{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:54:24Z","timestamp":1777949664467,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":122,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["123541"],"award-info":[{"award-number":["123541"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nurse and patient outcomes in South Africa were poor before COVID\u201019 and are believed to have worsened during and after the pandemic. Limited evidence exists on modifiable organisational factors contributing to these outcomes hindering targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This paper aims to develop a better understanding of potentially modifiable organisational factors of hospitals that, if addressed, would likely contribute to improving nurse wellbeing and retention, and quality and safety of patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were collected from 143 private and public hospitals (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094298 nurses) across South Africa using a cross\u2010sectional survey. Independent variables included working time with COVID\u201019 patients, incidence of death and dying, resources, staffing, and the practice environment; dependent variables focused on nurse outcomes (job satisfaction, intent to leave, burnout, mental and physical health) and patient outcomes (quality of care and patient safety).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nurse and patient outcomes were worse in public compared to private hospitals. Favourable practice environments had the strongest association with nurse and patient outcomes, followed by staffing and resources. Within the practice environment, nurse management, leadership and support of nurses showed the greatest association with job satisfaction (OR\u2009=\u20094.71\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20093.97\u20135.58), lower intent to leave (OR\u2009=\u20092.81\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20092.33\u20133.38) and more favourable mental health (OR\u2009=\u20092.58\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20092.19\u20133.04). Greater nurse participation in hospital affairs was associated with more favourable nurse assessments of quality of care (OR\u2009=\u20093.74\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20093.22\u20134.33 to OR\u2009=\u20096.51\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20093.81\u20134.95) and patient safety (OR\u2009=\u20094.35\n                      <jats:sup>\u2217\u2217<\/jats:sup>\n                      ; 95% CI\u2009=\u20093.81\u20134.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interventions to improve nurse wellbeing and retention as well as quality and safety of care should focus on improving hospital practice environments, specifically nurse manager expertise, nurse leadership, nurse participation in hospital affairs, and adequate staffing and resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/1853384","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:35:21Z","timestamp":1777865721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse and Patient Outcomes in Private and Public Hospitals in South Africa During the COVID\u201019 Pandemic: A Cross\u2010Sectional Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-0926","authenticated-orcid":false,"given":"Siedine K.","family":"Coetzee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8004-3630","authenticated-orcid":false,"given":"Linda H.","family":"Aiken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0590-2148","authenticated-orcid":false,"given":"Alwiena J.","family":"Blignaut","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6855-1031","authenticated-orcid":false,"given":"Anelle","family":"Erasmus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6952-7060","authenticated-orcid":false,"given":"Nicholin","family":"Scheepers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-6611","authenticated-orcid":false,"given":"Babalwa","family":"Tau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1270-3711","authenticated-orcid":false,"given":"Nokwanda Edith","family":"Bam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-0576","authenticated-orcid":false,"given":"Erika","family":"Fourie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"e_1_2_11_1_2","unstructured":"National Department of Health 2nd Presidential Health Summit 2023 https:\/\/www.gov.za\/news\/media-advisories\/conferences-summits-seminars-and-workshops\/president-cyril-ramaphosa-15."},{"key":"e_1_2_11_2_2","unstructured":"National Department of Health 2030 Human Resources for Health Strategy: Investing in the Health Workforce for Universal Health Coverage 2020 https:\/\/www.health.gov.za\/wp-content\/uploads\/2023\/06\/2030-HRH-Strategy-Final.pdf."},{"key":"e_1_2_11_3_2","unstructured":"World Health Organization State of the World\u2019s Nursing: Investing in Education Jobs and Leadership 2020 https:\/\/iris.who.int\/bitstream\/handle\/10665\/331677\/9789240003279-eng.pdf?sequence=1."},{"key":"e_1_2_11_4_2","article-title":"Recover to Rebuild: Investing in the Nursing Workforce for Health System Effectiveness","author":"Buchan J.","year":"2023","journal-title":"International Council of Nurses, Geneva"},{"key":"e_1_2_11_5_2","volume-title":"Future of Nursing Workforce","author":"National Department of Health","year":"2020"},{"key":"e_1_2_11_6_2","article-title":"When Numbers Matter \u2013 an Analysis of Current and Future Availability of Nursing Workforce in South Africa","volume":"4","author":"Armstrong S.","year":"2024","journal-title":"Trends in Nursing"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-D-19-00170"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104211"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.11.05009"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1225431"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13462"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12649"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13359"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12648"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14839"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e1717"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/job.4030020205"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.011"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001109"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2012.11.002"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12588"},{"key":"e_1_2_11_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104311"},{"key":"e_1_2_11_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.1809"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-079931"},{"key":"e_1_2_11_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2022.11.007"},{"key":"e_1_2_11_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12401"},{"key":"e_1_2_11_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2018.04.016"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mnl.2020.04.002"},{"key":"e_1_2_11_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/Jonm.12116"},{"key":"e_1_2_11_30_2","volume-title":"South African Health Review 2011","author":"Gilson L.","year":"2011"}],"container-title":["Journal of Nursing Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/1853384","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jonm\/1853384","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/1853384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:35:23Z","timestamp":1777865723000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jonm\/1853384"}},"subtitle":[],"editor":[{"given":"Ahmad","family":"Alnawafleh","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jonm\/1853384"],"URL":"https:\/\/doi.org\/10.1155\/jonm\/1853384","archive":["Portico"],"relation":{},"ISSN":["0966-0429","1365-2834"],"issn-type":[{"value":"0966-0429","type":"print"},{"value":"1365-2834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1853384"}}