[Work environment and patient safety: data comparison between Seneca and RN4CAST projects]

Objective: To analyze the relationship between the work environment and burnout of nurses and the quality of care for patient safety at the Spanish National Health System Hospitals included in SENECA and RN4CAST studies.

Method: Descriptive study with a secondary analysis that compares data of 984 patient records, 1469 patient, and 1886 professional surveys from SENECA project, with 2139 nurses' surveys from RN4CAST study, in 24 hospitals. Adverse events data related to care, and patient's and professional's perception of safety were compared with work environment (measured by the Nursing Work Index) and burnout (measured by Maslach Burnout Inventory).

Results: There was a statistically significant relation of pain with «Staffing and resource adequacy» (r=-0,435, p=0,03) and nosocomial infection with «Nursing foundations for quality of care» (r=-0,424; p=0,04) and «Nurse participation in hospital affairs» (r=-0,516, p=0,01) of the Nursing Work Index. The hospital classification obtained from the Nursing Work Index was associated with the patients' perception of safety (r=0,66, p<0,01). Professionals' perception of participation in patient safety issues was associated with the five factors of the Nursing Work Index (r ∈ [|0,41|-|0,78 |], p<0,046) and with Maslach emotional exhaustion (r=-0,518, p=0,01).

Conclusions: The organizations that foster a supportive work environment will have patients that perceive safer care. In addition, proper resource management could decrease the occurrence of adverse events such as pain.