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The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub‐scales from the Nursing Work Index – Revised (NWI‐R) to assess the nursing work environment and the performance of these sub‐scales across different units in a hospital. Data were derived from a cross‐sectional survey of 243 nurses from 13 units of a 300‐bed university‐affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five sub‐scales were confirmed; three of the sub‐scales had greater ability to discriminate between units. Using hierarchical regression models, “resource adequacy” was the sub‐scale most strongly associated with the perceived quality of care at the last shift. The NWI‐R sub‐scales are potentially useful for comparison of work environments of different nursing units at the same hospital.

The purpose of this article is to investigate the performance of scales to assess the work environment of hospital professional staff, other than nurses or physicians.

A survey was conducted among professional (non‐nursing or medical) staff at a 300‐bed urban, university‐affiliated Canadian hospital. A total of 24 work environment items were adapted from a scale previously validated among nursing staff. Scales were developed based on a principal components analysis, and were compared among four groups of staff. The relationships between the scales and the following measures were then explored using univariate and multivariate analyses: satisfaction with the work environment, perceived quality of patient care, perceived frequency of patient/family complaints, work‐related injuries, and verbal abuse of staff.

The survey response rate was 154/200 (76.6 percent). Four scales were identified (with corresponding Cronbach's alpha), assessing the following aspects of the work environment: supervisory support (0.88), team‐work (0.84), professionalism (0.77), and interdisciplinary relations (0.64). In multivariate analyses, there were significant differences between the job groups in all four scales. One or more of the scales was significantly associated with overall satisfaction, perceived quality, and adverse incidents, even after adjustment for other staff characteristics.

Limitations include: the cross‐sectional design, subjective measurement of quality of care, small sample sizes in some groups of staff, and the single study site.

The scales developed in this study may be used by managers to assess hospital staff perceptions of the work environment.

The four proposed scales appear to measure meaningful aspects of the working environment that are important in determining overall satisfaction with the work environment and are related to quality of care.