Abstract

This exploratory study examined the relationship between hospital nursing resources and quality outcomes of hospital care. A portion of Donabedian's model linking structure to outcome was used to frame the study. Structure variables consisted of hospital nursing resources. Outcomes were (1) patient satisfaction (with a: overall hospital stay, and with b: nursing care) and, (2) inpatient (risk-adjusted) mortality. The purpose of this study was to explore at the institutional level these relationships; the hospital being the unit of analysis. Nursing resource data were collected by the investigator from hospitals belonging to the same health care market. Chief nursing officers (nursing directors) of 22 hospitals were interviewed for qualitative data; 17 supplied requested quantitative nursing resources data. Outcomes data were provided by a major cost-quality project (Cleveland Health Quality Choice Coalition) involving all hospitals in the metropolitan health care market. In addition, data pertaining to 15 selected hospital characteristics were obtained from a number of primary and secondary, published data sources. Four research questions were addressed, beginning with an isolated exploration of singular variables and progressing to relationships between the nursing resources and outcome variables, with the final addition of selected hospital characteristics. Data analysis included descriptive, exploratory data analysis (EDA), correlational, and multiple regression techniques. Statistical significance was generally lacking and the sample size was small, specific to one health care market. Nevertheless, several trends were identified relative to the four research questions. The general patterns identified in this analysis are as follows. The two service volume measures (patient days and discharges) produced variable distributions whose characteristics differed in such a way that questions were raised regarding the potential impact on findings of studies using these variable measures. Licensed practical nurse variables behaved in distinctly and statistically significant different ways from registered nurse and nurse aide variables. A relationship between patient satisfaction with overall hospital stay, and amount and type of nursing resources appeared to emerge. A relationship between patient satisfaction with nursing care and nursing resources was less evident. A number of study findings yielded suggestions for future studies related to: variable measurement; data collection methods; statistical analytic techniques; macrolevel data analysis at the institutional level; and research questions requiring exploration, testing, and further confirmatory analysis.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9835516; ProQuest document ID: 304470630. The author still retains copyright.

Author Details

Dr. Cheryl A. Patterson, PhD, MBA, RN

Sigma Membership

Alpha Mu

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Quantitative Research

Keywords:

Patient Satisfaction, Nursing Resources, Hospital Characteristics

Advisors

Moore, Shirley M.

Degree

PhD

Degree Grantor

Case Western Reserve University

Degree Year

1998

Rights Holder

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2020-07-06

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