Meta-Analysis of Evidence from the Practice Environment Scale of the Nursing Work Index

The Practice Environment Scale of the Nursing Work Index (PES-NWI) is a National Quality Forum nursing care performance standard with sizable global evidence about nurse practice environments. This research synthesis includes qualitative integration (meta-synthesis) and quantitative integration (meta-analysis). A multinomial meta-analysis was used to model multiple classes of like outcomes for which separate coefficients were estimated. One hundred nineteen articles utilizing the PES-NWI, published from 2002 through 2014, were reviewed and 22 were included in the meta-analysis. Most articles linked practice environments to nurse job outcomes, to nurse-reported assessments of quality, safety, and frequency of adverse events and patient outcomes from administrative data, to organizational outcomes, or to a combination of these outcomes. The preliminary meta-analysis showed strong associations between nursing practice environment and patient safety outcomes. There is also a strong association between practice environment and nurse job outcomes, including dissatisfaction, burnout, and intent to leave.