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Background: There is a growing body of evidence for associations between the work environment and patient outcomes. A good work environment may maximise healthcare workers' efforts to avoid failures and to facilitate quality care that is focused on patient safety. Several studies use nurse-reported quality measures, but it is uncertain whether these outcomes are correlated with clinical outcomes. The aim of this study was to determine the correlations between hospital-aggregated, nurse-assessed quality and safety, and estimated probabilities for 30-day survival in and out of hospital., Methods: In a multicentre study involving almost all Norwegian hospitals with more than 85 beds (sample size=30, information about nurses' perceptions of organisational characteristics were collected. Subscales from this survey were used to describe properties of the organisations: quality system, patient safety management, nurse-physician relationship, staffing adequacy, quality of nursing and patient safety. The average scores for these organisational characteristics were aggregated to hospital level, and merged with estimated probabilities for 30-day survival in and out of hospital (survival probabilities) from a national database. In this observational, ecological study, the relationships between the organisational characteristics (independent variables) and clinical outcomes (survival probabilities) were examined., Results: Survival probabilities were correlated with nurse-assessed quality of nursing. Furthermore, the subjective perception of staffing adequacy was correlated with overall survival., Conclusions: This study showed that perceived staffing adequacy and nurses' assessments of quality of nursing were correlated with survival probabilities. It is suggested that the way nurses characterise the microsystems they belong to, also reflects the general performance of hospitals., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Introduction: Adherence to infection control guidelines is low, and several efforts have been made to improve healthcare workers' performance of infection control measures. In this study, the performance and evaluation of a hospital-wide infection control programme is described. The most important measure was distribution of an infection control newsletter., Methods: In evaluation of the programme, a randomised selection of healthcare workers received a questionnaire to investigate in what degree the healthcare workers was aware of the programme and whether they reported behavioural change and refreshed knowledge as result of the programme., Results: The intervention made it possible to reach >80% of the personnel in a Norwegian university hospital. Among those who actually read Infection Control Newsletter, 92.9% reported that their knowledge was refreshed and 60.6% reported behavioural change., Discussion: The intervention had a significant impact on nurses and nurse assistants' reports on knowledge and behaviour related to infection control. Our study supports the importance of a long-term and multimodal approach to healthcare workers in infection control work. The time and resources spent to produce and distribute the Infection Control Newsletter was an effective way to reach out to a large number of healthcare workers.