Organizational Support for Nurse Practitioners in Primary Care and Workforce Outcomes.

Lusine Poghosyan, Affan Ghaffari, Jianfang Liu, Matthew D McHugh
Author Information
  1. Lusine Poghosyan: Lusine Poghosyan, PhD, RN, FAAN, is Stone Foundation and Elise D. Fish Associate Professor, Columbia University School of Nursing, New York, New York. Affan Ghaffari, PhD, is Research Coordinator, Columbia University School of Nursing, New York, New York. Jianfang Liu, PhD, is Assistant Professor of Quantitative Research, Columbia University School of Nursing, New York, New York. Matthew D. McHugh, PhD, JD, RN, CRNP, FAAN, is Professor of Nursing, University of Pennsylvania School of Nursing, Philadelphia.

Abstract

BACKGROUND: Lack of organizational support in healthcare settings has been linked to high levels of clinician stress, burnout, and job dissatisfaction. Little research exists on organizational support for nurse practitioners.
OBJECTIVE: We investigated the relationship between organizational support and nurse practitioner outcomes, including job satisfaction, intent to leave, and quality of care.
METHODS: A cross-sectional survey design was used to collect survey data from nurse practitioners (n = 398) in primary care practices in New York State in 2017. Nurse practitioners completed mail surveys with validated measures of organizational support, job satisfaction, intent to leave, and quality of care. Information on participant demographics and work characteristics was also collected. Multilevel regression models assessed the relationship between organizational-level organizational support and resources measure and job satisfaction, intent to leave, and quality of care.
RESULTS: The organizational-level organizational support and resources measure had a mean of 3.31 on a 4-point scale. Twenty-five percent of the participants were either moderately dissatisfied or very dissatisfied with their jobs, and about 11% intended to leave their current jobs within 1 year. The average quality of care rated by participants was 8.51 out of 10-10 being the best quality of care. After adjusting for covariates, higher organizational-level organizational support and resources measure score was associated with higher job satisfaction category, lower odds of intent to leave, and higher quality of care.
DISCUSSION: Nurse practitioners from primary care practices with higher levels of organizational support are more likely to be satisfied with their jobs, have less intent to leave their jobs, and report better quality of care. Thus, in order to promote nurse practitioner job satisfaction, retain them in clinical positions, and improve quality of care, administrators should take actions to promote organizational support for them. Our findings are consistent with existing literature regarding the relationship between organizational support and clinician outcomes.

References

  1. Health Care Manage Rev. 2015 Jan-Mar;40(1):46-55 [PMID: 24727678]
  2. Policy Polit Nurs Pract. 2013 Feb;14(1):6-15 [PMID: 23528433]
  3. Nurs Outlook. 2016 Jan-Feb;64(1):71-85 [PMID: 26475528]
  4. Health Care Manage Rev. 2017 Apr/Jun;42(2):162-171 [PMID: 26587998]
  5. J Appl Psychol. 1997 Apr;82(2):247-52 [PMID: 9109282]
  6. Health Aff (Millwood). 2011 Feb;30(2):202-10 [PMID: 21289340]
  7. J Gen Intern Med. 2015 Aug;30 Suppl 3:S595-601 [PMID: 26105676]
  8. Health Aff (Millwood). 2018 Jun;37(6):908-914 [PMID: 29863933]
  9. Ann Fam Med. 2013 May-Jun;11(3):272-8 [PMID: 23690328]
  10. J Adv Nurs. 2004 Dec;48(5):519-29 [PMID: 15533090]
  11. J Appl Psychol. 2002 Aug;87(4):698-714 [PMID: 12184574]
  12. Acad Med. 2010 Jun;85(6):947-58 [PMID: 20505392]
  13. Med Care. 2018 Jun;56(6):484-490 [PMID: 29613873]
  14. J Prof Nurs. 2013 Nov-Dec;29(6):338-49 [PMID: 24267928]
  15. Med Care Res Rev. 2018 Feb;75(1):66-87 [PMID: 29148318]
  16. Nurs Res. 2013 Sep-Oct;62(5):325-34 [PMID: 23995466]
  17. J Gen Intern Med. 2015 Aug;30(8):1105-11 [PMID: 25724571]
  18. Health Serv Res. 2016 Aug;51(4):1407-23 [PMID: 26707840]
  19. Health Serv Res. 2017 Feb;52 Suppl 1:481-507 [PMID: 28127767]
  20. J Appl Psychol. 2005 Nov;90(6):1217-27 [PMID: 16316275]
  21. Int J Qual Health Care. 2011 Aug;23(4):357-64 [PMID: 21561979]
  22. Res Nurs Health. 2012 Dec;35(6):566-75 [PMID: 22911102]

Grants

  1. R03 HS024758/AHRQ HHS

MeSH Term

Cross-Sectional Studies
Female
Health Workforce
Humans
Intention
Job Satisfaction
Male
Middle Aged
New York
Nurse Practitioners
Organizational Culture
Personnel Turnover
Primary Health Care
Quality of Health Care
Surveys and Questionnaires

Word Cloud

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