The impact of restructuring and work design on nursing practice and patient care

The purpose of this study was to examine if registered nurses' (RNs) reports of the structure, work processes and performance of Massachusetts hospitals have changed over a five year period. Responses of 928 randomly selected RNs surveyed in 1989 and 858 randomly selected RNs in 1994 to the RN Quality of Worklife Survey (RNQOWS) were compared. Data analysis was performed with a between-subjects multivariate analysis of covariance, controlling for number of years as an RN and as a member of a collective bargaining unit. Significant differences were found in the variables that measure human resources, administrative motivating conditions, task effectiveness, and efficiency (p < 0.001). The implications of the findings for nursing practice in hospitals is discussed and recommendations are made for further research.