Nurse Perceptions of the Impact of Nursing Care on Patient Outcomes: An Exploratory Study

By Schreuders, Louise; Bremner, Alexandra P. et al. | Contemporary Nurse : a Journal for the Australian Nursing Profession, June 1, 2012 | Go to article overview

Nurse Perceptions of the Impact of Nursing Care on Patient Outcomes: An Exploratory Study


Schreuders, Louise, Bremner, Alexandra P., Geelhoed, Elizabeth, Finn, Judith, Contemporary Nurse : a Journal for the Australian Nursing Profession


For almost a decade researchers have investigated the relationship between the quality and/or quantity of nursing care and adverse patient outcomes (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Kane, Shamliyan, Mueller, Duval, & Wilt, 2007; Lankshear, Sheldon, & Maynard, 2005; Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002). Interest in quantifying this relationship emerged in response to a trend of reducing numbers of Registered Nurses per patient in an effort to curb rising health care costs (Aiken, Clarke, & Sloane, 2000; McCloskey & Diers, 2005; Shindul- Rothschild, Berry, & Long-Middleton, 1996). Some of the challenges in this field of research are yet to be fully resolved, for example, defining and accurately measuring nursing care (Reinier et al., 2005) and deciding upon suitable and measurable indicators of quality nursing care (Doran et al., 2006; Jennings, Staggers, & Brosch, 1999; Spetz, Donaldson, Aydin, & Brown, 2008). In 2002, a team of researchers constructed fourteen clinical indicators (listed in Table 1) that could be both conceptually linked to nursing care and feasibly measured using routinely collected hospital discharge information from administrative data sets (Needleman et al., 2002).

Following on from the work of Aiken, Smith, and Lake (1994) and Needleman, Buerhaus, Mattke, Stewart, and Zelevinsky (2001) there has been growth in the literature in the field. A systematic review of studies relating to hospital nurse staffing and patient outcomes was commissioned by the Agency for Healthcare Research and Quality, published in 2007 (Kane et al., 2007). Of the 94 eligible studies included in the metaanalysis, the pooled results showed that: every additional registered nurse full-time equivalent (FTE) per patient day was associated with a 'relative risk reduction in hospital-related mortality by 9% in intensive care units and 16% in surgical patients' (Kane et al., 2007, p. 2); the death rate decreased 1.98% for each additional nurse hour per patient day (95% CI 0.96-3.0%; Kane et al., 2007); and there was a significant negative correlation between the percentage of nurses with Bachelor of Nursing Science degrees and the incidence of death related to health care (r = -0.46, p = 0.02; Kane et al., 2007). The systematic review concluded that increased nurse staffing in hospitals is associated with better patient outcomes, but acknowledged that the relationship does not necessarily imply causation (Kane et al., 2007).

Despite the concept of nursing sensitive outcomes (NSO) being embraced internationally (International Council of Nurses, 2007) and a growing research focus in Australia there is limited evidence to support the conceptual validity of Needleman's 14 NSOs for practising nurses in Australia (Duffield et al., 2007; Twigg, Duffield, Bremner, Rapley, & Finn, 2011). There is a lack of research elucidating practising nurse's perceptions of how NSO have been defined and how NSO may be affected by measures of nursing care. Moreover we were interested in whether characteristics of the nurse, such as age, education level or job description, influence a registered nurse's perception of the impact of nursing care on NSOs. Aiken et al. (2002), argue that nurses are at the front line of patient care delivery and as such are well placed to influence patient outcomes, but is this potentially compromised if nurses do not recognise the effect of their care on patient outcomes? In addition, nurses at the 'front line' of patient care may have novel ideas about additional indicators that might reflect the quality of nursing care delivered.

AIM

The aim of our study was to explore registered nurses' perceptions of the impact of nursing care on 13 of the 14 clinical outcomes defined by Needleman et al. (2001). We targeted Registered Nurses attending a nursing practice conference where the keynote speaker was an international researcher into nurse sensitive outcomes. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Nurse Perceptions of the Impact of Nursing Care on Patient Outcomes: An Exploratory Study
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.