2.50
Hdl Handle:
http://hdl.handle.net/10755/149409
Type:
Presentation
Title:
Nursing Work Environment and Patient Outcomes
Abstract:
Nursing Work Environment and Patient Outcomes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Hoare, Kathy, DNS/DNSc/DSN
P.I. Institution Name:Kaiser Permanente
Title:Director Nursing Research
Objective: The project purpose was to explore relationships between patient outcomes and characteristics of nurses’ work environment that create conditions for high work motivation, satisfaction and performance. Design: A timed series design was used. Characteristics of work environment data was collected four times during the year from staff nurses providing care to patients admitted to 17 acute care hospitals from January to December 2000. Patient outcome data came from computerized databases that contain information on patient satisfaction with hospital stay and unscheduled hospital readmission rates. All 17 hospitals collect satisfaction with hospital stay information from a random sample of patients discharged each month. Similarly information on unscheduled readmission to the 17 hospitals is collected each month. Sample: Characteristics of work environment information came from registered nurses employed full or part time in 17 hospitals in a group model health maintenance organization. 1936 nurses responded to the first data collection mailing. 1548 nurses responded to the second mailing. 1405 nurses responded to the third mailing. 1388 nurses responded to the fourth mailing. Patient information came from 40173 returned questionnaires mailed each month to patients discharged from the hospitals in 2000. Setting: The project took place in 17 acute care hospitals that are part of a group model health maintenance organization located in Northern California. The hospitals range in licensed bed capacity from 204 to 400. Variables/Concepts: The variables studied were work environment characteristics that create conditions for positive work motivation, performance and patient outcomes. Work environment characteristics included the concepts of autonomy, skill variety, task identity, task significance, feedback, growth opportunity, supervision, responsibility for outcome, responsibility for organization, work conflict, co-worker relations, dealing with others, work meaningfulness, work motivation, job security, work influence, promotion, and planning. Patient outcomes were defined as unscheduled readmissions to the hospital within 3 days of discharge and patient satisfaction with nursing care. Measurement: Work environment characteristics were measured by a 61-item questionnaire. Nurses indicated on a 5-point scale whether they agreed or disagreed with positive and negative statements about job characteristics present in their work environment. The questionnaire was adapted from the job diagnostic survey developed by Hackman and Oldham (1975) and revised by Sims, Szilagyi and Keller (1976). A mean score is calculated for each characteristic and hospitals are ranked on the mean score. Internal reliability coefficients for the concepts comprising the survey vary from .58 to .78. The patient satisfaction survey was developed by the Kaiser Permanente Program Performance department to measure overall quality of hospital stay, quality of medical care, quality of nursing care and overall quality of services received. Only the nursing index section of the questionnaire was used for analysis. Items included in the nursing index are trust, respect, introducing self, teamwork, personal interest, skill, availability, and emotional support. Patients are asked to rate on a 5-point scale (poor to excellent) how satisfied they are with nurse’s performance in areas identified in the index. Hospitals are ranked according to the percentage of patients reporting very good/excellent to the items. Findings: A moderate relationship (r=0.4) exists between patient satisfaction and work motivation, work conflict, task identity, dealing with others, autonomy, job security, and responsibility for outcome. A statistically significant relationship (p<0.05) exists between unscheduled 3 day readmissions, planning opportunity and task identity. Conclusions: Hospital patient outcomes are definitely related to the characteristics of nurses work environment. Hospitals with work environments that provide adequate resources to complete an assignment and ability to completely finish work assigned, are hospitals with low readmissions. Hospitals with work environments that provide opportunity to plan for care and discuss care with other healthcare professionals are hospitals with low readmissions. Implications: One way hospitals can control their unscheduled readmissions is to be alert to the unit environment in which nurses work. If nurses do not have opportunity and resources to plan their care, then conditions that create positive work motivation and performance are lacking which may alter the nursing care process and increase the possibility that patients will be dissatisfied with their nursing care and will be readmitted within 3 days. Assessing work environment characteristics might be a useful function for quality management teams if hospitals want to prevent unscheduled readmissions. Identifying the absence of positive work environment characteristics can give unit managers a focus for improving the quality of nurses work environments. This project gives us a beginning look at the work environment characteristics that might alter the nursing care process.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleNursing Work Environment and Patient Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149409-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nursing Work Environment and Patient Outcomes</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">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hoare, Kathy, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Kaiser Permanente</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director Nursing Research</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kathy.hoare@kp.org</td></tr><tr><td colspan="2" class="item-abstract">Objective: The project purpose was to explore relationships between patient outcomes and characteristics of nurses&rsquo; work environment that create conditions for high work motivation, satisfaction and performance. Design: A timed series design was used. Characteristics of work environment data was collected four times during the year from staff nurses providing care to patients admitted to 17 acute care hospitals from January to December 2000. Patient outcome data came from computerized databases that contain information on patient satisfaction with hospital stay and unscheduled hospital readmission rates. All 17 hospitals collect satisfaction with hospital stay information from a random sample of patients discharged each month. Similarly information on unscheduled readmission to the 17 hospitals is collected each month. Sample: Characteristics of work environment information came from registered nurses employed full or part time in 17 hospitals in a group model health maintenance organization. 1936 nurses responded to the first data collection mailing. 1548 nurses responded to the second mailing. 1405 nurses responded to the third mailing. 1388 nurses responded to the fourth mailing. Patient information came from 40173 returned questionnaires mailed each month to patients discharged from the hospitals in 2000. Setting: The project took place in 17 acute care hospitals that are part of a group model health maintenance organization located in Northern California. The hospitals range in licensed bed capacity from 204 to 400. Variables/Concepts: The variables studied were work environment characteristics that create conditions for positive work motivation, performance and patient outcomes. Work environment characteristics included the concepts of autonomy, skill variety, task identity, task significance, feedback, growth opportunity, supervision, responsibility for outcome, responsibility for organization, work conflict, co-worker relations, dealing with others, work meaningfulness, work motivation, job security, work influence, promotion, and planning. Patient outcomes were defined as unscheduled readmissions to the hospital within 3 days of discharge and patient satisfaction with nursing care. Measurement: Work environment characteristics were measured by a 61-item questionnaire. Nurses indicated on a 5-point scale whether they agreed or disagreed with positive and negative statements about job characteristics present in their work environment. The questionnaire was adapted from the job diagnostic survey developed by Hackman and Oldham (1975) and revised by Sims, Szilagyi and Keller (1976). A mean score is calculated for each characteristic and hospitals are ranked on the mean score. Internal reliability coefficients for the concepts comprising the survey vary from .58 to .78. The patient satisfaction survey was developed by the Kaiser Permanente Program Performance department to measure overall quality of hospital stay, quality of medical care, quality of nursing care and overall quality of services received. Only the nursing index section of the questionnaire was used for analysis. Items included in the nursing index are trust, respect, introducing self, teamwork, personal interest, skill, availability, and emotional support. Patients are asked to rate on a 5-point scale (poor to excellent) how satisfied they are with nurse&rsquo;s performance in areas identified in the index. Hospitals are ranked according to the percentage of patients reporting very good/excellent to the items. Findings: A moderate relationship (r=0.4) exists between patient satisfaction and work motivation, work conflict, task identity, dealing with others, autonomy, job security, and responsibility for outcome. A statistically significant relationship (p&lt;0.05) exists between unscheduled 3 day readmissions, planning opportunity and task identity. Conclusions: Hospital patient outcomes are definitely related to the characteristics of nurses work environment. Hospitals with work environments that provide adequate resources to complete an assignment and ability to completely finish work assigned, are hospitals with low readmissions. Hospitals with work environments that provide opportunity to plan for care and discuss care with other healthcare professionals are hospitals with low readmissions. Implications: One way hospitals can control their unscheduled readmissions is to be alert to the unit environment in which nurses work. If nurses do not have opportunity and resources to plan their care, then conditions that create positive work motivation and performance are lacking which may alter the nursing care process and increase the possibility that patients will be dissatisfied with their nursing care and will be readmitted within 3 days. Assessing work environment characteristics might be a useful function for quality management teams if hospitals want to prevent unscheduled readmissions. Identifying the absence of positive work environment characteristics can give unit managers a focus for improving the quality of nurses work environments. This project gives us a beginning look at the work environment characteristics that might alter the nursing care process.</td></tr></table>en_GB
dc.date.available2011-10-26T10:01:49Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:01:49Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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