All ETDs from UAB

Advisory Committee Chair

Patricia Patrician

Advisory Committee Members

Andres Azuero

Martha Dawson

Lori Loan

Rebecca Miltner

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Significance/Background: Work engagement may play a key role in quality patient outcomes. The inpatient hospital experience is a U.S. healthcare system priority with one component of the patients’ hospital experience focused on hospital staff-to-patient communication. Nurses are the main communicators of vital information about inpatient care and recovery and, therefore, play a critical role in achieving high scores on patient experience measures. Past studies show a relationship between high levels of nurse work engagement and positive patient outcomes, such as quality of health services, but it is unknown if hospital nurses’ work engagement is associated with patients’ hospital experience ratings. Purpose: The purpose of the study is to explore the association between hospital nurses’ work engagement and the patients’ ratings of nurse communication, overall hospital stay, and likelihood to recommend the hospital to others. Methods: Using a cross-sectional and correlational design, 448 registered nurses from 43 inpatient units participated in the study along with ratings from 1,259 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Hospital and nurse control variables were in the analysis, as well as a mediation analysis with practice environment. Findings: Participants had an average aggregated level of engagement (4.01). Work engagement only accounted for approximately 5% (Pseudo R2 = 0.05) of the variance in patient ratings of nurse communication and no apparent relationship was observed between WE and patient ratings of the overall hospital and likelihood of recommending the hospital to others. Control variables of Magnet-designation and married status were found to influence patient ratings of the overall hospital (Magnet p-value = 0.00, married p-value = 0.01). Inconsistent mediation was found between the variables of RN communication and practice environment. Discussion: It is important for nurses to know the positive outcomes associated with work engagement. Although this study did not show relationships of work engagement to selected patient ratings, the concept has been shown to be important to patient outcomes and should be considered for future research. Keywords: work engagement, nurses, patient hospital ratings, HCAHPS, practice environment

Included in

Nursing Commons



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