Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction

Geriatr Nurs. 2020 Mar-Apr;41(2):158-164. doi: 10.1016/j.gerinurse.2019.08.007. Epub 2019 Sep 3.


The objective of this cross-sectional study was to examine the relationships between work environment, care quality, registered nurse (RN) burnout, and job dissatisfaction in nursing homes. We linked 2015 RN4CAST-US nurse survey data with LTCfocus and Nursing Home Compare. The sample included 245 Medicare and Medicaid-certified nursing homes in four states, and 674 of their RN employees. Nursing homes with good vs. poor work environments, had 1.8% fewer residents with pressure ulcers (p = .02) and 16 fewer hospitalizations per 100 residents per year (p = .05). They also had lower antipsychotic use, but the difference was not statistically significant. RNs were one-tenth as likely to report job dissatisfaction (p < .001) and one-eighth as likely to exhibit burnout (p < .001) when employed in good vs. poor work environments. These results suggest that the work environment is an important area to target for interventions to improve care quality and nurse retention in nursing homes.

Keywords: Burnout; Nursing home; Quality; Registered nurses; Work environment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Burnout, Professional / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Health Facility Environment*
  • Humans
  • Job Satisfaction*
  • Male
  • Middle Aged
  • Nursing Homes*
  • Nursing Staff / psychology*
  • Quality of Health Care*
  • United States
  • Workplace