Date of Award

2014-07-01

Degree Name

PhD Nursing

Dissertation Committee

Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN, Chairperson; Cynthia D. Connelly, PhD, RN, FAAN; Laurie A. Ecoff, PhD, RN, NEA-BC

Keywords

magnet designation, nurse practice environment, nursing, patient-centered outcomes, pediatric hospital, peripheral intravenous infiltrations, quality of life, southern California

Abstract

Background: Characteristics such as quality patient care, excellence in nursing, and innovations in professional nursing practice shape a health care organization into a "magnet" organization. Magnet designation is a key aspect of nursing, which places pressure on healthcare organizations to commit to nursing excellence and patient care should they take the challenge of attaining this prestige. With growing focus on quality and safety, nursing needs to remain diligent in ensuring a healthy work environment that not only supports the profession, but also sustains exceptional patient outcomes. The purpose of this research study was to describe the relationship of the nurse practice environment and peripheral intravenous (PIV) infiltrations in a large urban stand-alone, pediatric teaching hospital on the Magnet journey. Methods: A descriptive correlational design with an on-line self-administered nurse survey was used for the study. The research setting took place in a large urban stand-alone, pediatric teaching hospital located in Southern California. The sampling plan included purposive, non-randomized sampling of eligible nurses who spent at least 50% of their time in direct patient care in any of the selected five types of inpatient units, with a minimum of six months employment on their current unit. An on-line self-administered nurse survey was sent to an estimated 400 nurses during August/May 2014. The study measures were organized into 3 dimensions: PIV infiltrations, Nurse Attributes, and Nurse Practice Environment. Descriptive and inferential statistics were conducted using SPSS version 22. Results: The research findings from this study indicated there were several statistically significant relationships with PIV infiltrations, Nurse Attributes, and the Nurse Practice Environment. Data showed that a nurse who works on the Medical Inpatient Units has a higher proportion of experiencing PIV infiltrations, as well as not experiencing PIV infiltrations. Subsequently, the PES-NWI subscale score by nursing unit presented statistically significant differences in one or more of the nursing units in 4 of the 5 PES-NWI subscales. Overall, the PES-NWI composite mean score was 2.87, which indicated that nurses were generally satisfied with their work environment in their current job. Additionally, Nursing Unit and Years as RN on Primary Unit indicated a statistically significant association with PIV infiltrations. This supports the inference that the unit on which the nurse works does matter in relation to experiencing or not experiencing PIV infiltrations. Conclusions: This study highlighted the importance of how the nurse practice environment and nursing-sensitive indicators contribute to pediatric patient-centered outcomes for hospitals on the Magnet journey. Focusing on measures that matter to consumers will enhance the success of healthcare organizations in supporting important quality initiatives for continuous improvement, and sustainability of nursing work culture and patient outcomes. The study findings can also help us better understand the associations amongst the nurse practice environment and patient outcomes, and provide a framework for nursing and their professional impact and responsibilities in addressing current and future healthcare demands.

Document Type

Dissertation: Open Access

Department

Nursing

Included in

Nursing Commons

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