Impact of Quiet Quitting and Nursing Work Environment on Quality of Care and Patient Safety: A Cross-Sectional Study Among Nurses in Greece.

Background/

Objectives

The quality and safety of care provision have consistently remained central concerns for the management of healthcare organizations worldwide. Nurses' work environment and occupational behaviors may significantly affect these outcomes. The present study aimed to evaluate the nursing work environment, assess the extent of quiet quitting among nurses, and investigate their impact on the quality and safety of care delivery.

Methods

A cross-sectional study was conducted in Greece, and data were collected via an online survey between October and December 2025. Quiet quitting and work environment were measured using the nine-item Quiet Quitting Scale (QQS) and the five-item short form of the Practice Environment Scale of the Nursing Work Index (PES-5), respectively. Multivariable logistic regression analyses were performed using IBM SPSS Statistics 28.0. The level of statistical significance was set at 0.05.

Results

The sample included 492 nurses. The overall quiet quitting rating was low to moderate (mean = 2.18, SD = 0.65), and the mean score for the PES-5 was 2.44 (SD = 0.53) indicating a moderate realization of a supportive work environment. More than half of the participants (52.0%, n = 256) rated the quality of care at their unit as good, and 23.6% (n = 116) as fair. Additionally, 33.1% (n = 163) of the nurses described patient safety as good and 28.5% (n = 140) very good. In the multivariable model, lower scores for quiet quitting were significantly associated with higher likelihood of reporting perceived quality of care as good or excellent (adjusted OR = 0.429; 95% CI: 0.310-0.593; p < 0.001) and increased odds of reporting perceived patient safety as good or excellent (adjusted OR = 0.394; 95% CI: 0.281-0.553; p < 0.001). Higher PES-5 scores were linked to more than nine-fold increased odds of reporting good or excellent perceived quality of care (adjusted OR = 9.155; 95% CI: 5.374-15.596; p < 0.001) and an over twenty-fold increase in the odds of reporting good or excellent perceived patient safety (adjusted OR = 22.190; 95% CI: 11.533-42.693; p < 0.001).

Conclusions

This study highlighted that low levels of quiet quitting and a more favorable nursing practice environment are important and independent predictors of better perceived quality and safety of care.