Michelle Simpson, PhD, RN, Assistant Professor

To create a work setting that enables nurses and CNAs to deliver the resident centered quality care they are capable of providing.

Nurses performance is critical to achieving optimal patient outcomes (NQF, 2004; JCAHO, 2005) Factors that best predict optimal nurse performance have been elusive. Attitudinal predictors – weakest association Job satisfaction Most commonly studied factor in the work attitude-turnover relationship A main premise of the study of job satisfaction has been the more satisfied the employee, the better their job performance.

Nurses and CNAs job satisfaction r/t turnover intention and turnover Job satisfaction r/t resident satisfaction Job satisfaction r/t family satisfaction (Probst et al., 2010) Job satisfaction and job performance outcomes (i.e., quality of care outcomes) relationship is not supported. Weak association between job satisfaction and job performance (Iaffaldano & Muchinsky 1985, Judge et al. 2001)

Defined broadly: A persons general attitude (or positive feelings) toward their job or toward specific dimensions of their job (McNeese,-Smith, 1996; McCloskey & McCain, 1988) Focus is on the positive (or negative) feelings about various factors of work (i.e., pay, leadership) vs the actual feelings (happiness, sadness, excitement) while working This distinction is not unimportant

Varying measurements comprised of numerous factors Mental model is comprehensive, training,,, Work environment Management Leadership Supervisor Learning Salary/wages Challenge Benefits Best predictors of job satisfaction: pay and leadership Job Satisfaction Morale

A positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption (Schaufeli, Salanova et al., 2002; 2003) Vigor and dedication conceptualized as opposite emotional exhaustion and cynicism (burnout dimensions). Emprically distinct from burnout, job involvement and organizational commitment (Duran, Extremera, & Rey, 2004; Gonzalex,-Roma,Schaufeli, Bakker, & Lloret, 2006; Hallberg & Schaufeli, 2006; Schaufeli, Martinez et al., 2002; Schaufeli, Salanova et al., 2002)

Rather than a momentary and specific state, engagement refers to a more persistent and pervasive affective-cognitive state that is not focused on any particular object, event, individual, or behavior. Vigor is characterized by high levels of energy and mental resilience while working, the willingness to invest effort in ones work, and persistence even in the face of difficulties. Dedication refers to being strongly involved in ones work and experiencing a sense of significance, enthusiasm, inspiration, pride, and challenge. Absorption is characterized by being fully concentrated and happily engrossed in ones work, whereby time passes quickly and one has difficulties with detaching oneself from work (Schaufeli, Salanova, 2002, p.74).

42 studies, 36 independent companies (Harter, Schmidt, Hayes, 2002) Relationship between engagement and Employee turnover, Customer satisfaction-loyalty, Safety Profitability Productivity (job performance) Higher performance in work groups with higher levels of engagement.

Laschinger & Leiter, 2006 Salanova, Agut, & Peiro, 2005 Schaufeli & Bakker, 2004 Xanthopoulou, Bakker, Demerouti, & Schaufeli, 2008

Thinking of Quitting, Professional status, Interaction 47% of the variance explained (Simpson,2009) Six areas of worklife (workload, control, rewards, community, fairness, value) (Laschinger & Leiter 2006) Core Work Environment Resources (physical, psychological, social) (Simpson, In review)

Physical Resources Equipment, materials Recovery Social Resources Co-worker relationship Co-worker support Core Work Environment Resources Psychological Resources Formal nursing leadership: Contribution Recognition Growth, development unit-specific foundational

To date, research suggests work engagement is a promising concept to consider in the study of Nurses and other nursing staff (CNA) job performance (e.g., resident quality outcomes) Other long-term care organizational outcomes including employee safety (injury) and financial indicators

Move beyond merely retaining nursing staff to retaining highly engaged nursing staff. Systematically focus on: work engagement by targeting core work environment resources Continue to collaborate on studies so that we can gain more understandings of what factors best predict nurses and other nursing staff job performance