Nursing organizational practice and its relationship with other features of ward organization and job satisfaction

Adams, Ann; Bond, Senga; Hale, Claire

doi:10.1046/j.1365-2648.1998.00657.x

Cited by 60 publications

(83 citation statements)

References 25 publications

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“…The analytic approach to taxonomy development is well established in the organizational literature [36] and has been applied to healthcare in a number of prior studies [37-39]. In this study, the unit of analysis was the care unit.…”

Section: Methodsmentioning

confidence: 99%

A taxonomy of nursing care organization models in hospitals

Dubois

D’Amour

Tchouaket

et al. 2012

BMC Health Serv Res

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BackgroundOver the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features.MethodsThis study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data.ResultsThe study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work.ConclusionsThis study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice model described by some leaders in the contemporary nursing literature. While the two professional models appear closer to this ideal, the two functional models are farther removed.

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Section: Methodsmentioning

confidence: 99%

A taxonomy of nursing care organization models in hospitals

Dubois

D’Amour

Tchouaket

et al. 2012

BMC Health Serv Res

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“…In the nursing field, hospitals use four models of organising nurses' work that range from a nurse doing all the nursing care for a patient, to care done by shifts or teams of nurses, to dividing outpatient care by tasks assigned to different nurses (Adams, Bond, and Hale 1998;Tiedeman and Lookinland 2004). In functional nursing, motivated by the argument of efficiency, the overall care for an individual patient is divided into disparate tasks; nurses are assigned these and then carry out the same task for all patients in a ward.…”

Section: The Organisation Of Educators' Workmentioning

confidence: 99%

“…As a result, many different staff members provide care for any one patient for the duration of their stay. This arrangement has been criticised for creating 'professional distance' between nurses and patients, for being mechanistic, and resembling an industrial production line (Adams, Bond, and Hale 1998). Likewise, to what extent is there 'professional distance' between the educator and the learner when educational work in museums is divided?…”

Section: The Organisation Of Educators' Workmentioning

confidence: 99%

The work of science museum educators

Tran

2008

Museum Management and Curatorship

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This paper reports the findings from an interview study with 24 educators from 10 museums in England. The investigation looked at how educators characterise their work and how their work is organised. The analytical framework of this investigation draws on sociological discussions on professionalism. The findings show that there is shared conception of what museum educators do and that a technical language to talk about their work is emerging. However, further development may be effected by the diversity in educators' educational backgrounds. Furthermore, the way work is divided in some (large) institutions directly challenges the integrity and expert knowledge of the practitioners, which may ultimately impede the occupation from truly becoming a profession. The findings have implications for researchers and practitioners interested in science teaching in museum environments, and to the professionalisation of museum education.

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“…Studies indicate that the frequency and duration of (direct) nursing care activities are closely correlated [10,14] and influenced by such factors as the methods of care provision [32], caregiver characteristics [33,34], patient characteristics [11][12][13] and the organizational structure [35]. A study by Lundgren and Segesten [9] with respect to a medical-surgical ward, for instance, showed that changing the staffing pattern through the introduction of a patient focused system of nursing delivery increased the time used for direct care.…”

Section: Theory On Direct Carementioning

confidence: 99%