EXHIBIT 1.

Hospital nurses’ reports on quality of care, patient safety, and work environment indicators, 2015–16

Indicator	Percent of nurses
GLOBAL MEASURES
Quality of patient care less than excellent	60.4
Unfavorable rating of their hospital (8 or less on a 10-point scale)a	67.8
Would not definitely recommend their hospitala	54.9
Unfavorable grade on patient safety	29.6
Unfavorable grade on infection preventiona	28.9
CULTURE OF PATIENT SAFETY INDICATORS
Staff feel like mistakes are held against them	50.1
Important information is lost during shift changes	37.3
Things fall between the cracks	41.9
Staff do not feel free to question authority	36.9
Patient safety is not a top priority of management	21.5
WORK ENVIRONMENT INDICATORS AND RELATED MEASURES
Work environment less than excellentb	80.7
Large part of shift spent on work-aroundsa	27.1
Large part of shift spent on nonnursing tasksa	30.7
Less than very satisfied with job	69.4
High score on Maslach Burnout Inventory	30.8

SOURCE Authors’ analysis of data for 2015–16 from the RN4CAST-US Nurse Survey.

NOTES Percentages are based on the responses of 12,919–13,457 staff registered nurses (RNs) in 535 hospitals, after small numbers of missing responses were deleted. Unfavorable grades of hospitals were C, D, or F.

^aItem included in the 2015–16 survey but not the 2005–08 survey.

^bSingle-item measure of the work environment, where nurses were asked to rate that environment on a four-point scale (1 being poor and 4 being excellent).