2.50
Hdl Handle:
http://hdl.handle.net/10755/148513
Type:
Presentation
Title:
Decision-making about patient assignments
Abstract:
Decision-making about patient assignments
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Bostrom, Janet, PhD
P.I. Institution Name:Stanford University Hospital
Title:Director of Research
The increasing complexities of patient care, coupled with staffing

difficulties, have made the process of assigning nursing resources

to individual patients a difficult one. The aims of this study

were to: 1) determine what factors nurses consider in making

patient assignments and to assess the relative importance of these

factors in this decision process, and 2) test Benner's concepts of

novice and expert in the context of the patient assignment decision

process.



Research on administrative decision-making in nursing has focused

almost exclusively on upper level management. No research was

found that dealt with the unit-based patient assignment decision

process, though nursing leadership textbooks frequently contain

guidelines for this process. Benner (1982) suggests that novice

nurses would be more likely to use such guidelines or standardized

hospital protocols for this decision-making. Experienced nurses

would be more likely to rely on clinical judgment and to consider

a wide variety of factors.



Nursing textbooks and structured interviews with experienced and

inexperienced charge nurses were used to identify decision factors

that were then incorporated into a survey. A sample of 271 nurses

at two hospitals completed a survey which asked them to 1) record

demographic and work history data, 2) rate the importance of each

decision factors (on a five point Likert scale), 3) write in

additional decision factors, and 4) rank the five most important

factors.



Nurses had worked an average of 12.3 years (SD = 7.8); 20 percent

had worked five years or less (novice) and 58 percent had worked

ten years or more (expert). The factors identified as most

important in making patient assignments were information from the

patient acuity system; nurse experience with a specific type of

patient; nurse level, e.g. staff nurse I; and clinical judgment.

Novices rated patient acuity system data as significantly more

important than did experts. Experts showed much more variability

in response than did novices.



This study provides the first description of the process by which

nurses make patient assignments and supports the concepts of novice

and expert proposed by Benner. By explicitly describing this

process, nurses can gain better understanding of a very common and

complex nursing decision process. Novice nurses can perhaps more

rapidly develop the complex decision-making capacities of expert

nurses when provided with information about the factors that these

experts consider.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDecision-making about patient assignmentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148513-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Decision-making about patient assignments</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bostrom, Janet, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Stanford University Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director of Research</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value"> </td></tr><tr><td colspan="2" class="item-abstract">The increasing complexities of patient care, coupled with staffing<br/><br/>difficulties, have made the process of assigning nursing resources<br/><br/>to individual patients a difficult one. The aims of this study<br/><br/>were to: 1) determine what factors nurses consider in making<br/><br/>patient assignments and to assess the relative importance of these<br/><br/>factors in this decision process, and 2) test Benner's concepts of<br/><br/>novice and expert in the context of the patient assignment decision<br/><br/>process.<br/><br/><br/><br/>Research on administrative decision-making in nursing has focused<br/><br/>almost exclusively on upper level management. No research was<br/><br/>found that dealt with the unit-based patient assignment decision<br/><br/>process, though nursing leadership textbooks frequently contain<br/><br/>guidelines for this process. Benner (1982) suggests that novice<br/><br/>nurses would be more likely to use such guidelines or standardized<br/><br/>hospital protocols for this decision-making. Experienced nurses<br/><br/>would be more likely to rely on clinical judgment and to consider<br/><br/>a wide variety of factors.<br/><br/><br/><br/>Nursing textbooks and structured interviews with experienced and<br/><br/>inexperienced charge nurses were used to identify decision factors<br/><br/>that were then incorporated into a survey. A sample of 271 nurses<br/><br/>at two hospitals completed a survey which asked them to 1) record<br/><br/>demographic and work history data, 2) rate the importance of each<br/><br/>decision factors (on a five point Likert scale), 3) write in<br/><br/>additional decision factors, and 4) rank the five most important<br/><br/>factors.<br/><br/><br/><br/>Nurses had worked an average of 12.3 years (SD = 7.8); 20 percent<br/><br/>had worked five years or less (novice) and 58 percent had worked<br/><br/>ten years or more (expert). The factors identified as most<br/><br/>important in making patient assignments were information from the<br/><br/>patient acuity system; nurse experience with a specific type of<br/><br/>patient; nurse level, e.g. staff nurse I; and clinical judgment.<br/><br/>Novices rated patient acuity system data as significantly more<br/><br/>important than did experts. Experts showed much more variability<br/><br/>in response than did novices.<br/><br/><br/><br/>This study provides the first description of the process by which<br/><br/>nurses make patient assignments and supports the concepts of novice<br/><br/>and expert proposed by Benner. By explicitly describing this<br/><br/>process, nurses can gain better understanding of a very common and<br/><br/>complex nursing decision process. Novice nurses can perhaps more<br/><br/>rapidly develop the complex decision-making capacities of expert<br/><br/>nurses when provided with information about the factors that these<br/><br/>experts consider.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T09:46:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:46:17Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.