How Unit Level Nursing Responsibilities Are Structured in US Hospitals

Minnick, Ann F.; Mion, Lorraine C.; Johnson, Mary E.; Catrambone, Cathy

doi:10.1097/01.nna.0000285147.87612.96

Cited by 11 publications

(14 citation statements)

References 6 publications

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“…The results support previous warnings against the use of self-identification for nursing organizational models in research [3]. Outside the research field, in education as well as in discussions of nursing organization, we must be aware that terminology is an imperfect description of practice.…”

Section: Discussionsupporting

confidence: 81%

“…It has been suggested, therefore, that self-identification (i.e. model identified by staff on ward) should be avoided as a way of describing nursing organization [3]. …”

Section: Introductionmentioning

confidence: 99%

“…[3] suggested that the lack of conclusive research findings with regard to the strengths and weaknesses of different organizational models is a consequence of indistinct classifications; there is a need for knowledge on this topic to guide decisions in nursing administration re work force deployment, with the aim of improving patient outcomes and nurses' work conditions. The predicted health personnel shortage [12] could lead to modifications of existing organizational models [13] with a consequent increase in the need for knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

2010

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BackgroundThe organization of nursing services could be important to the quality of patient care and staff satisfaction. However, there is no universally accepted nomenclature for this organization. The objective of the current study was to classify general hospital wards based on data describing organizational practice reported by the ward nurse managers, and then to compare this classification with the name used in the wards to identify the organizational model (self-identification).MethodsIn a cross-sectional postal survey, 93 ward nurse managers in Norwegian hospitals responded to questions about nursing organization in their wards, and what they called their organizational models. K-means cluster analysis was used to classify the wards according to the pattern of activities attributed to the different nursing roles and discriminant analysis was used to interpret the solutions. Cross-tabulation was used to validate the solutions and to compare the classification obtained from the cluster analysis with that obtained by self-identification. The bootstrapping technique was used to assess the generalizability of the cluster solution.ResultsThe cluster analyses produced two alternative solutions using two and three clusters, respectively. The three-cluster solution was considered to be the best representation of the organizational models: 32 team leader-dominated wards, 23 primary nurse-dominated wards and 38 wards with a hybrid or mixed organization. There was moderate correspondence between the three-cluster solution and the models obtained by self-identification. Cross-tabulation supported the empirical classification as being representative for variations in nursing service organization. Ninety-four per cent of the bootstrap replications showed the same pattern as the cluster solution in the study sample.ConclusionsA meaningful classification of wards was achieved through an empirical cluster solution; this was, however, only moderately consistent with the self-identification. This empirical classification is an objective approach to variable construction and can be generally applied across Norwegian hospitals. The classification procedure used in the study could be developed into a standardized method for classifying hospital wards across health systems and over time.

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Section: Discussionsupporting

confidence: 81%

“…It has been suggested, therefore, that self-identification (i.e. model identified by staff on ward) should be avoided as a way of describing nursing organization [3]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

2010

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“…If we wish to shift unit-level practice to include more open and direct communication with colleagues, it is crucial that we attend to the pragmatic considerations that influence nurse-nurse relationships. In this context, it might be worthwhile to re-visit the issues of care delivery models and systems (Latimer, 2000; Lookinland et al, 2005; Minnick et al, 2007). …”

Section: Discussionmentioning

confidence: 99%

“…While there exists a basic vocabulary for care delivery models (e.g., primary nursing, team nursing, total patient care), it is not clear to what extent these are being implemented in reliable or consistent ways (Minnick, Mion, Johnson and Catrambone, 2007). Nor is it clear how effective these models are in organizing and producing quality nursing care (Lookinland, Tiedeman and Crosson, 2005).…”

Section: Background and Significancementioning

confidence: 99%

Professional collegiality and peer monitoring among nursing staff: An ethnographic study

Padgett

2013

International Journal of Nursing Studies

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Background Patient safety and professional self-regulation systems both rely on professional colleagues to hold each other accountable for quality of care. Objectives To understand how staff nurses manage variations in practices within the group, and negotiate the rules-in-use for quality of care, collegiality, and accountability. Design/Methods Ethnographic case study; participant-observation, semi-structured interviews, policy analysis. Setting In-patient unit in an urban US teaching hospital. Results Explicit acknowledgement of conflicts and practice variations was perceived as risky to group cohesion. The dependence of staff on mutual assistance, and the absence of a system of group practice, led to the practice of “mutual deference”, a strategy of reciprocal tolerance and non-interference that gave wide discretion to each nurse’s decisions about care. Conclusions Efforts to improve professional accountability will need to address material constraints and the organization of nursing work, as well as communication and leadership skills.

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It's time for updating primary nursing in pediatric oncology care: Qualitative study highlighting the perceptions of nurses, physicians and parents

Korhonen

Kangasniemi

2013

European Journal of Oncology Nursing

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How Unit Level Nursing Responsibilities Are Structured in US Hospitals

Abstract: Administrators must recognize the differences in work models within their institutions as a part of any quality improvement effort. Attempts to test new work models must be rigorous in the measurement of their implementation.

Cited by 11 publications

References 6 publications

Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

Professional collegiality and peer monitoring among nursing staff: An ethnographic study

It's time for updating primary nursing in pediatric oncology care: Qualitative study highlighting the perceptions of nurses, physicians and parents

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