The relationship between working environment and quality of nursing care: an integrative literature review

Abstract

Background/Aims There is evidence that work environment is positively related to quality of care in different healthcare professions, but the nature of this relationship needs further exploration. This study aimed to synthesise the evidence about the relationship between work environment and quality of care in nursing. Methods An integrative literature search was conducted to identify articles and studies investigating work environment and quality of care in nursing. Studies that were published between January 2000 and February 2020 in PubMed and EBSCOhost databases were included in the review. Results A total of 12 studies were included in the final analysis, of which four used an explicit theoretical framework to guide their research. Sample sizes were generally large. Work environmental was classified as consisting of physical, psychological, environmental and organisational factors. Most studies reported a direct positive correlation between work environment and quality of nursing care. Only one study found that work environment indirectly influenced quality of care through job satisfaction and burnout. Conclusions There is clear evidence that the quality of care delivered by nurses is influenced by the work environment. Particularly important factors were support from management and adequate staffing. To improve quality of care, healthcare leaders should focus on improving the work environment.