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Impact of Nurse Work Environment on Rural Quality of Care and Clinical Outcomes

护士工作环境对农村护理质量和临床结果的影响

基本信息

批准号：
7626485
负责人：
Marianne Baernholdt
金额：
$ 8.59万
依托单位：
UNIVERSITY OF VIRGINIA
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-28 至 2011-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7626485
关键词：
Acute Address Administrator American Anesthesia procedures Beds Caring Characteristics Clinical Collaborations Communities Community Hospitals Complex Computers Data Data Set Databases Decubitus ulcer Discipline of Nursing Distal Effectiveness Future Geographic Locations Goals Hip Fractures Hospital Nursing Hospitals Incidence Individual Infection Institution Internet K-Series Research Career Programs Knowledge Lead Life Link Measures Mediation Medical Mentors Mission Modeling Nurses Nurses&apos Health Study Nursing Assessment Nursing Staff Online Systems Outcome Patient Care Patients Perception Physicians Policy Maker Postoperative Period Poverty Principal Investigator Process Measure Quality Indicator Quality of Care Quality of life Reaction Research Role Rural Rural Community Rural Health Rural Hospitals Services Source Statistical Methods Structure Surveys Techniques Testing Training United States Agency for Healthcare Research and Quality Urban Hospitals Work Workplace base career development design health disparity mortality multilevel analysis patient safety programs research study rural area theories

项目摘要

DESCRIPTION (provided by applicant): The proposed study addresses NINR's mission of eliminating health disparities due to geographic location. Rural hospitals are absent from existing studies that identify community factors (i.e. level of poverty) and organizational factors (i.e. the nurse work environment and hospital characteristics) that influence quality of care and clinical outcomes. In this proposed K01, structural contingency theory is used to conceptualize the association between the nurse work environment, rural community characteristics, hospital and nursing unit characteristics, quality of care, and clinical outcomes (Ml mortality). The goals of this proposed mentored research are to: a) develop a nurse assessed quality indicator and test this measure against established quality indicators (hospital collected, and large public data sets); b) evaluate the relationship between quality indicators and clinical outcomes in small rural hospitals; c) examine characteristics of the community, hospital, nursing unit, and nurse work environment that may influence quality of care indicators and Ml mortality in small rural hospitals. To accomplish this, the candidate will pursue a career development program, and will gain knowledge and proficiency in designing, developing, and using Web surveys; using large secondary public data bases; negotiating the special challenges that rural health research poses; and acquiring advanced knowledge of statistical methods and computer applications needed to do large scale studies using multilevel data. The candidate will be prepared to assume a lead role in planning and conducting complex rural nursing health studies. The training will be applied to the proposed study where small rural hospitals in two states will be invited to participate through their chief nursing officer. Data will be collected from multiple sources: Web-based staff nurse surveys, hospital administrative data, and large public data bases (i.e. Hospital Compare and state discharge data). The data will be analyzed using multilevel modeling and regression techniques. This study will form the basis for future research that includes an expansion of quality of care in the hospital to patient's quality of life after discharge. Findings from this study may inform administrators and policy makers on how quality of care and Ml mortality rates for patients in small rural hospitals are influenced by factors in the nurses' work environment as well as characteristics of the rural community, hospital, and nursing unit.

描述（由申请人提供）：拟议的研究解决了NINR的使命，即消除由于地理位置造成的健康差异。农村医院是缺乏现有的研究，确定社区因素（即贫困程度）和组织因素（即护士的工作环境和医院的特点），影响护理质量和临床结果。在这个建议的K 01，结构权变理论被用来概念化之间的关联护士工作环境，农村社区的特点，医院和护理单位的特点，护理质量和临床结果（MI死亡率）。本研究的目的是：a）制定一个护士评估质量指标，并根据既定的质量指标测试这一措施（收集的医院和大型公共数据集）; B）评估小型农村医院中质量指标和临床结果之间的关系; c）检查社区、医院、护理单位的特点，和护士工作环境，可能会影响护理质量指标和MI死亡率在小型农村医院。为了实现这一目标，候选人将追求职业发展计划，并将获得设计，开发和使用网络调查的知识和熟练程度;使用大型二级公共数据库;谈判农村卫生研究带来的特殊挑战;并获得使用多级数据进行大规模研究所需的统计方法和计算机应用的先进知识。候选人将准备承担规划和进行复杂的农村护理健康研究的主导作用。培训将应用于拟议的研究，其中两个州的小型农村医院将通过其首席护理官被邀请参加。将从多个来源收集数据：基于网络的护士调查、医院管理数据和大型公共数据库（即医院比较和州出院数据）。将使用多级建模和回归技术分析数据。这项研究将为未来的研究奠定基础，包括将医院的护理质量扩展到患者出院后的生活质量。这项研究的结果可能会告知管理人员和政策制定者如何在小型农村医院的护理质量和MI患者的死亡率的影响因素，护士的工作环境，以及农村社区，医院和护理单位的特点。