Meta-Analysis of Evidence from the Practice Environment Scale of the Nursing Work Index

The Practice Environment Scale of the Nursing Work Index (PES-NWI) is a National Quality Forum nursing care performance standard with sizable global evidence about nurse practice environments. This research synthesis includes qualitative integration (meta-synthesis) and quantitative integration (meta-analysis). A multinomial meta-analysis was used to model multiple classes of like outcomes for which separate coefficients were estimated. One hundred nineteen articles utilizing the PES-NWI, published from 2002 through 2014, were reviewed and 22 were included in the meta-analysis. Most articles linked practice environments to nurse job outcomes, to nurse-reported assessments of quality, safety, and frequency of adverse events and patient outcomes from administrative data, to organizational outcomes, or to a combination of these outcomes. The preliminary meta-analysis showed strong associations between nursing practice environment and patient safety outcomes. There is also a strong association between practice environment and nurse job outcomes, including dissatisfaction, burnout, and intent to leave. Keywords Organizational and Workforce Issues, Methods – Qualitative, Quantitative, and Community-based participatory research Disciplines Business This thesis or dissertation is available at ScholarlyCommons: http://repository.upenn.edu/spur/3 Sanders 1 Title: Meta-Analysis of Evidence from the Practice Environment Scale of the Nursing Work Index Author: Jordan Sanders Faculty Advisor: Eileen T. Lake, PhD, RN, FAAN Jessie M. Scott Term Chair in Nursing and Health Policy Associate Professor of Sociology Associate Director, Center for Health Outcomes and Policy Research Chair, Graduate Group in Nursing Email: sanej@wharton.upenn.edu elake@nursing.upenn.edu Sanders 2 ABSTRACT The Practice Environment Scale of the Nursing Work Index (PES-NWI) is a National Quality Forum nursing care performance standard with sizable global evidence about nurse practice environments. This research synthesis includes qualitative integration (meta-synthesis) and quantitative integration (meta-analysis). A multinomial meta-analysis was used to model multiple classes of like outcomes for which separate coefficients were estimated. One hundred nineteen articles utilizing the PES-NWI, published from 2002 through 2014, were reviewed and 22 were included in the meta-analysis. Most articles linked practice environments to nurse job outcomes, to nurse-reported assessments of quality, safety, and frequency of adverse events and patient outcomes from administrative data, to organizational outcomes, or to a combination of these outcomes. The preliminary meta-analysis showed strong associations between nursing practice environment and patient safety outcomes. There is also a strong association between practice environment and nurse job outcomes, including dissatisfaction, burnout, and intent to