Organizational Environment and Its Association With Burnout and Turnover Intention Among Hospital Nurses: A Cross‐Sectional Study

AIMS: To examine how organizational environment characteristics relate to burnout and turnover intention among hospital nurses and how much burnout accounts for that relationship. DESIGN: Secondary analysis of cross-sectional data from the 2022 National Sample Survey of Registered Nurses. METHODS: The analysis included 6592 hospital-based registered nurses in direct patient care, surveyed in the United States in 2022. A six-item organizational environment index was constructed and psychometrically examined. Weighted logistic regression examined associations with each outcome, and the association with turnover intention was decomposed by the Karlson-Holm-Breen method, with variances from the supplied replicate weights. RESULTS: Among nurses eligible to answer each item, 87.3% reported having felt burned out and 67.0% had considered leaving. The index was internally consistent and unidimensional. Each one-point increase was associated with about half the adjusted odds of each outcome. Burnout was the strongest correlate of turnover intention, accounting for 21.7% of its association with the environment. CONCLUSION: A more supportive organizational environment is associated with substantially lower odds of burnout and of turnover intention, part of which burnout accounts for. Cross-sectional data cannot establish causation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Organizational commitment to evidence-based, team-based, and quality-focused care is a candidate target for interventions to reduce burnout and improve retention. IMPACT: What problem did the study address? How far modifiable organizational characteristics relate to hospital nurse burnout and turnover intention. What were the main findings? Organizational environment support was independently associated with both outcomes; about one fifth of its association with turnover intention was accounted for by burnout. Where and on whom will the research have an impact? Hospital administrators and workforce policymakers setting organizational priorities. REPORTING METHOD: This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology reporting guideline for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.