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The Influence of Nursing Unit Empowerment and Social Capital on Unit Effectiveness and Nurse Perceptions of Patient Care Quality

Spence Laschinger, Heather K. PhD, RN, FAAN; Read, Emily MSc, RN; Wilk, Piotr PhD; Finegan, Joan PhD

Journal of Nursing Administration: June 2014 - Volume 44 - Issue 6 - p 347–352
doi: 10.1097/NNA.0000000000000080

OBJECTIVE: This study tested a multilevel model examining the effects of work-unit structural empowerment and social capital on perceptions of unit effectiveness and nurses’ ratings of patient care quality.

BACKGROUND: Structural empowerment and social capital are valuable resources for staff nurses that promote work effectiveness and high-quality patient care. No studies have examined social capital in nursing at the group level.

METHODS: A cross-sectional survey of 525 nurses in 49 nursing units in 25 acute care hospitals in Ontario was conducted to test the hypothesized multilevel model using structural equation modeling.

RESULTS: Both unit-level structural empowerment and social capital had significant effects on unit effectiveness (β = .05 and β = .29, P < .05, respectively). Unit-level predictors explained 87.5% of level 2 variance in individual nurses’ ratings of patient care quality.

CONCLUSIONS: This study provides a better understanding of how unit-level structural empowerment and social capital affect both unit- and individual-level outcomes.

Author Affiliations: Distinguished University Professor and Arthur Labatt Family Nursing Research Chair in Health Human Resources Optimization (Dr Spence Laschinger); Doctoral Student (Ms Read), Arthur and Sonia Labatt Family School of Nursing; Assistant Professor, Schulich School of Medicine and Dentistry, Department of Paediatrics and Epidemiology & Biostatistics (Dr Wilk); and Associate Professor and Associate Dean Faculty of Social Science, Department of Psychology (Dr Finegan), University of Western Ontario, London, Canada.

This study was funded by a research grant from the Canadian Social Sciences and Humanities Research Council.

The authors declare no conflicts of interest.

Correspondence: Dr Spence Laschinger, University of Western Ontario, Health Sciences Addition Room H41, 1151 Richmond St, London, ON, Canada N6A 5C1 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins