The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience A Moderated Mediation Model

OBJECTIVE The aim of this study was to explore the influence of nurse work characteristics, resiliency, and burnout on retention, and patient quality and safety. BACKGROUND With an ongoing nursing shortage, maintaining qualified nursing staff is critical. We explored the direct and indirect effects of practice environment, nurse work characteristics, and burnout on retention, and perceived quality and safety. METHODS Responses from 507 RNs were collected via an anonymous online survey. Theorized relationships were explored via path analysis and invariance testing. RESULTS Positive practice environment and favorable work characteristics lowered burnout and improved outcomes. The indirect effects of work characteristics and burnout were dependent upon individual level of resilience. Social capital minimized the effects of burnout for participants reporting below-average resilience. CONCLUSIONS Leader support was critical in shaping positive perception of the practice environment. A nurse leader's visibility and actions impact intent to stay. Results of this study may inform healthcare systems struggling to retain a robust, engaged nursing workforce.