The Nursing Worklife Model4 served as the
theoretical framework for this study. The model
describes relationships among nursing worklife
factors, burnout, and nurse and patient outcomes.
In this model, 5 worklife factors identified by
Lake5 as characteristics of effective professional
nursing practice environments interact with each
other and affect nurse and patient outcomes
through the burnout/engagement process. The 5
worklife factors are the following: (1) effective
nursing leadership, (2) staff participation in organizational
affairs, (3) adequate staffing for quality
care, (4) support for a nursing (vs medical) model
of patient care, and (5) effective nurse/physician
relationships. Leiter and Laschinger6 described
how these factors interact to predict the extent of
nurses’ burnout or engagement with their work. In
that study, nursing leadership was found to be the
driving force of the model, strongly influencing the
other professional practice environment factors,
which in turn influenced the degree of work
engagement/burnout. In this study, we further test
the model by adding patient safety as an outcome
of this process.