Date of Award

2026

Degree Name

Business Administration

College

College of Business

Type of Degree

D.B.A.

Document Type

Dissertation

First Advisor

Dr. Doohee Lee

Second Advisor

Dr. Alberto Coustasse

Third Advisor

Curtis Metzler

Abstract

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care outcomes using secondary data from the National Sample Survey of Registered Nurses (NSSRN), with burnout and engagement operationalized through validated NSSRN items reflecting established burnout and engagement constructs. The research investigated whether organizational engagement may serve as an intervening pathway linking burnout with two quality related outcome: participation in quality improvement initiatives, patient-centered care, and evidence-based care practices.

Findings from the multivariate regression analysis show that higher levels of burnout were significantly associated with lower organizational engagement and reduced participation in quality-related activities. The results support key propositions of the Theory of Reasoned Action by demonstrating that burnout-related attitudes are associated with diminished engagement intentions and subsequent quality-related behaviors. The study findings provide empirical insights for healthcare leaders and human resources executives to develop targeted interventions that mitigate burnout, enhance engagement, and improve overall patient care. Addressing nurse burnout is critical for workforce sustainability, staff retention, and the delivery of high-quality healthcare. This study contributes to the existing literature by identifying key organizational and environmental factors associated with variation in burnout experiences and engagement levels, and by offering evidence-based strategies to optimize workforce management in healthcare settings.

Healthcare leaders, HR executives, and policymakers must consider evidence-based strategies that address burnout’s systemic drivers and enhance engagement. The findings provide a foundation for continued empirical examination of how organizational and contextual factors influence RN engagement and quality outcomes across acute care settings. While effect sizes varied across outcomes, the theoretical contributions and large-scale scope provide a foundation for continued inquiry into improving nurse engagement and care quality outcomes.

Subject(s)

Industrial management.

Health services administration.

Medical care.

Burn out (Psychology) -- Nurses.

Nurses.

Labor supply -- Nurses.

Nurses -- Psychology.

Nurses -- Job satisfaction.

Hospitals.

Labor turnover -- Nurses.

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