A comparison of nurses' perceptions of the culture of nursing in suburban community and urban academic hospitals

Date

2009-05

Authors

Anderson, Jacqueline J.

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Abstract

The purpose of this research was to explore the differences in the perceptions of the culture of nursing of nurses in suburban community hospitals when compared to nurses in urban academic hospitals. A secondary goal was to identify potential demographic variables of the nurses or the hospitals that could influence the culture of nursing, regardless of the setting. This descriptive exploratory study used an across-methods triangulation design to compare the culture of nursing in suburban academic hospitals and urban academic hospitals.

The theoretical framework used for this study was Leininger's Culture Care Diversity and Universality Theory and the Sunrise Model. The quantitative data were collected using a demographic questionnaire and the Organizational Culture Assessment Instrument (OCAI). The qualitative data were collected using open-ended questions. A convenience sample of 164 nurses from the 4 suburban community hospitals and 187 nurses from the 2 urban academic hospitals completed the instruments.

The suburban community nurses had the following mean scores: (a) 28.83 for the clan culture, (b) 25.57 for the adhocracy culture, (c) 26.68 for the hierarchy culture, and (d) 26.33 for the market culture. The urban academic nurses had the following mean scores: (a) 28.03 for the clan culture, (b) 26.54 for the adhocracy culture, (c) 26.98 for the hierarchy culture, and (d) 27.10 for the market culture. The ANOVA substantiated this finding with no statistically significant difference in the mean scores of the four culture types.

Regression analysis was used to identify potential demographic variables of the nurses and the hospitals that may influence the culture type scores on the OCAI, regardless of the setting. Two variables, ethnic origin of the nurses and highest degree held in nursing were identified as factors influencing the culture scores, but the results were not strong enough to suggest a relationship. The qualitative analysis of the written answers to the open-ended questions revealed three themes: (a) relationships, (b) professionalism and empowerment of nursing, and (c) commitment to quality and patient safety. The themes and specific comments shared supported the ranking of the mean scores in each setting.

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Keywords

Health and environmental sciences, Academic hospitals, Community hospitals, Nursing culture, Organizational Culture Assessment Inventory, Suburban, Suburban community hospital, Urban academic hospital, Urban health care

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