ArticleInternational journal of nursing studies2017
Association of nurse work environment and safety climate on patient mortality: A cross-sectional study.
Article in International journal of nursing studies, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
58 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Towards a Quality Care Climate Perspective: A Systematic Review of Associations Among Patient Experience, Patient Outcomes, and Organisational Climate Factors in Hospitals.International journal of environmental research and public health · 2026Pooled it
- Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Systematic review: Nurses' safety attitudes and their impact on patient outcomes in acute-care hospitals.Nursing open · 2022Pooled it
- The relationship between the nursing practice environment and five nursing-sensitive patient outcomes in acute care hospitals: A systematic review.Nursing open · 2021Pooled it
- Are hospital nurse staffing practices associated with postoperative cardiac events and death? A systematic review.PloS one · 2019Pooled it
- The impact of intraoperative non-technical skills training on scrub practitioners' self-efficacy: a randomized controlled trial.BMC medical education · 2025Trial
- No effect of learning from excellence on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study.BMC health services research · 2026Observational
- A panel study of job demands and practices toward infection prevention and control among healthcare workers: the moderating role of competing safety climate constructs.Industrial health · 2026Article
- The Role of Surveillance in the Association Between the Nurse Work Environment and Patient Safety Culture.Research in nursing & health · 2026Article
- Pathway to Excellence Designation, Nurse Work Environment, and Hospital Quality and Safety: A Multi-State Hospital Study.Research in nursing & health · 2026Article
- Nursing Practice Environments and Professional and Care-Related Outcomes in Portuguese Emergency Services: A Descriptive Study of 2018 and 2022.Nursing reports (Pavia, Italy) · 2026Article
- Status and related factors of medication safety behaviour of nurses in the operating room: A cross-sectional survey in China.PloS one · 2025Article
- The Safety Climate and Patient Safety Activities in Mental Health Nurses: The Mediating Effect of Safety Control.Healthcare (Basel, Switzerland) · 2024Article
- The Impact of Work Environment on Structural Empowerment among Nurses in Governmental Hospitals.Nursing reports (Pavia, Italy) · 2024Article
- Influence of the work environment of nurses on the 30-day mortality of patients hospitalized in Polish hospitals. cross-sectional studies.BMC nursing · 2024Article
- Assessment of Nursing Practice Environment and Its Influencing Factors: A Cross-Sectional Study at Shandong Province, Jinan.Risk management and healthcare policy · 2024Article
- I Was Merely a Brick in the Game: A Qualitative Study on Registered Nurses' Reasons for Quitting Their Jobs in Hospitals.Journal of nursing management · 2024Article
- Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care.BMC nursing · 2023Article
- Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman.Sultan Qaboos University medical journal · 2023Article
- Turkish Version of the Perceived Future Decent Work Securement Scale: Validity and Reliability for Nursing Students.Safety and health at work · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundThere are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes.
objectiveTo determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality.
designCross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics.
settingAcute care hospitals in California, Florida, New Jersey, and Pennsylvania.
participantsThe sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients.
methodsNurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression.
resultsIn a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316).
conclusionsWe found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.