Leading a Research Based Practice: Achieving Clinical Excellence through Caring Practice Guidelines, Caring Performance Standards, and a Patient Satisfaction Measure

2.50
Hdl Handle:
http://hdl.handle.net/10755/150194
Type:
Presentation
Title:
Leading a Research Based Practice: Achieving Clinical Excellence through Caring Practice Guidelines, Caring Performance Standards, and a Patient Satisfaction Measure
Abstract:
Leading a Research Based Practice: Achieving Clinical Excellence through Caring Practice Guidelines, Caring Performance Standards, and a Patient Satisfaction Measure
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Shepherd, Mary
P.I. Institution Name:The Methodist Hospital
Purpose: The Nursing Quality Indicators Task Force on Caring provided leadership to achieve excellence in patient care delivery outcomes by implementing a research based relationship centered care delivery model in a large tertiary care, teaching hospital (800 beds, RN staff of 2000) and 2 of its community affiliates. Method: An academic and clinical partnership between the hospital and a school of nursing sought to demonstrate accountability for nursing practice by building a framework for operationalizing caring. The Task Force completed Phase I by identifying nursing quality indicators for caring through a content analysis of 42 literature citations that described 27 structure, process, and outcome of caring characteristics perceived by patients. To address content validity, focus groups of 200 nurses identified 51 dimensions of caring that were cross-referenced through constant comparative analysis with the literature analysis. These were collapsed into the 12 dominant dimensions (care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family involvement, physical environment, spiritual environment, outcomes) and 14 supportive dimensions (pain management, continuity, problem-solving, intervention, discharge planning, knowledge, privacy, knowing, monitoring, interactions, intentional response, resources, overall satisfaction, and therapeutic outcomes). Two focus groups of 20 patients confirmed the final inventory. In Phase II, the group, guided by faculty consultants, translated the 12 dominant and 14 supportive dimensions into a 33-item instrument to measure patient perception of nurses’ caring. Phase II had two purposes: to test the psychometric properties of the Nurses’ Caring Instrument and to utilize the tool to establish a baseline of nurse caring from the patient perspective for future outcome measures mailed to 1250 recently discharged patients from three of the system hospitals. Data from the 367 returned questionnaires confirmed the validity of the instrument. Construct validity from factor analysis compressed the study to a final 20-item instrument for an annual resurvey. Outcomes: Data from the study was used to develop caring practice guidelines and nursing performance standards addressing the 12 dominant and 14 supportive characteristics of caring. The guidelines and standards are part of an architectural redesign that included implementation of a shared governance model, care that is outcome focused, and bedside accountability. The caring practice guidelines are now unit based and the caring performance standards are part of the new philosophy of “360” evaluation for each nurse. A pilot study of 328 registered nurses using the caring performance standards provided a link to performance review. A comparison with the patient responses from the Nurses’ Caring Instrument allows unit by unit analysis of performance. A yearlong education program was based on gaps identified by the survey, including manager training for value based practice; reflective practice; healing environments using music, silence, laughter, and self care strategies; brainstorming; behavior change models including ladders of inference, mental models, and personality typing; and collaborative leadership sessions. Processes are now shaping a reward system that reflects the commitment to caring practice guidelines and performance standards. Implications: To complete the goal of interdisciplinary team work, relationship centered care (Pew-Fetzer Task Force, 1994), is now being piloted on three units to address commitments and responsibilities of the patient and family to the care team. Leading the way to clinical excellence by translating to practice the nursing quality indicators for caring identified through research, this hospital system is fostering an environment conducive to quality patient care, patient satisfaction, and staff retention. Patient outcomes are linked with nursing practice to demonstrate the impact of nurses’ caring for consistency from philosophy to bedside care to performance review. Design of new research approaches will measure the impact on patient satisfaction, staff satisfaction, interdisciplinary approaches, lowered length of stay as teamwork reduces adverse events, and improved clinical outcomes.
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.titleLeading a Research Based Practice: Achieving Clinical Excellence through Caring Practice Guidelines, Caring Performance Standards, and a Patient Satisfaction Measureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150194-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Leading a Research Based Practice: Achieving Clinical Excellence through Caring Practice Guidelines, Caring Performance Standards, and a Patient Satisfaction Measure</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">Shepherd, Mary</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Methodist Hospital</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mshepherd@tmh.tmc.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The Nursing Quality Indicators Task Force on Caring provided leadership to achieve excellence in patient care delivery outcomes by implementing a research based relationship centered care delivery model in a large tertiary care, teaching hospital (800 beds, RN staff of 2000) and 2 of its community affiliates. Method: An academic and clinical partnership between the hospital and a school of nursing sought to demonstrate accountability for nursing practice by building a framework for operationalizing caring. The Task Force completed Phase I by identifying nursing quality indicators for caring through a content analysis of 42 literature citations that described 27 structure, process, and outcome of caring characteristics perceived by patients. To address content validity, focus groups of 200 nurses identified 51 dimensions of caring that were cross-referenced through constant comparative analysis with the literature analysis. These were collapsed into the 12 dominant dimensions (care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family involvement, physical environment, spiritual environment, outcomes) and 14 supportive dimensions (pain management, continuity, problem-solving, intervention, discharge planning, knowledge, privacy, knowing, monitoring, interactions, intentional response, resources, overall satisfaction, and therapeutic outcomes). Two focus groups of 20 patients confirmed the final inventory. In Phase II, the group, guided by faculty consultants, translated the 12 dominant and 14 supportive dimensions into a 33-item instrument to measure patient perception of nurses&rsquo; caring. Phase II had two purposes: to test the psychometric properties of the Nurses&rsquo; Caring Instrument and to utilize the tool to establish a baseline of nurse caring from the patient perspective for future outcome measures mailed to 1250 recently discharged patients from three of the system hospitals. Data from the 367 returned questionnaires confirmed the validity of the instrument. Construct validity from factor analysis compressed the study to a final 20-item instrument for an annual resurvey. Outcomes: Data from the study was used to develop caring practice guidelines and nursing performance standards addressing the 12 dominant and 14 supportive characteristics of caring. The guidelines and standards are part of an architectural redesign that included implementation of a shared governance model, care that is outcome focused, and bedside accountability. The caring practice guidelines are now unit based and the caring performance standards are part of the new philosophy of &ldquo;360&rdquo; evaluation for each nurse. A pilot study of 328 registered nurses using the caring performance standards provided a link to performance review. A comparison with the patient responses from the Nurses&rsquo; Caring Instrument allows unit by unit analysis of performance. A yearlong education program was based on gaps identified by the survey, including manager training for value based practice; reflective practice; healing environments using music, silence, laughter, and self care strategies; brainstorming; behavior change models including ladders of inference, mental models, and personality typing; and collaborative leadership sessions. Processes are now shaping a reward system that reflects the commitment to caring practice guidelines and performance standards. Implications: To complete the goal of interdisciplinary team work, relationship centered care (Pew-Fetzer Task Force, 1994), is now being piloted on three units to address commitments and responsibilities of the patient and family to the care team. Leading the way to clinical excellence by translating to practice the nursing quality indicators for caring identified through research, this hospital system is fostering an environment conducive to quality patient care, patient satisfaction, and staff retention. Patient outcomes are linked with nursing practice to demonstrate the impact of nurses&rsquo; caring for consistency from philosophy to bedside care to performance review. Design of new research approaches will measure the impact on patient satisfaction, staff satisfaction, interdisciplinary approaches, lowered length of stay as teamwork reduces adverse events, and improved clinical outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T10:18:39Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:18:39Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.