2.50
Hdl Handle:
http://hdl.handle.net/10755/163833
Category:
Abstract
Type:
Presentation
Title:
Do nursing sensitive patient outcomes vary across specialty units?
Author(s):
Whitman, Gayle; Kim, Yookyung; Davidson, Lynda J.
Author Details:
Gayle Whitman, University of Pittsburgh, Mars, Pennsylvania, USA, email: gwh100@pitt.edu; Yookyung Kim; Lynda J. Davidson
Abstract:
Purpose: To determine if the rates of nursing sensitive outcomes (NSO) vary across patient specialty units. Specific Aims: Are there differences in the rates of nurse sensitive outcomes (central line infections [CLI], pressure ulcers [PU], falls [F], medication errors [Med E], restraint rates [RR] and satisfaction with pain management by RNs [SatRN] across various patient specialty units (cardiac intensive care [C-ICU], non-cardiac intensive care [NC-ICU], cardiac intermediate care units [C-IMC], non-cardiac intermediate care units [NC-IMC] and medical surgical units [MS]? Framework: The study used the Donabedian conceptual framework to determine the impact that structure variables (unit specialty) have on patient outcomes (CLI, PU, F, MedE, RR, and SatRN). Methods: This was a descriptive longitudinal study in which data on the NSOs were prospectively collected on a monthly basis for one year from 98 patient care units (CICU, n = 16; NC-ICU, n = 6; C-IMC, n = 18; NC-IMC, n = 12; and MS, n = 46) across 11 hospitals within a integrated eastern healthcare system and aggregated into annual rates. An ANOVA was used to compare the differences between the means of the NSOs across the specialty units and post hoc Tukey's HSD was used to determine the differences between the units. Results: There were no significant differences in the mean rates for falls (p = .83), MedE (p = .75) and SatRN (p = .63) across the specialty units. There were significant differences across the specialty units for CLI (F = 6.7, p = .001), PU (F = 6.1, p = .001) and RR (F = 12.68, p = .001). CLIs were significantly higher in the NC-ICUs than in the C-IMC ( p = .04) or MS (p = .001) units. PUs were significantly higher in the NC-ICUs than in the C-IMC (p = .001), NC-IMC (p = .01) and MS (p = .001) units. And RRs were significantly higher in the NC-ICU than the C-IMC (p = .001), NC-IMC (p =.002) and the MS (p = .002)units and higher in the C-ICU than the C-IMC (p = .001), NC-IMC (p = .001) and the MS (p = .001) units. Conclusions: These results suggest that the NSOs of falls, medication errors and satisfaction with RN management of pain do not appear to be specialty sensitive, occurring at equal rates across the specialties. However, the NSOs of CLI, PU and RR do vary significantly across specialties suggesting that they are specialty sensitive. Their higher presence in the ICUs suggests that patient acuity is an important factor in their presence. Implications: Currently there are a number of regulatory agencies requiring hospitals to report the rates of NSOs and some states are considering legislation to require hospitals to publicly report NSOs as evidence of the quality of nursing care provided by hospitals. This study demonstrates that some NSOs (falls, med errors and patient satisfaction with RN pain management) are equally present across specialty units, suggesting that aggregating their rates and reporting them as hospital level data may be appropriate. However, the variability present in other NSOs (central line infections, pressure ulcers and restraint rates) across the specialties suggests that reporting of their rates should either occur only at the specialty level or be linked with some measure of patient acuity in order to provide a more meaningful measure.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDo nursing sensitive patient outcomes vary across specialty units?en_GB
dc.contributor.authorWhitman, Gayleen_US
dc.contributor.authorKim, Yookyungen_US
dc.contributor.authorDavidson, Lynda J.en_US
dc.author.detailsGayle Whitman, University of Pittsburgh, Mars, Pennsylvania, USA, email: gwh100@pitt.edu; Yookyung Kim; Lynda J. Davidsonen_US
dc.identifier.urihttp://hdl.handle.net/10755/163833-
dc.description.abstractPurpose: To determine if the rates of nursing sensitive outcomes (NSO) vary across patient specialty units. Specific Aims: Are there differences in the rates of nurse sensitive outcomes (central line infections [CLI], pressure ulcers [PU], falls [F], medication errors [Med E], restraint rates [RR] and satisfaction with pain management by RNs [SatRN] across various patient specialty units (cardiac intensive care [C-ICU], non-cardiac intensive care [NC-ICU], cardiac intermediate care units [C-IMC], non-cardiac intermediate care units [NC-IMC] and medical surgical units [MS]? Framework: The study used the Donabedian conceptual framework to determine the impact that structure variables (unit specialty) have on patient outcomes (CLI, PU, F, MedE, RR, and SatRN). Methods: This was a descriptive longitudinal study in which data on the NSOs were prospectively collected on a monthly basis for one year from 98 patient care units (CICU, n = 16; NC-ICU, n = 6; C-IMC, n = 18; NC-IMC, n = 12; and MS, n = 46) across 11 hospitals within a integrated eastern healthcare system and aggregated into annual rates. An ANOVA was used to compare the differences between the means of the NSOs across the specialty units and post hoc Tukey's HSD was used to determine the differences between the units. Results: There were no significant differences in the mean rates for falls (p = .83), MedE (p = .75) and SatRN (p = .63) across the specialty units. There were significant differences across the specialty units for CLI (F = 6.7, p = .001), PU (F = 6.1, p = .001) and RR (F = 12.68, p = .001). CLIs were significantly higher in the NC-ICUs than in the C-IMC ( p = .04) or MS (p = .001) units. PUs were significantly higher in the NC-ICUs than in the C-IMC (p = .001), NC-IMC (p = .01) and MS (p = .001) units. And RRs were significantly higher in the NC-ICU than the C-IMC (p = .001), NC-IMC (p =.002) and the MS (p = .002)units and higher in the C-ICU than the C-IMC (p = .001), NC-IMC (p = .001) and the MS (p = .001) units. Conclusions: These results suggest that the NSOs of falls, medication errors and satisfaction with RN management of pain do not appear to be specialty sensitive, occurring at equal rates across the specialties. However, the NSOs of CLI, PU and RR do vary significantly across specialties suggesting that they are specialty sensitive. Their higher presence in the ICUs suggests that patient acuity is an important factor in their presence. Implications: Currently there are a number of regulatory agencies requiring hospitals to report the rates of NSOs and some states are considering legislation to require hospitals to publicly report NSOs as evidence of the quality of nursing care provided by hospitals. This study demonstrates that some NSOs (falls, med errors and patient satisfaction with RN pain management) are equally present across specialty units, suggesting that aggregating their rates and reporting them as hospital level data may be appropriate. However, the variability present in other NSOs (central line infections, pressure ulcers and restraint rates) across the specialties suggests that reporting of their rates should either occur only at the specialty level or be linked with some measure of patient acuity in order to provide a more meaningful measure.en_GB
dc.date.available2011-10-27T11:14:39Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:14:39Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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