2.50
Hdl Handle:
http://hdl.handle.net/10755/165813
Category:
Abstract
Type:
Presentation
Title:
Perceptions of staffing adequacy: Results from the ORNA project
Author(s):
Salyer, Jeanne
Author Details:
Jeanne Salyer, PhD, Virginia Commonwealth University, Department of Adult Health Nursing, Richmond, Virginia, USA, email: jsalyer@hsc.vcu.edu
Abstract:
The purpose of this study was to identify hospital, nursing unit, staff nurse and patient characteristics that affect staff nurse perceptions of the adequacy of unit staffing. This analysis was conducted as a part of the Outcomes Research in Nursing Administration Project (ORNA), a multi-site study examining the effects of a variety of hospital and nursing unit characteristics and nursing unit organization structure on a variety of nursing administration and patient outcomes. Methods - Design, sample and setting. The ORNA Project is a non-experimental, longitudinal, causal modeling study conducted in 67 hospitals in the southeastern United States, Texas, and the District of Columbia. Sampling criteria included: not-for-profit, non-federal, general acute care hospitals with 150 beds that were accredited by JCAHO. Two general medical-surgical nursing units at each hospital participated, for a total of 134 nursing units. Data collection. Study coordinators at each hospital, who were prepared for their roles during a 1 1/2 day training session, were responsible for the conduct of the study at that hospital. Following IRB approval in each hospital, data were collected using Dillman's Total Design Method to assure high response rates. Cross-sectional data, obtained during the Fall of 1996, were used in this analysis. Measures. Hospital characteristics included technological sophistication measures by the number of "high tech" services offered; the case mix intensity index (CMI) as assigned by HCFA; the number of open/staffed beds; and the hospital lifecycle, categorized as "decliner", "stable", "unstable" or "grower". Unit characteristics included the complexity of care measured by a 12-item Likert format patient technology scale (alpha=0.78); the availability of support services measured by a 27-item support service questionnaire (alpha=0.85); the number of open/staffed beds; a workload measure defined as total patient days divided by total number of RNs; total number of unit staff; and unit lifecycle. Nurse characteristics included highest educational level, years of experience, and age. Patient characteristics included patient age. The dependent variable, perceptions of staffing adequacy, was measured using one item from the team effectiveness questionnaire that asks about the adequacy of unit staffing. Data analysis. Data were analyzed using descriptive statistics and hierarchical block regression with stepwise within-block entry. Results - Descriptive statistics. Hospitals had 352 open/staffed beds, offered 6 "high tech" services, and reported a CMI of 1.35. Four percent of hospitals were "decliners, 39% were "stable", and 51% were "unstable", and 6.5% were "growers. Nursing units had 34 beds open and staffed and "about half" the patients had complex nursing care needs (mean=3.55). Support services were inconsistently available (mean=1.51). Average workload was 279.0 , total RNs on the unit averaged 18 and total staff averaged 31. Only 3% of units were "decliners", 35.5% were "stable", 47% were "stable", and 14.5% were "growers". Nurses were 39 years old, had 6-10 years experience, and 32% were BSN-prepared. Average patient age was 54 years. Perceptions of staffing adequacy reflected that staffing was "somewhat below average" to "average". Stepwise regression identified three variables explaining 11.9% of the variance in perceived staffing adequacy (F=6.20; p=0.001): greater technological sophistication of the hospital (B=0.222; p=0.01), lower workload (B=-0.235; p=0.01), and less complex patients on the unit (B=-0.188; p=0.03). These findings suggest that while there is some objective basis for nurses' perceptions of staffing adequacy, there is a large amount of still unexplained variance that needs to be more fully addressed.
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.titlePerceptions of staffing adequacy: Results from the ORNA projecten_GB
dc.contributor.authorSalyer, Jeanneen_US
dc.author.detailsJeanne Salyer, PhD, Virginia Commonwealth University, Department of Adult Health Nursing, Richmond, Virginia, USA, email: jsalyer@hsc.vcu.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165813-
dc.description.abstractThe purpose of this study was to identify hospital, nursing unit, staff nurse and patient characteristics that affect staff nurse perceptions of the adequacy of unit staffing. This analysis was conducted as a part of the Outcomes Research in Nursing Administration Project (ORNA), a multi-site study examining the effects of a variety of hospital and nursing unit characteristics and nursing unit organization structure on a variety of nursing administration and patient outcomes. Methods - Design, sample and setting. The ORNA Project is a non-experimental, longitudinal, causal modeling study conducted in 67 hospitals in the southeastern United States, Texas, and the District of Columbia. Sampling criteria included: not-for-profit, non-federal, general acute care hospitals with 150 beds that were accredited by JCAHO. Two general medical-surgical nursing units at each hospital participated, for a total of 134 nursing units. Data collection. Study coordinators at each hospital, who were prepared for their roles during a 1 1/2 day training session, were responsible for the conduct of the study at that hospital. Following IRB approval in each hospital, data were collected using Dillman's Total Design Method to assure high response rates. Cross-sectional data, obtained during the Fall of 1996, were used in this analysis. Measures. Hospital characteristics included technological sophistication measures by the number of "high tech" services offered; the case mix intensity index (CMI) as assigned by HCFA; the number of open/staffed beds; and the hospital lifecycle, categorized as "decliner", "stable", "unstable" or "grower". Unit characteristics included the complexity of care measured by a 12-item Likert format patient technology scale (alpha=0.78); the availability of support services measured by a 27-item support service questionnaire (alpha=0.85); the number of open/staffed beds; a workload measure defined as total patient days divided by total number of RNs; total number of unit staff; and unit lifecycle. Nurse characteristics included highest educational level, years of experience, and age. Patient characteristics included patient age. The dependent variable, perceptions of staffing adequacy, was measured using one item from the team effectiveness questionnaire that asks about the adequacy of unit staffing. Data analysis. Data were analyzed using descriptive statistics and hierarchical block regression with stepwise within-block entry. Results - Descriptive statistics. Hospitals had 352 open/staffed beds, offered 6 "high tech" services, and reported a CMI of 1.35. Four percent of hospitals were "decliners, 39% were "stable", and 51% were "unstable", and 6.5% were "growers. Nursing units had 34 beds open and staffed and "about half" the patients had complex nursing care needs (mean=3.55). Support services were inconsistently available (mean=1.51). Average workload was 279.0 , total RNs on the unit averaged 18 and total staff averaged 31. Only 3% of units were "decliners", 35.5% were "stable", 47% were "stable", and 14.5% were "growers". Nurses were 39 years old, had 6-10 years experience, and 32% were BSN-prepared. Average patient age was 54 years. Perceptions of staffing adequacy reflected that staffing was "somewhat below average" to "average". Stepwise regression identified three variables explaining 11.9% of the variance in perceived staffing adequacy (F=6.20; p=0.001): greater technological sophistication of the hospital (B=0.222; p=0.01), lower workload (B=-0.235; p=0.01), and less complex patients on the unit (B=-0.188; p=0.03). These findings suggest that while there is some objective basis for nurses' perceptions of staffing adequacy, there is a large amount of still unexplained variance that needs to be more fully addressed.en_GB
dc.date.available2011-10-27T14:34:13Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:34:13Z-
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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