2.50
Hdl Handle:
http://hdl.handle.net/10755/157900
Type:
Presentation
Title:
A Pilot Study of a Comprehensive Nursing Workload Measurement System
Abstract:
A Pilot Study of a Comprehensive Nursing Workload Measurement System
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Axford, Rita, PhD, RN, CNE
P.I. Institution Name:Regis University, Loretto Heights School of Nursing
Title:Assistant Dean, Nursing
Contact Address:Mail Code G-8, 3333 Regis Blvd, Denver, CO, 80221, USA
Contact Telephone:303-964-3600
Purpose: The purpose of this study was to pilot the measurement system for a structural equation model of nursing workload in hospitals. Objectives of the pilot were to determine the measurement protocol for use in the final study; to establish inter-rater reliability of data collectors; establish reliability and validity of measurement instruments; determine data collection costs; and test the effects of subject compensation on sample response rate. Conceptual Basis: The measurement model was based on the theory of Donabedian (1980) determining elements of structure, function and process that create demands for nurses and contribute to workload. Additional work by Mitchell (1998) demonstrated the cyclical nature of the model, and Brewer's model (2008) enhanced the conceptual basis by focusing on the contextual elements that impact care delivery. Methods: Data were collected from nurses using the Work Environment Scale, the Professional Practices Inventory, and a self-assessment of competency. Additional demographic and educational data were collected via survey. Surveys were administered in a private conference room and nurses were compensated with a gift card. Patient level data were collected from assigned nurses via structured interview using a standard set of questions with prescribed response sets. Variable interview methods were tested, including: reading the interview questions; asking the nurse to read the interview questions; and a combination. A research team member also coded responses enabling calculation of inter-rater reliability using Cohen's Kappa. Unit level data were collected from the charge nurse relative to perceived workload and adequacy of nurse staffing. Results: Fourteen patient care units submitted data representing 69 patients (96% response rate) and 80 nurses (93% response rate). Three data collectors were checked for inter-rater reliability on-site and one was checked with a mock interview in a university setting. The reliability of the Work Environment Survey and the Professional Practice Inventory were all greater than the a priori standard of .80. Users of the interview guide provided feedback that resulted in revisions to both interview questions and response sets. The combination interview method resulted in the most reliable responses. Mock interviews were as effective as on-site interviews in establishing inter-rater reliability. Direct costs per nurse were $37.04 and mean time per survey was 22 minutes. Conclusions: Engagement of unit leaders, continuous communication with staff, and compensation with gift cards resulted in dramatic response rates. Mean time per data collection element was less than anticipated, providing prospective subject hospitals with more accurate data to determine their time investment. Inter-rater reliability was confirmed with mock interviews as opposed to the more costly on-site interviews. Pilot testing a measurement system can provide actionable information that improves both process and content of research, particularly those in which complex measurement systems are planned, the error of measurement must be minimized, and population representation is critical.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Pilot Study of a Comprehensive Nursing Workload Measurement Systemen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157900-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Pilot Study of a Comprehensive Nursing Workload Measurement System</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Axford, Rita, PhD, RN, CNE</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Regis University, Loretto Heights School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Dean, Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Mail Code G-8, 3333 Regis Blvd, Denver, CO, 80221, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">303-964-3600</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">raxford@regis.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this study was to pilot the measurement system for a structural equation model of nursing workload in hospitals. Objectives of the pilot were to determine the measurement protocol for use in the final study; to establish inter-rater reliability of data collectors; establish reliability and validity of measurement instruments; determine data collection costs; and test the effects of subject compensation on sample response rate. Conceptual Basis: The measurement model was based on the theory of Donabedian (1980) determining elements of structure, function and process that create demands for nurses and contribute to workload. Additional work by Mitchell (1998) demonstrated the cyclical nature of the model, and Brewer's model (2008) enhanced the conceptual basis by focusing on the contextual elements that impact care delivery. Methods: Data were collected from nurses using the Work Environment Scale, the Professional Practices Inventory, and a self-assessment of competency. Additional demographic and educational data were collected via survey. Surveys were administered in a private conference room and nurses were compensated with a gift card. Patient level data were collected from assigned nurses via structured interview using a standard set of questions with prescribed response sets. Variable interview methods were tested, including: reading the interview questions; asking the nurse to read the interview questions; and a combination. A research team member also coded responses enabling calculation of inter-rater reliability using Cohen's Kappa. Unit level data were collected from the charge nurse relative to perceived workload and adequacy of nurse staffing. Results: Fourteen patient care units submitted data representing 69 patients (96% response rate) and 80 nurses (93% response rate). Three data collectors were checked for inter-rater reliability on-site and one was checked with a mock interview in a university setting. The reliability of the Work Environment Survey and the Professional Practice Inventory were all greater than the a priori standard of .80. Users of the interview guide provided feedback that resulted in revisions to both interview questions and response sets. The combination interview method resulted in the most reliable responses. Mock interviews were as effective as on-site interviews in establishing inter-rater reliability. Direct costs per nurse were $37.04 and mean time per survey was 22 minutes. Conclusions: Engagement of unit leaders, continuous communication with staff, and compensation with gift cards resulted in dramatic response rates. Mean time per data collection element was less than anticipated, providing prospective subject hospitals with more accurate data to determine their time investment. Inter-rater reliability was confirmed with mock interviews as opposed to the more costly on-site interviews. Pilot testing a measurement system can provide actionable information that improves both process and content of research, particularly those in which complex measurement systems are planned, the error of measurement must be minimized, and population representation is critical.</td></tr></table>en_GB
dc.date.available2011-10-26T20:18:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:18:47Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.