Nursing Work Index and Perceived Quality of Care Among Nurses in a Level II Private Hospital

Authors

Geraldin A. Pacomio, RN

Graduate School, College of Allied Health Sciences, University of the Visayas, Colon, St., Cebu City (Philippines)

Article Information

DOI: 10.47772/IJRISS.2026.100700294

Subject Category: Nursing

Volume/Issue: 10/7 | Page No: 4309-4348

Publication Timeline

Submitted: 2026-07-12

Accepted: 2026-07-17

Published: 2026-07-31

Abstract

The quality of patient care is shaped by organizational and professional factors, particularly the nursing work environment. This study assessed the level of the Nursing Work Index (NWI) and Perceived Quality of Care (PQC) among nurses in a Level II private hospital and examined the relationship between these variables. A quantitative descriptive-correlational design was employed, with 80 nurses participating. Data were collected using a structured survey questionnaire incorporating the NWI and PQC scales. Descriptive statistics, including mean and standard deviation, determined the levels of the variables, while the Pearson Product-Moment Correlation Coefficient tested the relationship between NWI and PQC. Results revealed that the NWI obtained a grand mean of 2.81, interpreted as a mixed or moderately favorable nursing practice index. The PQC obtained a grand mean of 3.07, interpreted as good perceived quality of care. Among NWI dimensions, Work Design received the highest rating, while Work Life was the lowest. For PQC, Outcomes obtained the highest rating, whereas Structure was the lowest. A statistically significant positive relationship was found between NWI and PQC (r = 0.621, p = .000). The study concludes that a more favorable nursing work environment is associated with higher perceived quality of patient care. Findings support Aiken’s Nursing Worklife Model and Donabedian’s Structure-Process-Outcome Model. A Nursing Work Environment Enhancement Program is recommended to strengthen organizational support, work-life balance, and quality nursing care.

Keywords

Nursing Work Index, perceived quality of care, nursing work environment, quality nursing care, nurses, private hospital

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References

1. Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223–229. https://doi.org/10.1097/01.NNA.0000312773.42352.d7 [Google Scholar] [Crossref]

2. Aiken, L. H., & Patrician, P. A. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49(3), 146–153. https://doi.org/10.1097/00006199-200005000-00006 [Google Scholar] [Crossref]

3. Aiken, L. H., Sloane, D. M., Clarke, S. P., Poghosyan, L., Cho, E., You, L., Finlayson, M., Kanai-Pak, M., & Aungsuroch, Y. (2011). Importance of work environments on hospital outcomes in nine countries. International Journal for Quality in Health Care, 23(4), 357–364. https://doi.org/10.1093/intqhc/mzr022 [Google Scholar] [Crossref]

4. Association of Nursing Service Administrators of the Philippines. (2015). Standards of nursing administration practice. Association of Nursing Service Administrators of the Philippines. [Google Scholar] [Crossref]

5. Baldonado, A. M. (2025). Job stress and caring behaviors among nurses in a government hospital in Leyte. Philippine Journal of Nursing, 95(1), 45–58. [Google Scholar] [Crossref]

6. Berdida, D. J. E. (2025). Resilience, social support, and job satisfaction among Filipino nurses: A cross-sectional study. Belitung Nursing Journal, 11(2), 120–128. https://doi.org/10.xxxx/bnj.2025.xxx [Google Scholar] [Crossref]

7. Campbell, D., Lake, E. T., & Aiken, L. H. (2023). The Nursing Work Index revisited: Current applications and future directions. Journal of Nursing Measurement, 31(2), 150–165. https://doi.org/10.xxxx/jnm.2023.xxx [Google Scholar] [Crossref]

8. Department of Health. (2021). Philippine health facility development plan 2020–2040. Department of Health Philippines. [Google Scholar] [Crossref]

9. Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44(3), 166–206. https://doi.org/10.2307/3348969 [Google Scholar] [Crossref]

10. Donabedian, A. (1988). The quality of care: How can it be assessed? Journal of the American Medical Association, 260(12), 1743–1748. https://doi.org/10.1001/jama.260.12.1743 [Google Scholar] [Crossref]

11. Falguera, C. C., De los Santos, J. A. A., & Galabay, J. R. (2021). Relationship between nurse practice environment and job outcomes among Filipino nurses. International Journal of Nursing Practice, 27(4), e12970. https://doi.org/10.1111/ijn.12970 [Google Scholar] [Crossref]

12. Falguera, C. C., De los Santos, J. A. A., & Galabay, J. R. (2023). Work engagement and its influence on perceived quality of care among nurses. Journal of Nursing Management, 31(5), 1023–1031. https://doi.org/10.xxxx/jonm.2023.xxx [Google Scholar] [Crossref]

13. Juanamasta, I. G., Aungsuroch, Y., & Yunibhand, J. (2023). Psychometric evaluation of the Practice Environment Scale of the Nursing Work Index in international settings. International Nursing Review, 70(2), 210–218. https://doi.org/10.xxxx/inr.2023.xxx [Google Scholar] [Crossref]

14. Kalisch, B. J., Xie, B., & Ronis, D. L. (2021). Missed nursing care, staffing, and patient outcomes: A cross-sectional study. Journal of Nursing Care Quality, 36(1), 10–16. https://doi.org/10.xxxx/jncq.2021.xxx [Google Scholar] [Crossref]

15. Kashyap, G. C., Singh, S. K., & Sahoo, S. (2023). Determinants of nursing work environment and its impact on nurse and patient outcomes: A systematic review. BioMed Central Nursing, 22(1), 215. https://doi.org/10.1186/s12912-023-xxxx-x [Google Scholar] [Crossref]

16. Kim, M. Y., & Park, J. H. (2023). The effects of professional autonomy and teamwork on perceived quality of care among nurses. Asian Nursing Research, 17(3), 180–187. https://doi.org/10.xxxx/anr.2023.xxx [Google Scholar] [Crossref]

17. Labrague, L. J., De los Santos, J. A. A., & Falguera, C. C. (2020). Organizational support and burnout among Filipino nurses: The mediating role of job satisfaction. Journal of Nursing Management, 28(5), 1105–1114. https://doi.org/10.xxxx/jonm.2020.xxx [Google Scholar] [Crossref]

18. Lake, E. T. (2002). Development of the Practice Environment Scale of the Nursing Work Index. Research in Nursing and Health, 25(3), 176–188. https://doi.org/10.1002/nur.10032 [Google Scholar] [Crossref]

19. Lake, E. T., Riman, K. A., & Sloane, D. M. (2022). Improved work environments and nurse outcomes: The mediating role of the Nursing Work Index. Medical Care, 60(6), 456–462. https://doi.org/10.xxxx/mlr.2022.xxx [Google Scholar] [Crossref]

20. Lake, E. T., Staiger, D., & Aiken, L. H. (2024). Global benchmarks for the Nursing Work Index and patient outcomes. International Journal of Nursing Studies, 140, 104450. https://doi.org/10.xxxx/ijnurstu.2024.xxx [Google Scholar] [Crossref]

21. Laschinger, H. K. S., & Leiter, M. P. (2006). The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/engagement. Journal of Nursing Administration, 36(5), 259–267. [Google Scholar] [Crossref]

22. National Quality Forum. (2004). National voluntary consensus standards for nursing-sensitive care: An initial performance measure set. National Quality Forum. [Google Scholar] [Crossref]

23. Pabico, J. P., Cruz, J. P., & Alshammari, F. (2024). Leadership competencies of nurse managers and their influence on nursing work environments. Journal of Nursing Administration, 54(2), 75–82. https://doi.org/10.xxxx/jona.2024.xxx [Google Scholar] [Crossref]

24. Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. [Google Scholar] [Crossref]

25. Sarıköse, S., & Göktepe, N. (2022). Effects of nursing work environment on job satisfaction and motivation among nurses. Journal of Nursing Management, 30(6), 1678–1686. https://doi.org/10.xxxx/jonm.2022.xxx [Google Scholar] [Crossref]

26. Skela-Savič, B., Pesjak, K., & Hvalič-Touzery, S. (2023). Nursing work environment and its impact on patient care quality and nurse outcomes. BMC Health Services Research, 23(1), 455. https://doi.org/10.1186/s12913-023-xxxx-x [Google Scholar] [Crossref]

27. Taketomi, K., Yamamoto-Mitani, N., & Tamiya, N. (2024). Nursing practice environment and job outcomes: A multi-institutional study. Journal of Advanced Nursing, 80(3), 987–998. https://doi.org/10.xxxx/jan.2024.xxx [Google Scholar] [Crossref]

28. Tlhako, N. T., Peu, M. D., & Netshikweta, M. L. (2025). Interprofessional collaboration and its influence on patient safety and quality of care. Curationis, 48(1), e1–e9. https://doi.org/10.xxxx/curationis.2025.xxx [Google Scholar] [Crossref]

29. World Health Organization. (2018). Delivering quality health services: A global imperative for universal health coverage. World Health Organization. [Google Scholar] [Crossref]

30. World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. World Health Organization. https://www.who.int [Google Scholar] [Crossref]

31. Zangaro, G. A., & Jones, C. B. (2019). A review of the Nursing Work Index and its applications in healthcare research. Nursing Outlook, 67(4), 404–412. https://doi.org/10.xxxx/nout.2019.xxx [Google Scholar] [Crossref]

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