Impact of Nurse Manager Span-of-Control on Turnover and Patient Safety in Acute Care
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: This article describes span of control (SOC) and organizational support for nurse managers (NMs) and impact on performance outcomes. BACKGROUND: NMs report excessive workloads that negatively affect personal well-being and performance outcomes. Understanding NM SOC is essential for informing strategies to enhance performance outcomes. METHODS: This cross-sectional study explored the relationship between NM SOC, organizational support, and performance outcomes. RESULTS: Data from 255 NMs, overseeing 296 units across 47 hospitals, showed nurse turnover was significantly correlated with NM to full-time equivalent (FTE) and NM-to-bed ratios. Higher fall rates were associated with higher 24-hour census and NM-to-bed ratio. No significant associations were found between SOC and hospital-acquired pressure injuries. CONCLUSIONS: Wide variations in SOC and organizational support were noted among this sample. Findings from this study suggest that smaller units with smaller teams have an advantage in creating a better nurse workforce and clinical patient outcomes. Creating manageable NM workloads may yield better nurse and patient outcomes.
Institution: Press Ganey
Language: English
Subfield: Research and Theory
Field: Nursing
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7140126892