsEvidence that health care organizations can use to better understand how workplace injuries occur and insight into ways to reduce the current staggering rate of on-the-job injuries occurring in health care workplaces were offered in this study. The findings also offer empirical support for an extension of the National Institute for Occupational Health and Safety/National Occupational Research Agenda Work Organization Framework for Occupational Illness and Injury.

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