Effects of self-rated workload and nurse staffing on work engagement among nurses: A cross-sectional survey

Aim To analyse net effects of self-rated workload and nurse staffing (nurse-to-patient ratio and staff skill mix) on work engagement among clinical nurses. Background Improving nurses' engagement is necessary to enhance patient outcomes, so factors that influence engagement should be explored. Methods A cross-sectional study was conducted in 1,428 registered nurses from 145 units of 11 hospitals. A hierarchical linear model was used to analyse the data. Results Self-rated workload had a negative effect on engagement (beta = -0.353, p < .001, effect size (f(2)) = 14.20%), while only one index of skill mix (percentage of nurses with <= 5 work years) had a significant effect on engagement, which was positive (beta = 0.258, p < .05, f(2) = 8.50%). These two variables explained 22.7% of the variance of engagement at the unit level (R-between(2) = 22.7%, p < .05). No significant effect of staffing on self-rated workload was found. Conclusions Self-rated workload had more effect on engagement than did staffing, and factors that influence self-rated workload need to be explored. Implications for nursing management Balancing the mix of experience levels in nursing teams may improve work engagement. Managers should pay attention to multiple strategies to motivate nurses to engage in work in clinical practice.

Automated summary

The study analyzed the net effects of self-rated workload and nurse staffing on work engagement among clinical nurses. Self-rated workload had a larger impact on engagement than staffing. Balancing the mix of experience levels in nursing teams can improve work engagement.