Paper
Thursday, July 22, 2004
This presentation is part of : Nursing Administration
Patients' Perceptions of Nurse Staffing, Adverse Events, Nursing Care, and Overall Satisfaction With the Hospital Experience
Lee A. Schmidt, RN, PhD, School of Nursing, School of Nursing, University of Miami, Coral Gables, FL, USA
Learning Objective #1: Describe an empirical model of patientsí perception of nurse staffing, adverse events and perception of nursing care, and their overall satisfaction with the hospital experience
Learning Objective #2: Identify concerns related to focusing on the presence or absence of adverse events as an indicator of the quality of nursing care

Objective: Describe patientsí perceptions of nursing staffing, their nursing care, adverse events, and overall satisfaction with the hospital experience.

Design: Non-experimental, model generating and testing

Population: Discharged medical-surgical patients from two hospitals in the United States.

Concepts: Patientsí perceptions of nurse staffing, perceptions of their nursing care, self-reported adverse events, and overall satisfaction with the hospital experience.

Methods: Data collection through a mail survey, sent to patientsí home address 10-14 days after discharge. Data analysis included descriptive statistics of study variables, multivariate analysis of variance and model generating and testing using structural equation modeling.

Findings: Patients reported a higher frequency of adverse events than statistics reported in the literature. Patientsí perception of nurse staffing was a weak predictor of the number of adverse events experienced, and a strong predictor of their perception of the nursing care they received. Patientsí perception of their nursing care was a strong predictor of overall satisfaction with the hospital experience. The number of adverse events did not predict overall satisfaction with the hospital experience. Significant group differences in three of four dimensions of patientsí perceptions of their nursing care (Seeing the Individual Patient, Responding, and Watching Over) based on whether adverse events occurred.

Conclusions: Perceptions of nursing care was predicted more strongly by nurse staffing than the number of adverse events experienced. Perceptions of nursing care was a strong predictor of overall satisfaction with the hospital experience, providing further evidence of the central nature of nursing care in the hospitalization experience.

Implications: The presence or absence of adverse events requires careful consideration as an indicator of the quality of nursing care. The absence of adverse events may represent the lowest threshold of quality and a focus on a perceived negative outcome may overshadow the important contributions of nursing care in the hospital experience of patients.

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