The influence of nursing unit empowerment and social capital on unit effectiveness and nurse perceptions of patient care quality.

OBJECTIVE This study tested a multilevel model examining the effects of work-unit structural empowerment and social capital on perceptions of unit effectiveness and nurses' ratings of patient care quality. BACKGROUND Structural empowerment and social capital are valuable resources for staff nurses that promote work effectiveness and high-quality patient care. No studies have examined social capital in nursing at the group level. METHODS A cross-sectional survey of 525 nurses in 49 nursing units in 25 acute care hospitals in Ontario was conducted to test the hypothesized multilevel model using structural equation modeling. RESULTS Both unit-level structural empowerment and social capital had significant effects on unit effectiveness (β = .05 and β = .29, P < .05, respectively). Unit-level predictors explained 87.5% of level 2 variance in individual nurses' ratings of patient care quality. CONCLUSIONS This study provides a better understanding of how unit-level structural empowerment and social capital affect both unit- and individual-level outcomes.