Study of the Strengths and Weaknesses of Nursing Work Environments in Primary Care in Spain

Int J Environ Res Public Health. 2021 Jan 7;18(2):434. doi: 10.3390/ijerph18020434.


Background: Nursing work environments are defined as the characteristics of the workplace that promote or hinder the provision of professional care by nurses. Positive work environments lead to better health outcomes. Our study aims to identify the strengths and weaknesses of primary health care settings in Spain.

Methods: Cross-sectional study carried out from 2018 to 2019. We used the Practice Environment Scale of the Nursing Work Index and the TOP10 Questionnaire of Assessment of Environments in Primary Health Care for data collection. The associations between sociodemographic and professional variables were analyzed.

Results: In total, 702 primary care nurses participated in the study. Responses were obtained from 14 out of the 17 Spanish Autonomous Communities. Nursing foundation for quality of care, management and leadership of head nurse and nurse-physician relationship were identified as strengths, whereas nurse participation in center affairs and adequate human resources to ensure quality of care were identified as weaknesses of the nursing work environment in primary health care. Older nurses and those educated to doctoral level were the most critical in the nursing work environments. Variables Age, Level of Education and Managerial Role showed a significant relation with global score in the questionnaire.

Conclusion: Interventions by nurse managers in primary health care should focus on improving identified weaknesses to improve quality of care and health outcomes.

Keywords: nurse’s role; nursing; primary care; quality of health care; workplace.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Nurse Administrators*
  • Nursing Staff, Hospital*
  • Primary Health Care
  • Spain
  • Workplace