Assessing the relationships between nurse working conditions and patient outcomes: systematic literature review

J Nurs Manag. 2011 Sep;19(6):700-13. doi: 10.1111/j.1365-2834.2011.01291.x. Epub 2011 Aug 16.


Aim: The purpose of the study was to systematically evaluate nurse working conditions and to review the literature dealing with their association with patient outcomes.

Background: Improving nurse working conditions is essential to address nursing shortages. Although general reviews of the literature support the positive link between working conditions and patient outcomes, definitive evidence has been lacking.

Evaluation: A search of six electronic bibliographic databases was conducted for the primary research published in English, from January 2000 to October 2009.

Key issues: The concepts of working conditions were categorized into 10 groups of working conditions. A total of 69 relationships between working conditions and patient outcomes were examined.

Conclusions: Increased attention has been drawn to nurse working conditions resulting from nursing shortages. The findings of this review suggested that the evidence supporting positive relationships between working conditions and patient outcomes is inconclusive. Further studies of a longitudinal and interventional nature in various settings are needed to advance knowledge of the complex contextual and multivariate influences among nurse working conditions and patient outcomes.

Implications for nursing management: Efforts to improve working conditions should be made in various health-care work settings to ensure patient safety and improve patient quality of outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Evidence-Based Nursing
  • Humans
  • Nursing Administration Research
  • Nursing Staff, Hospital / organization & administration*
  • Nursing Staff, Hospital / supply & distribution
  • Outcome Assessment, Health Care*