Nurse Attitudes toward Patient Advocacy in the Long-Term Acute Care Hospital Setting

Advocacy is the essence of nursing’s professional commitment to preserving human rights, protecting patients from harm, and providing quality care.  In this dynamic healthcare environment with increased patient complexity and clinical acuity, sub-acute transitional care settings flourished.  Given the vulnerability of patients in transitional settings such as long-term acute care (LTAC), the essential role of nurses as patient advocates emerged as a cornerstone of nursing practice.  Despite the universally recognized importance of nursing advocacy in maximizing patient safety and delivery of quality care, no consensus existed about the concepts comprising nursing advocacy actions.  To explore nurses’ attitudes toward advocacy in LTAC, a quantitative, descriptive, cross-sectional study was conducted with two specific aims: to measure nurse attitudes along three core attributes of advocacy (safeguarding patients’ autonomy, acting on behalf of patients, and championing social justice in the care of vulnerable patients) and to determine if levels of nursing education influenced attitudes toward advocacy.  The Attitude toward Patient Advocacy Scale employed in this study demonstrated high internal consistency at 0.94%, p = 0.05, study sample size n = 108 (67% response rate), and confidence interval of 95%.  ANOVA analysis indicated no statistically significant association between educational levels and advocacy attitudes in LTAC nurse respondents.  Findings also indicated the majority of nurse respondents disagreed that it was their role to mediate when the patients’ wishes were in conflict with the physician or family. The study findings have important clinical implications for LTAC nurses and nurse leaders in the LTAC setting.