Organizational Characteristics and Adverse Patient Outcomes in Provincial Hospital, Thailand

The quality of care is an important goal for improving healthcare service. Nurses have significant roles in preventing adverse patient outcomes and improve quality of care. Moreover, nursing practice environment is important for good patient outcomes. This study aimed to examine the relationship between organizational characteristics and adverse patient outcomes in provincial hospitals, Thailand. Populations in this study were patients who were hospitalized and registered nurses who were working at selected units from August to December, 2014. Sample included 155 units and 886 registered nurses.

The research instruments included 1) organizational characteristics form including ward type, number of bed, number of nurses and patients, and ocupancy rate. 2) An adverse patient outcome recording form and 2) the Nursing Practice Environment Questionnaire transladed by Nantsupawat (2010). Data was analyzed by using frequency, percentage, mean, standard deviation and spearman Rank Correlation Coefficients.

Results revealed that the average of nurse to patient ratio was 8.01 (SD= 2.70), of occupancy rate was 84.72 (SD= 34.84), of practice environment was at a favorable category. The incidents rate per month of fall was .09 (SD=.32), of pressure sore was .94(SD=3.86), of hospital-acquired pneumonia was .23 (SD=.72), of hospital-acquired urinary tract infection was .35 (SD=1.00), of medication error was 5.26 (SD=9.82), of complaint was .08 (SD= .33), and of patient identification error was .08 (SD=.33). Occupancy rate were positively related with pressure sore (Rs = .396, p <.001), hospital-acquired pneumonia (Rs = .261, p<.01), and hospital-acquired urinary tract infection (Rs = .295, p <.001). Nursing practice environment was negatively related to fall (r = -.163, p<.05) and medical error (r = -.204, p<.05).

The results of this study can be an information for nurse managers to manage occupancy rate and nursing practice environment in order to prevent the occurrence of adverse patient outcomes and improve quality of care.