Engagement at work: A review of the literature

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Abstract

Objectives

Engagement at work has emerged as a potentially important employee performance and organizational management topic, however, the definition and measurement of engagement at work, and more specifically, nurse engagement, is poorly understood. The objective of this paper is to examine the current state of knowledge about engagement at work through a review of the literature. This review highlights the four lines of engagement research and focuses on the determinants and consequences of engagement at work. Methodological issues, as identified in the current research, and recommendations for future nurse-based engagement research are provided.

Design

A systematic review of the business, organizational psychology, and health sciences and health administration literature about engagement at work (1990–2007) was performed.

Data sources

The electronic databases for Health Sciences and Health Administration (CINAHL, MEDLINE), Business (ABI INFORM), and Psychology (PsycINFO) were systematically searched.

Review methods

Due to the limited amount of research that has examined engagement among the nursing workforce, published research that included varying employee types were included in this review. The selection criteria for this review include those studies that were: (1) written in English and (2) examined engagement at work in employee populations of any type within any work setting.

Results

The literature review identified four distinct lines of research that has focused on engagement within the employee work role. Of the 32 engagement-based articles referenced in this paper, a sample of 20 studies report on the examination of antecedents and/or consequences of engagement at work among varying employee types and work settings. Key findings suggest organizational factors versus individual contributors significantly impact engagement at work. A common implication in this body of research was that of the performance-based impact.

Conclusions

The study of nurses’ work engagement and its relationship to nurses’ organizational behavior, including work performance and healthcare organizational outcomes can be achieved by first building upon a conceptually consistent definition and measurement of work engagement. Future research is needed to provide nurse leaders with a better understanding of how nurse work engagement impacts organizational outcomes, including quality of care indicators.

Introduction

Engagement at work has emerged as a potentially important employee performance and organizational management topic. A growing body of evidence supports the relationship between engagement of the employee at work and organizational outcomes, including those which are performance-based (Harter et al., 2002, Laschinger and Finegan, 2005, Laschinger and Leiter, 2006, Salanova et al., 2005, Schaufeli and Bakker, 2004). Although professions in both the academic and clinical arena tout engagement as an important work-related factor, definitions and measurements of engagement at work, and more specifically nurse engagement, are poorly understood. Clear theoretical and practical understanding of nurse engagement is needed in order to prioritize and implement interventions targeted toward bettering nurse performance, patient outcomes, and other core healthcare organizational outcomes. In order to build upon a potentially significant area of nurse performance research, a review of the literature examining the current state of knowledge about engagement at work was conducted. This review focuses on the four lines of engagement research and highlights the determinants and consequences of engagement. Methodological issues identified in the current research and recommendations for future research are also provided.

Section snippets

Background

Nurses form the largest group of healthcare professionals in the United States (American Hospital Association, 2006). Accordingly, the nature and quality of service provided to individuals within healthcare organizations may largely be dependent on nurse performance. Due to various public and private stakeholders’ interest in decreasing healthcare costs and improving healthcare quality, nurse researchers focusing on nurse performance and its impact on quality outcomes are at an important

Methods

The aim of this review was to explore the current state of knowledge about engagement at work. To extract pertinent research from the published literature the electronic databases for Health Sciences and Health Administration (CINAHL, MEDLINE), Business (ABI INFORM), and Psychology (PsycINFO) were scanned prior to more detailed searches. Key words used in the literature searches included engagement, engagement at work, employee engagement, job engagement, nurse engagement, personal engagement,

Findings

The term engagement, understood within the context of the employee work role, began to emerge within the organizational psychology and business literature some 15 years ago and more recently is noted within the nursing workforce. To date, four lines of research characterize this study topic and include personal engagement, burnout/engagement, work engagement, and employee engagement. Engagement at work research has developed in a relatively sequential manner and as summarized in Table 2, the

Limitations

There are limitations to this review of the literature. The key words used to describe engagement may have led to missing published research. Research was also limited to peer-reviewed business, organizational psychology, and nursing journals to identify the state of the science of engagement at work and to identify antecedents and consequences of engagement at work. Additional research reports that could have met the inclusion criteria may have been available in other nursing or non-nursing

Conclusion

As we continue to search for ways to improve healthcare quality and decrease healthcare costs the identification of additional nurse work-related factors that are predictive of nurse performance and patient and organizational outcomes is needed. Work engagement may be one such factor. The study of nurses’ engagement at work and its relationship to work performance and healthcare organizational outcomes can be best achieved by addressing current research methodological limitations—the first of

Conflict of interest

None.

Funding

None.

Ethical Approval

  • 1)

    University of Wisconsin Institutional Review Board approval:12/28/2007: IRB# 08.192.

  • 2)

    Approved by Extendicare: 12/2007 by Barb Haag-Heitman, PhD, RN, Steve Biondi, RN, NHA: no reference number provided by individuals providing ethical approval.

Acknowledgments

The author gratefully acknowledges the feedback of Christine Kovach, PhD, RN, FAAN and the Helen Bader Foundation, Center on Age and Community, University of Wisconsin-Milwaukee for post-doctoral sponsorship.

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