Impact of Nurse Manager Span-of-Control on Turnover and Patient Safety in Acute Care

This article describes span of control (SOC) and organizational support for nurse managers (NMs) and impact on performance outcomes.

NMs report excessive workloads that negatively affect personal well-being and performance outcomes. Understanding NM SOC is essential for informing strategies to enhance performance outcomes.

This cross-sectional study explored the relationship between NM SOC, organizational support, and performance outcomes.

Data from 255 NMs, overseeing 296 units across 47 hospitals, showed nurse turnover was significantly correlated with NM to full-time equivalent (FTE) and NM-to-bed ratios. Higher fall rates were associated with higher 24-hour census and NM-to-bed ratio. No significant associations were found between SOC and hospital-acquired pressure injuries.

Wide variations in SOC and organizational support were noted among this sample. Findings from this study suggest that smaller units with smaller teams have an advantage in creating a better nurse workforce and clinical patient outcomes. Creating manageable NM workloads may yield better nurse and patient outcomes.