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Organizational Effects on Patient Satisfaction in Hospital Medical-Surgical Units

Bacon, Cynthia Thornton MSN, RN; Mark, Barbara PhD, RN, FAAN

Journal of Nursing Administration: May 2009 - Volume 39 - Issue 5 - p 220-227
doi: 10.1097/NNA.0b013e3181a23d3f

Objective: The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients' satisfaction with nursing care in hospitals.

Background: Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited.

Methods: The data source for this study was the Outcomes Research in Nursing Administration Project, a multisite organizational study conducted to investigate relationships among nurse staffing, organizational context and structure, and patient outcomes. The sample for this study was 2,720 patients and 3,718 RNs in 286 medical-surgical units in 146 hospitals.

Results: Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status, and better symptom management were also associated with higher levels of patient satisfaction.

Conclusions: Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses' work engagement and effective symptom management, are important influences on patient satisfaction.

Authors' Affiliations: Doctoral Student (Ms Bacon), and Sarah Frances Russell Distinguished Professor (Dr Mark), School of Nursing, University of North Carolina at Chapel Hill.

Corresponding author: Ms Bacon, c/o Dr Barbara Mark, School of Nursing, University of North Carolina at Chapel Hill, Campus Box 7460, Carrington Hall, Chapel Hill, NC 27599 (

Funding sources: National Institute of Nursing Research (National Institutes of Health) grant nos. 5R01NR003149 ("A Model of Patient and Nursing Administration Outcomes") and 5T32NR008856 ("Research Training: Health Care Quality and Patient Outcomes").

© 2009 Lippincott Williams & Wilkins, Inc.