Acute Care Nurse's Perceptions of Changing Health Care Delivery Models: Total Patient Care to Primary Nursing

2.50
Hdl Handle:
http://hdl.handle.net/10755/156304
Type:
Presentation
Title:
Acute Care Nurse's Perceptions of Changing Health Care Delivery Models: Total Patient Care to Primary Nursing
Abstract:
Acute Care Nurse's Perceptions of Changing Health Care Delivery Models: Total Patient Care to Primary Nursing
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Crandall, Margie, PhD, RN
P.I. Institution Name:UC Davis Health Systems
Title:Clinical Nurse Scientist
Co-Authors:Barbara Rickabaugh, RN, MS
[Research Presentation] Purpose:áTo explore what acute care nurses perceived influenced their process of implementation from total patient care to primary nursing, at initial implementation and 6 months post implementation.áMethod:áA qualitative study was conducted using thematic analysis. Unit based nurse practice councils, responsible for planning and implementing change, were interviewed. Twenty-six semi-structured group interviews (15 in phase 1, 11 in phase 2) were audio-recorded and transcribed.áUsing constant comparative analysis, transcripts were read line-by-line and significant words and phrases were categorized and coded.áAn audit trail was maintained to document all aspects of the study, data analysis and description of the findings. Participants verified 4 themes.áResults:áInitial implementation data analysis identified 2 themes that emerged as barriers to practice change:áTheme 1 - The need for preparation, resources, and administrative support. Nurses required knowledge about primary nursing and practice council structure and responsibilities, knowledgeable guidance from leadership, and adequate staffing to support the change.áTheme 2 - Staff resistance to change. Staff resistance included both behavioral and emotional reactions to practice change.á Fear, anxiety, anger, being overwhelmed, sabotage and hostility were reported.áSix months post implementation data analysis identified 2 themes:áTheme 3 - Confronting barriers with creative practice strategies. Nurses identified several strategies that included assignment modification, tools, orientation program, and revision of the existing job description to include key components of primary nursing.áTheme 4 - Improved outcomes through patient knowing. Subsequent to the implementation of the strategies, nurses perceived improved nurse-patient relationships and improved patient and nurse satisfaction and outcomes.áConclusion:áPrior to implementation of a system-wide nursing practice change, nurses require preparational education regarding the model, committee process and communication strategies in order to plan and implement system changes.áOn-going leadership involvement and support is critical.áNurses perceived the primary nursing model improved patient and nurse outcomes.
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.titleAcute Care Nurse's Perceptions of Changing Health Care Delivery Models: Total Patient Care to Primary Nursingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156304-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Acute Care Nurse's Perceptions of Changing Health Care Delivery Models: Total Patient Care to Primary Nursing</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">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Crandall, Margie, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">UC Davis Health Systems</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Scientist</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">margie.crandall@ucdmc.ucdavis.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara Rickabaugh, RN, MS</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Purpose:&aacute;To explore what acute care nurses perceived influenced their process of implementation from total patient care to primary nursing, at initial implementation and 6 months post implementation.&aacute;Method:&aacute;A qualitative study was conducted using thematic analysis. Unit based nurse practice councils, responsible for planning and implementing change, were interviewed. Twenty-six semi-structured group interviews (15 in phase 1, 11 in phase 2) were audio-recorded and transcribed.&aacute;Using constant comparative analysis, transcripts were read line-by-line and significant words and phrases were categorized and coded.&aacute;An audit trail was maintained to document all aspects of the study, data analysis and description of the findings. Participants verified 4 themes.&aacute;Results:&aacute;Initial implementation data analysis identified 2 themes that emerged as barriers to practice change:&aacute;Theme 1 - The need for preparation, resources, and administrative support. Nurses required knowledge about primary nursing and practice council structure and responsibilities, knowledgeable guidance from leadership, and adequate staffing to support the change.&aacute;Theme 2 - Staff resistance to change. Staff resistance included both behavioral and emotional reactions to practice change.&aacute; Fear, anxiety, anger, being overwhelmed, sabotage and hostility were reported.&aacute;Six months post implementation data analysis identified 2 themes:&aacute;Theme 3 - Confronting barriers with creative practice strategies. Nurses identified several strategies that included assignment modification, tools, orientation program, and revision of the existing job description to include key components of primary nursing.&aacute;Theme 4 - Improved outcomes through patient knowing. Subsequent to the implementation of the strategies, nurses perceived improved nurse-patient relationships and improved patient and nurse satisfaction and outcomes.&aacute;Conclusion:&aacute;Prior to implementation of a system-wide nursing practice change, nurses require preparational education regarding the model, committee process and communication strategies in order to plan and implement system changes.&aacute;On-going leadership involvement and support is critical.&aacute;Nurses perceived the primary nursing model improved patient and nurse outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T14:39:07Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:39:07Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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