2.50
Hdl Handle:
http://hdl.handle.net/10755/165810
Category:
Abstract
Type:
Presentation
Title:
The outcomes research in nursing administration project
Author(s):
Mark, Barbara
Author Details:
Barbara Mark, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA, email: bmark@email.unc.edu
Abstract:
The Outcomes Research in Nursing Administration project (ORNA) is a longitudinal causal modeling study, in which data were collected on 134 nursing units in 67 randomly selected general acute care hospitals located in 10 southeastern states, Texas, and the District of Columbia. Structural contingency theory was utilized as the theoretical framework, and guided the selection of relevant variables to represent the theory's major constructs: context, structure, and effectiveness. Structural contingency theory suggests that an organization's effectiveness is contingent upon the context in which the organization operates as well as upon the structure enacted to accomplish organizational tasks. Contextual variables included both hospital characteristics (technological complexity, teaching status, admission volatility, organizational size, and case mix), as well as nursing unit characteristics (nursing skill mix, experience, education, unit size, patient technology and availability of support services). Structure was conceptualized as professional nursing practice -- a latent variable with the indicators of decentralization, autonomy, and RN - MD collaboration. Effectiveness was conceptualized as organizational outcomes (nurses' work satisfaction, average length of patient stay, and nursing turnover), as well as patient outcomes (patient satisfaction, and rates of reported medication errors and patient falls). Data were collected during 1996 from study coordinators (individuals within each participating hospital who were responsible for the conduct of the study in their hospital), nurse managers, staff nurses and patients. Ninety percent of nursing units had better than 70% response rates (with 45% of units achieving 100% response rates). 2279 staff nurse questionnaires were distributed, with a response rate of 73.8%. Response rates for patient data were greater than 80% on 80% of units: a total of 1346 questionnaires were returned, 1326 were useable. Because nursing units were nested within hospitals, the assumption of independent observations was violated. We thus analyzed data using multilevel covariance structure analysis, which combines structural equation modeling using latent variables with hierarchical linear modeling. MCA simultaneously develops a model that provides information about two sources of variation: that arising from differences between hospitals and that arising from differences within nursing units. For ease of presentation, we first present the "between" model -- addressing sources of variation arising from differences between hospitals, and then present the "within" model -- addressing sources of variation arising from differences among nursing units.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
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.titleThe outcomes research in nursing administration projecten_GB
dc.contributor.authorMark, Barbaraen_US
dc.author.detailsBarbara Mark, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA, email: bmark@email.unc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165810-
dc.description.abstractThe Outcomes Research in Nursing Administration project (ORNA) is a longitudinal causal modeling study, in which data were collected on 134 nursing units in 67 randomly selected general acute care hospitals located in 10 southeastern states, Texas, and the District of Columbia. Structural contingency theory was utilized as the theoretical framework, and guided the selection of relevant variables to represent the theory's major constructs: context, structure, and effectiveness. Structural contingency theory suggests that an organization's effectiveness is contingent upon the context in which the organization operates as well as upon the structure enacted to accomplish organizational tasks. Contextual variables included both hospital characteristics (technological complexity, teaching status, admission volatility, organizational size, and case mix), as well as nursing unit characteristics (nursing skill mix, experience, education, unit size, patient technology and availability of support services). Structure was conceptualized as professional nursing practice -- a latent variable with the indicators of decentralization, autonomy, and RN - MD collaboration. Effectiveness was conceptualized as organizational outcomes (nurses' work satisfaction, average length of patient stay, and nursing turnover), as well as patient outcomes (patient satisfaction, and rates of reported medication errors and patient falls). Data were collected during 1996 from study coordinators (individuals within each participating hospital who were responsible for the conduct of the study in their hospital), nurse managers, staff nurses and patients. Ninety percent of nursing units had better than 70% response rates (with 45% of units achieving 100% response rates). 2279 staff nurse questionnaires were distributed, with a response rate of 73.8%. Response rates for patient data were greater than 80% on 80% of units: a total of 1346 questionnaires were returned, 1326 were useable. Because nursing units were nested within hospitals, the assumption of independent observations was violated. We thus analyzed data using multilevel covariance structure analysis, which combines structural equation modeling using latent variables with hierarchical linear modeling. MCA simultaneously develops a model that provides information about two sources of variation: that arising from differences between hospitals and that arising from differences within nursing units. For ease of presentation, we first present the "between" model -- addressing sources of variation arising from differences between hospitals, and then present the "within" model -- addressing sources of variation arising from differences among nursing units.en_GB
dc.date.available2011-10-27T14:34:09Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:34:09Z-
dc.conference.hostSouthern Nursing Research Societyen_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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