Measuring nursing unit environments with four composite measure.

Understanding the context in which nurses work is an important step to designing work environments in which nurses can achieve targeted quality. Developing a usable instrument for describing the work environment and the relationship to staffing is essential for the development of evidence-based staffing decisions. The major implications of the research reported here are that the work environment of nurses, while complex, can be modeled with composite variables that reflect various dimensions of that environment. This ability to model the environment with fewer variables enhances the interpretation of environmental factors that have the greatest impact on patient outcomes. This reduction is valuable to the clinician, manager, and administrator in determining the key factors that need to be altered in the work environment to improve the quality of the patient experience.