An Examination of the Relationships among Nurses’ Work Environment, Nurses’ Education Level and Patient Outcomes

Abstract

This study sought to address the gap that exists in the empirical literature regarding the relationships among nurses’ education level, the nursing work environment, and nursingsensitive patient outcomes. This study was a secondary data analysis of data from sixteen units in a Magnet recognized, urban, teaching center in a large health system. Variables included nurse education level, characteristics of the nursing work environment, obtained through the Practice Environment Scale of the Nursing Work Index (PES-NWI) survey results, and the nursingsensitive patient outcomes of falls, hospital acquired pressure ulcers, catheter-associated urinary tract infections (CAUTI), central line-associated blood stream infections (CLABSI), and ventilator-associated pneumonia (VAP). Data were analyzed using path analysis to determine correlations among the hypothesized relationships between variables. The results of the study indicate that although significant correlations were seen between nurse education level, variables within the nursing work environment, and nursing-sensitive outcomes, the effect of nurse education level on nursing-sensitive outcomes is almost entirely made up of a direct effect. The indirect effect of nurse education level through the PES-NWI total score and subscale scores was minimal for all nursing-sensitive patient outcomes. There was strong evidence to suggest that nurse education level was associated with lower rates of falls and CLABSI.