Authors

1. Brooks Carthon, J. Margo PhD, APRN, FAAN
2. Hatfield, Linda PhD, RN, NNP-BC
3. Plover, Colin MSN, RN, MPH
4. Dierkes, Andrew BSN, RN
5. Davis, Lawrence BSN, RN
6. Hedgeland, Taylor BSN, RN
7. Sanders, Anne Marie BSN, RN
8. Visco, Frank BSN, RN, RN-BC
9. Holland, Sara DNP, RN
10. Ballinghoff, Jim MSN, MBA, RN, NEA-BC
11. Del Guidice, Mary MSN, RN, CENP
12. Aiken, Linda H. PhD, RN, FAAN, FRCN

Abstract

Background: Nurse engagement is a modifiable element of the work environment and has shown promise as a potential safety intervention.

Purpose: Our study examined the relationship between the level of engagement, staffing, and assessments of patient safety among nurses working in hospital settings.

Methods: A secondary analysis of linked cross-sectional data was conducted using survey data of 26 960 nurses across 599 hospitals in 4 states. Logistic regression models were used to examine the association between nurse engagement, staffing, and nurse assessments of patient safety.

Results: Thirty-two percent of nurses gave their hospital a poor or failing patient safety grade. In 25% of hospitals, nurses fell in the least or only somewhat engaged categories. A 1-unit increase in engagement lowered the odds of an unfavorable safety grade by 29% (P < .001). Hospitals where nurses reported higher levels of engagement were 19% (P < .001) less likely to report that mistakes were held against them. Nurses in poorly staffed hospitals were 6% more likely to report that important information about patients "fell through the cracks" when transferring patients across units (P < .001).

Conclusions: Interventions to improve nurse engagement and adequate staffing serve as strategies to improve patient safety.