Fig. 1

Model 1 - burnout as mediating outcome variable - retested model. Legend: All variables, with the exception of workload, emotional exhaustion and depersonalization were coded for analysis whereby higher scores indicated a stronger agreement or more favourable ratings. On the latter measures, higher scores are suggestive of unfavourable perceptions or conditions. All pathways were significant (p < .05). The independent variables of nurse practice environment predict the mediating variables of burnout dimensions, as well as job outcomes and nurse-assessed quality of care (dependent variables). In addition, workload, decision latitude, and social capital have a mediating position between the nurse practice environment and burnout dimensions. Nurse–physician relations and hospital management – organizational support impact nurse management at the unit level. Nurse management at the unit level has a strong direct impact on job outcomes and nurse-assessed quality of care as well as on decision latitude and social capital. Hospital management – organizational support has a direct impact on personal accomplishment and an indirect impact on the outcome variables through workload and burnout dimensions. Nurse–physician relations shows an indirect impact on the outcome variables through decision latitude. Social capital has an inverse impact on feelings of emotional exhaustion, and decision latitude supports feelings of personal accomplishments. Personal accomplishment, impacts indirectly by emotional exhaustion and directly by depersonalization, has a direct impact on job outcomes and nurse-assessed quality of care. The variances in job outcomes and nurse-assessed quality of care explained by this model were 63 and 53%, respectively. Nurse management at the unit level has a strong direct impact on outcome variables with explained variances of 25 and 36%, respectively