| Abstract |
The aim of this research study was to describe patient outcomes in active duty personnel, military retirees, and military dependents, and associated nursing organizational structures and processes in two U.S. Army hospitals. A total of 8 units in both hospitals were studied4 mixed-bed units and 4 specialty units. Patient outcomes included (a) adverse event occurrence, measured by three of the American Nurses Association (ANA) indicators (falls, urinary tract infections, and decubitus ulcers); (b) length of stay; (c) severity-adjusted acuity, measured by the Acute Physiological and Chronic Health Evaluation (APACHE II); (d) patient satisfaction with nursing care, measured by Hinshaw and Atwoods scale; and (e) health status, using the SF-36. Nursing organizational structures included the nursing practice model used, the nursing skill mix, and the education and experience of the nurses, all measured by interviews and questionnaires for administrative and staff nurses. Nursing organizational processes included (a) autonomy, nurse-physician relationship, and control over practice, measured with the Nurses Work Index- Revised (NWI-R); (b) nursing expertise, measured with the Manifestations of Early Recognition (MER); and (c) the extent to which an ethical work environment was present, measured with the Ethical Environment Questionnaire (EEQ). |
