2.50
Hdl Handle:
http://hdl.handle.net/10755/166221
Category:
Abstract
Type:
Presentation
Title:
Quality nursing care in the hospital versus the home: A question of
Author(s):
Lynn, Mary
Author Details:
Mary Lynn, PhD, Associate Professor, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA, email: mlynn.uncson@mhs.unc.edu
Abstract:
While the provision of optimum care to patients is cleariy a professional obligation of nurses, it is considerably less clear how quality care should be evaluated, or who should be involved in the evaluation. From the premise that the provider and the recipient Of care are essential evaluators of the quality of nursing care, a series of studies have been conducted to elicit the perspectives of these partners in the care exchange. This paper will address a comparison of these perspectives when nursing care is delivered in a hospital setting versus the increasingly common home setting. All studies were based on the same method: qualitative interviews of patients and registered nurses were conducted to determine their perceptions and definitions of quality nursing care. Using the grounded theory method, a single grand-tour question (How do you describe or define good nursing care?) was posed, followed up by intensive questioning designed to determine the full extent of the informant's possible responses and illustrations. Interviews were audio-taped and literally transcribed. Constant comparative analysis formed the basis for the generation of categories of responses as well as more general concepts from the data. In the hospital-based studies a total of 20 registered nurses and 20 patients on medical-surgical units were interviewed. Conceptual categories from the interviews included themes related to the concept of caring (e.g., getting to know the patient, being mindful, nurturance) and to vigilance (e.g., responsiveness) emerged. In the home health study, a total of 16 people were interviewed - 9 patients and 7 nurses. The patients had been in home health care for an average of 17 months, had a variety of medical and surgical diagnoses, and were primarily cared for by a family member in their home. The central process in this study, negotiated care, refers to the understanding that, unlike the hospital, the patient shares the responsibility with the nurse for the care exchange. Negotiated care differs markedly from the quality care process in the acute care setting in that, while the nurse in the acute care setting is largely in control, the nurse in the home setting is a genuine partner in the care exchange. She/he may be looked to for the same attentive behavior the acute care nurse is expected to display, but she/he is no longer in the catbird seat. In the home health setting the nurse is the "guest" and while she has the "authority" in the care exchange, the patient and family become empowered by their familiar surroundings or their ability to "not do" if they so choose. Therefore, in contrast to the hospital based nurse's control over the care exchange, it is incumbent upon the home health nurse to help the patient decide what care regimen is for them and how they will enact it. As nursing care moves from the hospital to the home setting it is essential that nurses understand the shift in control over the care exchange from the provider to a negotiation between the provider and recipient of care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
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.titleQuality nursing care in the hospital versus the home: A question ofen_GB
dc.contributor.authorLynn, Maryen_US
dc.author.detailsMary Lynn, PhD, Associate Professor, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA, email: mlynn.uncson@mhs.unc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166221-
dc.description.abstractWhile the provision of optimum care to patients is cleariy a professional obligation of nurses, it is considerably less clear how quality care should be evaluated, or who should be involved in the evaluation. From the premise that the provider and the recipient Of care are essential evaluators of the quality of nursing care, a series of studies have been conducted to elicit the perspectives of these partners in the care exchange. This paper will address a comparison of these perspectives when nursing care is delivered in a hospital setting versus the increasingly common home setting. All studies were based on the same method: qualitative interviews of patients and registered nurses were conducted to determine their perceptions and definitions of quality nursing care. Using the grounded theory method, a single grand-tour question (How do you describe or define good nursing care?) was posed, followed up by intensive questioning designed to determine the full extent of the informant's possible responses and illustrations. Interviews were audio-taped and literally transcribed. Constant comparative analysis formed the basis for the generation of categories of responses as well as more general concepts from the data. In the hospital-based studies a total of 20 registered nurses and 20 patients on medical-surgical units were interviewed. Conceptual categories from the interviews included themes related to the concept of caring (e.g., getting to know the patient, being mindful, nurturance) and to vigilance (e.g., responsiveness) emerged. In the home health study, a total of 16 people were interviewed - 9 patients and 7 nurses. The patients had been in home health care for an average of 17 months, had a variety of medical and surgical diagnoses, and were primarily cared for by a family member in their home. The central process in this study, negotiated care, refers to the understanding that, unlike the hospital, the patient shares the responsibility with the nurse for the care exchange. Negotiated care differs markedly from the quality care process in the acute care setting in that, while the nurse in the acute care setting is largely in control, the nurse in the home setting is a genuine partner in the care exchange. She/he may be looked to for the same attentive behavior the acute care nurse is expected to display, but she/he is no longer in the catbird seat. In the home health setting the nurse is the "guest" and while she has the "authority" in the care exchange, the patient and family become empowered by their familiar surroundings or their ability to "not do" if they so choose. Therefore, in contrast to the hospital based nurse's control over the care exchange, it is incumbent upon the home health nurse to help the patient decide what care regimen is for them and how they will enact it. As nursing care moves from the hospital to the home setting it is essential that nurses understand the shift in control over the care exchange from the provider to a negotiation between the provider and recipient of care.en_GB
dc.date.available2011-10-27T14:42:44Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:42:44Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
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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