 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
Margaret A. Kroposki, RN, PhD, Nursing Division, Greenville Technical College, P. O. Box 5616, Greenville, SC 29606, 864-250-8382, peggykro@innova.net
The purpose of this study was to described the relationship of nurses' role clarity, nurses' decision-making, nursing care processes, agency ownership, location, and patient outcomes. This descriptive study surveyed nurses and patients in 43 home health agency components. The sample included 23 state owned agency components employing public health nurses to make home visits. Some 205 nurses reported their perceptions of their roles, decision-making, care processes, and patient outcomes, and 325 patients completed satisfaction surveys. Demographic information about agencies, nurses, and patients was also collected. Univariate, t-test, and regression analyses were conducted. The results indicated that nurses' role clarity, length of employment, and agency ownership were related to nurses' decision-making. Nurses reported that 79% of patient outcomes were achieved and patients reported 92% satisfaction with care. When all dimensions of nurses' decision-making and nursing care processes were analyzed, the resulting models accounted for 34% of patient satisfaction and 23% of nurses' perceptions of patient outcomes. The findings suggested that the dimensions of nurses' decision-making, combined with the dimensions of care processes, predicted the best patient outcomes. In home health, the highest level of patient outcomes were produced when three specific combinations existed: 1) when nursing care was complex, nurses consulted with supervisors, 2) when patients had varying medical diagnoses, nurses used rules and procedures to guide their decisions, and 3) when patients needed close monitoring, nurses collaborated with peers. By using these guidelines, nurse managers can improve patient outcomes by promoting nurses' decision-making strategies to fit the nursing care processes.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.