Nurse Empowerment and Better Patient Outcomes

With hospitals around the U.S. looking at nurse burnout and how it might be affecting patient care, researchers in the past several years have looked at which factors have most contributed to the nurse malaise. Are there some factors that seem to have more impact on nurse dissatisfaction and thus directly impact health outcomes? Or is too difficult to pinpoint one area of concern versus another?

Nurse staffing has become an important consideration in terms of nurse burnout and patient care. In recent study, for example, higher number of nurses were associated with improved survival rates among patients that were very seriously ill. In another study, an increase in nurse numbers was linked to better survival rates in ICU.

But there’s been another thread of study that ties patient outcomes to a nursing work environments. The premise for all of these studies is – a better working environment results in higher nurse satisfaction, which in turn results in better patient safety and outcomes.


Two particular studies appear to confirm this hypothesis.

In one study canvassing nurses in 137 Pennsylvania hospitals, researchers looked at whether or not improvements in nurse work environments over time were associated with lower rates of burnout, intention to leave one’s current position and job dissatisfaction. The results showed that the percentage of nurses with high burnout across hospitals decreased by about 5% between 1999 and 2006 when work environments were improved. Similarly, the percentage of nurses who reported intention to leave diminished from 22.4% to 14.2% during that same time frame and job dissatisfaction decreased from 40% to 31.5%.[1]

But what constitutes an improved work environment and what factors or factor could be deployed to make it happen?

Researchers in Canada tried to tackle that question and the conclusion they reached was – empowered workplaces significantly improved and supported positive outcomes for both nurses and patients.

The researchers looked principally at structural empowerment – those elements within an organization or team that enable an employee to get work done. The also looked at two different structural factors – a formal environment in which power was achieved from specific roles within an organization and informal factors, which were achieved through personal alliances and connections within the work setting.

What did they conclude?


Structural empowerment, mediated through group processes, significantly impacted a variety of patient outcomes.[2] That is, when managers gave employees the opportunity to take more responsibility, initiate or make decisions without having to ask someone, complete a task in one’s own time frame, and take calculated risks without fear of repercussions, a higher level of care was achieved.

The researchers also noted that there were several ways in which managers could foster nurse empowerment. These included:

  1. Increase opportunities for professional growth
  2. Ensure access to information required for care
  3. Provide support and guidance
  4. Provide the necessary resources such as time and equipment to get the job done
  5. Provide regular feedback on performance or change assignments to ensure growth opportunities.

The results of the study suggest that “empowered work environments are predictive of nurses feeling autonomous and self-efficacious, which meant they felt their work was more meaningful and thus contributed to their overall job satisfaction.

[1]Int J Nurs Stud. 2013 Feb;50(2):195-201. doi: 10.1016/j.ijnurstu.2012.07.014. Epub 2012 Aug 14.
Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.
Kutney-Lee A1, Wu ES, Sloane DM, Aiken LH.
[2]Br J Nurs. 2017 Feb 9;26(3):172-176. doi: 10.12968/bjon.2017.26.3.172.
Effects of work environment on patient and nurse outcomes.
Copanitsanou P1, Fotos N2, Brokalaki H3.

To learn more about MedAptus’ patient assignment software — ASSIGN for Nurses — that saves time and balances workloads, click here


Why Nurses Are Hurting and How to Save Them

Earlier this month, MedAptus unveiled our vision for our Assign for Nursing solution at the 2016 American Nurses Credentialing Center (ANCC) National Magnet Conference held in Orlando. Also unveiled at event was a new campaign aimed at helping minimize work related injuries for nurses, “Save Our Nurses.” This movement recognizes the sacrifices nurses make every day to care for their patients and also recommends the implementation of changes to protect those who provide care.

So in the MedAptus booth, we met with hundreds of nurses to talk about how our Assign platform aligns nurses to the right patients, much like a “match.com.” The concept was well received by both nurses and charge nurses. Items of particular interest included workload balancing using acuity, continuity of care across multiple hospitalizations, and, of course, saving time. A few nurses asked, “How do you define the acuity?” Our answer? “We have built a customizable acuity tool that is embedded in the product.” While some thought that was ideal others told us that they have an acuity tool in their EMR. “Not a problem,” we replied. At MedAptus one of our guiding development principles is flexibility, followed closely by interoperability. We know that hospitals want to leverage what they have already and provide workflows that enhance a caregiver’s efficiency, not hinder.

Now, back to the Save Our Nurses movement for a moment. What does it have to do with workload balancing? Well, a lot quite possibly. According to Save Our Nurses, “One of the primary reasons for workplace injuries among caregivers is repositioning patients in bed to make them more comfortable or for clinical assessments/procedures. This includes turning patients from side to side and pulling them up in bed, both of which occur numerous times during every shift. While progress has been made in the industry to reduce this strain, nurses continue to sustain injuries from performing the basic functions of their jobs.”

Imagine if patient distribution could consider the repositioning related requirements of each patient and ensure that “physically intensive” patients could be spread across nursing resources in a fair manner? Well, with MedAptus Assign, this is completely achievable as one of our embedded protocols.

Suffice it so say, we agree completely with Save Our Nurses and their belief that, “It shouldn’t hurt to be a nurse.” While this is focused on the physical pain that can drive some out of the profession at an early age, this can also apply to the emotional pain that can come with the demands of the profession. Feelings of burnout and unfairness related to assignments can have a huge negative impact on a workforce that Congress is currently focused on helping to expand. We think our Assign platform can help tremendously in this area, and we are happy to report that many nurses at the ANCC Conference agreed.