THE NURSING PRACTICE ENVIRONMENT, STAFF RETENTION, AND QUALITY OF CARE

The effects of key factors in the nursing practice environment-managem ent style, group cohesion, job stress, organizational job satisfaction , and professional job satisfaction-on staff nurse retention and proce ss aspects of quality of care were examined. Hinshaw and Atwood's (198 5) anticipated turnover model was modified and expanded to include rel evant antecedent and outcome variables. The four-stage theoretical mod el was tested using data from 50 nursing units at four acute care hosp itals in the southeast. The model explained 49% of the variance in sta ff nurse retention and 39% of the variance in process aspects of quali ty of nursing care. Study findings warrant careful consideration in li ght of recent practice environment changes:experience on the unit and professional job satisfaction were predictors of staff nurse retention ; job stress and clinical service were predictors of quality of care. The variable contributing the most to indirect, and in turn, total mod el effects, was that of management style. These results substantiate t he belief that aspects of the practice environment affect staff nurse retention, and most importantly, the quality of care delivered on hosp ital nursing units. (C) 1996 John Wiley & Sons, Inc.