2.50
Hdl Handle:
http://hdl.handle.net/10755/158108
Type:
Presentation
Title:
Work Environment Effects on Telephone Advice Nursing
Abstract:
Work Environment Effects on Telephone Advice Nursing
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Reinhardt, Anita, RN, PhD
P.I. Institution Name:Oregon Health and Science University School of Nursing
Contact Address:3455 SW US Veteran's Hospital Rd, Portland, OR, 97239, USA
Problem: The goal of the work environment study was to describe the relationship between the work environment in telephone advice nursing (TAN) call centers and patient outcomes. Study aims were (1) to determine if ADVICE sites were a unique predictor of work environment scores beyond nurse characteristics, (2) to determine if ADVICE sites were a unique predictor of patient outcomes beyond caller characteristics, and (3) to determine if there was a relationship between work environment scores and patient outcomes beyond both nurse and caller characteristics. Background and Significance: Telephone advice is a growing area of specialty nursing practice. Because the relationship developed between the caller and the advice nurse is important to ensuring the caller receives clear advice, the identification of the factors in the work environment that influence that interaction are also important. By identifying the influencing factors of the work environment in advice services, nurses in ambulatory settings can better organize advice practice to support advice services and utilize the comparable literature from inpatient settings to support practice improvements. Method: Secondary analyses of the survey data from the “Predictors of Outcomes of Telephone Advice Nursing” (ADVICE) study. Sample & Setting: In three geographically dispersed regions of a large national HMO in the US, 96 telephone advice nurses employed in centralized call centers participated in a survey of the work environment in telephone advice. 1068 calls to telephone advice centers were recorded by 18 of these advice nurses. Measures: Work environment scores, patient outcomes, and covariates of nurse and caller characteristics were measured. The work environment scores from the questionnaires completed by nurses were five sub-scales: collaborative relationships, organizational support, work stress, communication, and autonomy/control of practice. Patient outcomes were callers’ understanding of the interaction (CUI), callers’ experience of the interaction (CEI), overall satisfaction, and follow-through with advice. Covariates were characteristics of nurses (nurses’ education, years of RN experience, and years working in TAN) and characteristics of callers (years of HMO membership, years of education, use of the Internet for health information, and number of times the member called the advice service in the past 12 months). Findings: A MANCOVA revealed overall differences among work environment scores and sites, F (10,154) = 3.145, p = .001. There were statistically significant differences on three of the five work environment subscales: autonomy/control of practice, F (2, 81), = 7.580, p=.001, communication, F (2, 81) = 5.251, p=.007, and work stress, F (2, 81) = 4.376, p=.016. A MANCOVA indicated differences in caller outcomes among sites, F (8, 1710) = 2.207, p = .024. In the individual sites, only the CEI, F (2, 858) =5.753, p=.003, was significant. A hierarchical linear model (HLM) was used to assess relationship of the work environment scores to patient outcomes. The CUI was inversely related to the highest degree in nursing, t (7) = -4.251, p<.01 and years employed as a registered nurse, t (7) = -4.297, p<.01. There was a significant difference in the CEI in the Mid-Atlantic site compared to the Northwest site, t (7) = 5.680, p<.01. However, work environment scores were not related to patient outcome measures in this study. Conclusions: Findings suggest that the work environment is a factor in TAN sites. The nurse appears to act as a buffer between work environment concerns and patient outcomes ensuring patients receive needed advice and contribute to caller satisfaction.
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.titleWork Environment Effects on Telephone Advice Nursingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158108-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Work Environment Effects on Telephone Advice Nursing</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">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Reinhardt, Anita, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health and Science University School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3455 SW US Veteran's Hospital Rd, Portland, OR, 97239, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">einhardtac@yahoo.com</td></tr><tr><td colspan="2" class="item-abstract">Problem: The goal of the work environment study was to describe the relationship between the work environment in telephone advice nursing (TAN) call centers and patient outcomes. Study aims were (1) to determine if ADVICE sites were a unique predictor of work environment scores beyond nurse characteristics, (2) to determine if ADVICE sites were a unique predictor of patient outcomes beyond caller characteristics, and (3) to determine if there was a relationship between work environment scores and patient outcomes beyond both nurse and caller characteristics. Background and Significance: Telephone advice is a growing area of specialty nursing practice. Because the relationship developed between the caller and the advice nurse is important to ensuring the caller receives clear advice, the identification of the factors in the work environment that influence that interaction are also important. By identifying the influencing factors of the work environment in advice services, nurses in ambulatory settings can better organize advice practice to support advice services and utilize the comparable literature from inpatient settings to support practice improvements. Method: Secondary analyses of the survey data from the &ldquo;Predictors of Outcomes of Telephone Advice Nursing&rdquo; (ADVICE) study. Sample &amp; Setting: In three geographically dispersed regions of a large national HMO in the US, 96 telephone advice nurses employed in centralized call centers participated in a survey of the work environment in telephone advice. 1068 calls to telephone advice centers were recorded by 18 of these advice nurses. Measures: Work environment scores, patient outcomes, and covariates of nurse and caller characteristics were measured. The work environment scores from the questionnaires completed by nurses were five sub-scales: collaborative relationships, organizational support, work stress, communication, and autonomy/control of practice. Patient outcomes were callers&rsquo; understanding of the interaction (CUI), callers&rsquo; experience of the interaction (CEI), overall satisfaction, and follow-through with advice. Covariates were characteristics of nurses (nurses&rsquo; education, years of RN experience, and years working in TAN) and characteristics of callers (years of HMO membership, years of education, use of the Internet for health information, and number of times the member called the advice service in the past 12 months). Findings: A MANCOVA revealed overall differences among work environment scores and sites, F (10,154) = 3.145, p = .001. There were statistically significant differences on three of the five work environment subscales: autonomy/control of practice, F (2, 81), = 7.580, p=.001, communication, F (2, 81) = 5.251, p=.007, and work stress, F (2, 81) = 4.376, p=.016. A MANCOVA indicated differences in caller outcomes among sites, F (8, 1710) = 2.207, p = .024. In the individual sites, only the CEI, F (2, 858) =5.753, p=.003, was significant. A hierarchical linear model (HLM) was used to assess relationship of the work environment scores to patient outcomes. The CUI was inversely related to the highest degree in nursing, t (7) = -4.251, p&lt;.01 and years employed as a registered nurse, t (7) = -4.297, p&lt;.01. There was a significant difference in the CEI in the Mid-Atlantic site compared to the Northwest site, t (7) = 5.680, p&lt;.01. However, work environment scores were not related to patient outcome measures in this study. Conclusions: Findings suggest that the work environment is a factor in TAN sites. The nurse appears to act as a buffer between work environment concerns and patient outcomes ensuring patients receive needed advice and contribute to caller satisfaction. </td></tr></table>en_GB
dc.date.available2011-10-26T20:31:01Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:31:01Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.