Nursing care delivery models and their impact on emotional exhaustion and practice environment: A cross-sectional study in Saudi Arabia

Background: Nursing staff outcomes, such as job satisfaction, work quality, emotional well-being, intent to leave, and the practice environment, have been linked to improvements in patient outcomes and staff job satisfaction. However, existing studies have not captured the impact of nursing models on emotional exhaustion and practice environments in the context of Saudi Arabia. Additionally, there is a gap in empirical evidence regarding the effectiveness of organizing nursing work within a total nursing or team nursing care model in ensuring staff well-being. Objective: This study aimed to examine the nursing care models used in a government hospital and their association with nurses’ emotional exhaustion and perceptions of the practice environment. Methods: A cross-sectional study was conducted with 314 nurses working at a hospital. Data were collected from January to May 2024 using the Maslach Burnout Inventory™ (MBI) to measure emotional exhaustion and the Practice Environment Scale of the Nursing Work Index (PES-NWI) to assess perceptions of the practice environment. Regression analyses were performed to examine the relationships between the nursing care model, emotional exhaustion, and the practice environment. Results: Among the 314 nurses surveyed, 201 (64%) reported using a total care model, 103 (32.8%) used a team nursing model, and 10 (3.2%) were unsure of the model used. Regression analysis revealed a significant association between the nursing care model and emotional exhaustion (p <0.001), with 42.5% of the variance in emotional exhaustion explained by the nursing care model (R² = 0.425). For the practice environment, a significant association was observed with the nursing care model (p <0.001), explaining 85.9% of the variance in the practice environment (R² = 0.859). Conclusion: The findings may guide nurse managers and policymakers in adopting nursing care models that best suit their organizations to enhance the quality of care. It is essential for hospitals to implement more flexible nursing care delivery models to enable nurses to utilize their full range of training and capabilities. These results have implications for healthcare administration and strategies that support the effective delivery of sustainable and holistic nursing care.