The development of a classification system for nurses' work methods

Bowman, Gerald S.; Webster, Reginald P.; Thompson, David R.

doi:10.1016/0020-7489(91)90007-p

Cited by 13 publications

(12 citation statements)

References 13 publications

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“…The WP describes objective features of wards and aspects of nursing practice. It was generated from qualitative interviews with ward nurses and managers which underpinned the study ( Adams & Bond 1995b) and from items included in previous instruments to assess ward practice ( MacGuire 1989; Thomas & Bond 1990, Mead 1993, Bowman et al . 1991 , 1993) which were likely to discriminate between wards.…”

Section: Methodsmentioning

confidence: 99%

Nursing organizational practice and its relationship with other features of ward organization and job satisfaction

Adams

Bond

Hale

1998

Journal of Advanced Nursing

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This paper describes a new classification of ward organizational practice in nursing. Data related to aspects of ward nursing practice were collected by postal survey from a nationally representative sample of 74 acute hospital wards, and subjected to hierarchical cluster analysis. The model which was deemed to best 'fit' the data, provided three types of ward practices, which have been named: 'devolved', 'two tier' and 'centralized' nursing. The distinguishing features of the three classifications are similar but not identical to accepted 'ideal types' of primary, team and functional systems. The relationships between wards in each of the three identified categories and other ward organizational practice processes of nursing care and job satisfaction are described.

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Section: Methodsmentioning

confidence: 99%

Nursing organizational practice and its relationship with other features of ward organization and job satisfaction

Adams

Bond

Hale

1998

Journal of Advanced Nursing

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Section: The Studymentioning

confidence: 99%

“…The charge nurses provided information about distribution of responsibility among the nurses of the wards. Items for this purpose were adapted from previous studies and modified for the contemporary, Norwegian context (Thomas & Bond 1990, Bowman et al 1991, Adams et al 1998, Makinen et al 2003. The charge nurse questionnaire also included items about type of service (medical or surgical), number of beds, and the proportion of full-time equivalent staff who had worked on the ward for less than 1 year, from 1 to 4 years, and 4 years or more.…”

Section: Charge Nurse Questionnairementioning

confidence: 99%

Service quality in hospital wards with different nursing organization: nurses’ ratings

Sjetne

Veenstra²,

Ellefsen

et al. 2009

Journal of Advanced Nursing

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(n=37), (1) and (2) combined. We prepared multilevel regression models using scales describing Quality of patient care, Climate to learning, Job satisfaction, and Relations with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results. 87 wards,1,137 nurses (55% response rate) provided complete data. The total proportion of variance at ward level ranged from 0.11 (Job satisfaction) to 0.22 (Relations with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions lead to a statistically significant effect of Primary nurse organization on Relations with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32%(Quality of patient care) to 24%(Climate to learning). Conclusion. This study could not show that any of the three organization models were better than the two others in terms of the nurses' perceived quality of patient care or practice environment. Suggested key words SUMMARY STATEMENT What is already known about this topic•Quality improvement is an important responsibility for hospital managers at all levels •The commission of first level nurse managers is to pursue quality for patients, employees, and society•There is little knowledge about the relations between nursing organization in hospital wards and the nurses' perceptions of the quality of patient care and practice environment What this paper adds•Nurses' ratings of quality is not related to the model of nursing organization•Local conditions other than nursing organization are associated with quality in the eyes of the nurses•Service quality seems to be a weak argument for choosing one model before another 7

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“…In four wards two nurse leaders completed the questionnaire, and the agreement in responses among these four pairs was excellent. Another study [18] used a similar questionnaire and compared staff nurses' responses to the questionnaire with the ward nurse managers' description of ward practice, reporting agreement re categorizations in 28 of 32 wards [18]. This approach has since been modified and used in other studies [1,19].…”

Section: Methodsmentioning

confidence: 99%

Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

2010

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BackgroundThe organization of nursing services could be important to the quality of patient care and staff satisfaction. However, there is no universally accepted nomenclature for this organization. The objective of the current study was to classify general hospital wards based on data describing organizational practice reported by the ward nurse managers, and then to compare this classification with the name used in the wards to identify the organizational model (self-identification).MethodsIn a cross-sectional postal survey, 93 ward nurse managers in Norwegian hospitals responded to questions about nursing organization in their wards, and what they called their organizational models. K-means cluster analysis was used to classify the wards according to the pattern of activities attributed to the different nursing roles and discriminant analysis was used to interpret the solutions. Cross-tabulation was used to validate the solutions and to compare the classification obtained from the cluster analysis with that obtained by self-identification. The bootstrapping technique was used to assess the generalizability of the cluster solution.ResultsThe cluster analyses produced two alternative solutions using two and three clusters, respectively. The three-cluster solution was considered to be the best representation of the organizational models: 32 team leader-dominated wards, 23 primary nurse-dominated wards and 38 wards with a hybrid or mixed organization. There was moderate correspondence between the three-cluster solution and the models obtained by self-identification. Cross-tabulation supported the empirical classification as being representative for variations in nursing service organization. Ninety-four per cent of the bootstrap replications showed the same pattern as the cluster solution in the study sample.ConclusionsA meaningful classification of wards was achieved through an empirical cluster solution; this was, however, only moderately consistent with the self-identification. This empirical classification is an objective approach to variable construction and can be generally applied across Norwegian hospitals. The classification procedure used in the study could be developed into a standardized method for classifying hospital wards across health systems and over time.

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The development of a classification system for nurses' work methods

Cited by 13 publications

References 13 publications

Nursing organizational practice and its relationship with other features of ward organization and job satisfaction

Nursing organizational practice and its relationship with other features of ward organization and job satisfaction

Service quality in hospital wards with different nursing organization: nurses’ ratings

Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

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