2.50
Hdl Handle:
http://hdl.handle.net/10755/151746
Type:
Presentation
Title:
Development of a unit level model of nurse exit behavior
Abstract:
Development of a unit level model of nurse exit behavior
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:August 6 - 8, 1992
Author:Robertson, Sandra, MS/MSc
P.I. Institution Name:Rush Presbyterian St. Lukes Medical Center
Title:Associate Director of Nursing
The purpose of the present investigation is to assess the

relationship between workload and nurse exit: Do longitudinal,

unit-level variables predict nurse exit? This paper reports

results from an ongoing two-stage retrospective study being

conducted at Rush. Stage I consisted of studying the staffing and

patient acuity data from three medical patient care units over a

five-year period. Results of autoregressive statistical models

using these data demonstrated significant differences between the

three units. On two of the study units, staff experience was

positively related to nurse exit. On the third unit, however,

staff experience was predictive of lower resignation and the best

predictors of nurse exit were workload-related variables of census

and patient acuity. When these variables were graphed over time

for the third unit, it was noted that nurse exit increased

dramatically during a 100-week period of time which was marked by

a steadily rising patient acuity. It was also noted that higher,

yet stable, levels of acuity did not produce more resignations

suggesting that it is changing acuity that disrupted the unit.

Interviews with the unit managers indicated that they were able to

exert influence on the workload of the unit through negotiation

with physicians and administrators. We have termed this

negotiation process, brokering.



Stage II consisted of gathering identical data from eleven

additional medical and surgical units. Given the results regarding

the impact of changing patient acuity on nurse exit, the 14 units

were ranked according to the standard deviation of mean unit

acuity. The units fell into three categories of change and mean

nurse resignation within the three categories were consistent with

the hypothesis that high workload variability is associated with

nurse exit behavior. Correlations were also computed between nurse

resignation and unit patient acuity and census. The preponderance

of these correlations was negative suggesting that periods of nurse

resignation were accompanied by decreases in unit workload. A

significant correlation between nurse resignation and either unit

acuity or census was used as a criterion for brokering behavior

on the part of the unit manager. In the eight units with medium

acuity change, four showed evidence of brokering behavior and four

did not. In three of the four with brokering behavior, there was

a low level of nurse resignation. Conversely, in three of the four

units without brokering behavior, high nurse resignation was noted.

Thus, the overall results of the study point to the importance of

unit workload in predicting nurse exit and suggest that the

relationship between nurse resignation and unit workload can be

modified by the unit manager's brokering behavior.



Repository Posting Date:
26-Oct-2011
Date of Publication:
6-Aug-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDevelopment of a unit level model of nurse exit behavioren_GB
dc.identifier.urihttp://hdl.handle.net/10755/151746-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Development of a unit level model of nurse exit behavior</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">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">August 6 - 8, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Robertson, Sandra, MS/MSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Rush Presbyterian St. Lukes Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Director of Nursing</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sroberts@cnis.rpslmc.edu</td></tr><tr><td colspan="2" class="item-abstract">The purpose of the present investigation is to assess the<br/><br/>relationship between workload and nurse exit: Do longitudinal,<br/><br/>unit-level variables predict nurse exit? This paper reports<br/><br/>results from an ongoing two-stage retrospective study being<br/><br/>conducted at Rush. Stage I consisted of studying the staffing and<br/><br/>patient acuity data from three medical patient care units over a<br/><br/>five-year period. Results of autoregressive statistical models<br/><br/>using these data demonstrated significant differences between the<br/><br/>three units. On two of the study units, staff experience was<br/><br/>positively related to nurse exit. On the third unit, however,<br/><br/>staff experience was predictive of lower resignation and the best<br/><br/>predictors of nurse exit were workload-related variables of census<br/><br/>and patient acuity. When these variables were graphed over time<br/><br/>for the third unit, it was noted that nurse exit increased<br/><br/>dramatically during a 100-week period of time which was marked by<br/><br/>a steadily rising patient acuity. It was also noted that higher,<br/><br/>yet stable, levels of acuity did not produce more resignations<br/><br/>suggesting that it is changing acuity that disrupted the unit.<br/><br/>Interviews with the unit managers indicated that they were able to<br/><br/>exert influence on the workload of the unit through negotiation<br/><br/>with physicians and administrators. We have termed this<br/><br/>negotiation process, brokering.<br/><br/><br/><br/>Stage II consisted of gathering identical data from eleven<br/><br/>additional medical and surgical units. Given the results regarding<br/><br/>the impact of changing patient acuity on nurse exit, the 14 units<br/><br/>were ranked according to the standard deviation of mean unit<br/><br/>acuity. The units fell into three categories of change and mean<br/><br/>nurse resignation within the three categories were consistent with<br/><br/>the hypothesis that high workload variability is associated with<br/><br/>nurse exit behavior. Correlations were also computed between nurse<br/><br/>resignation and unit patient acuity and census. The preponderance<br/><br/>of these correlations was negative suggesting that periods of nurse<br/><br/>resignation were accompanied by decreases in unit workload. A<br/><br/>significant correlation between nurse resignation and either unit<br/><br/>acuity or census was used as a criterion for brokering behavior<br/><br/>on the part of the unit manager. In the eight units with medium<br/><br/>acuity change, four showed evidence of brokering behavior and four<br/><br/>did not. In three of the four with brokering behavior, there was<br/><br/>a low level of nurse resignation. Conversely, in three of the four<br/><br/>units without brokering behavior, high nurse resignation was noted.<br/><br/>Thus, the overall results of the study point to the importance of<br/><br/>unit workload in predicting nurse exit and suggest that the<br/><br/>relationship between nurse resignation and unit workload can be<br/><br/>modified by the unit manager's brokering behavior.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:12:23Z-
dc.date.issued1992-08-06en_GB
dc.date.accessioned2011-10-26T11:12:23Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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