The Quality of Nurses' Work Environment and Workforce Outcomes From the Perspective of Swiss Allied Healthcare Assistants and Registered Nurses: A Cross-Sectional Survey

J Nurs Scholarsh. 2015 Sep;47(5):458-67. doi: 10.1111/jnu.12151. Epub 2015 Jul 28.


Background: Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear.

Aims: (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes.

Design: A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals.

Methods: We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes.

Findings: AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction.

Conclusions: This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals.

Clinical relevance: Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses.

Keywords: Allied healthcare assistant; burnout; hospitals; intention to leave; job satisfaction; work environment.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Burnout, Professional / etiology
  • Career Choice
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intention
  • Job Satisfaction*
  • Logistic Models
  • Male
  • Middle Aged
  • Nursing Staff, Hospital / psychology*
  • Surveys and Questionnaires
  • Switzerland
  • Workplace / standards*