Relationship of organizational and nurse subsystem variables to nursing productivity
The Systems Model for Nursing Productivity provided the framework needed to examine the relationships between specific input and output variables in this non-experimental, four-group design, explanatory study. The model defined productivity as the efficient and effective delivery of quality care to satisfied patients. The tool used to measure these four parameters was the Multifactorial Measure of Nursing Productivity (MMNP).
The hospitals were a convenience sample selected to represent for-profit and non-profit institutions and circular/cluster or rectangular designed patient care units. The organizational input variables examined included ownership (for-profit and non-profit) and design (circular/cluster and rectangular). The nurse subsystem variables included age, years of nursing experience, years of employment at the hospital under study, years of employment on the unit and the nurses' perception of their work environment. Demographic variables of the patients who participated in the study were also considered. These variables included age, number of previous admissions and number of days hospitalized. Patients and nurses were randomly sampled at each facility, with a total population of 120 patients and 76 nurses.
The quality of care and effectiveness scores for the MMNP were determined from the Rush-Medicus Quality of Care tool. The LaMonica Oberst Patient Satisfaction Scale, mailed to patients one week after discharge, was used for the patient satisfaction score. The efficiency score was a compilation of utilization of staff, minutes of overtime, and unscheduled absences.
There were no significant differences observed based on the interrelationship of the organizational variables of ownership and design and the MMNP scores. An analysis, however, of the findings did reveal a number of significant relationships and differences between specific variables. Both Pearson correlations and two-way ANOVAs were used to identify these relationships. Descriptive statistics used to describe demographic variables of both patient and nurse populations revealed similar groups.
The study demonstrated the interaction of multiple input variables which can impact on how well nurses perform. Of the organizational variables examined, the circular/cluster designed hospitals were found to be more frequently correlated with higher levels of productivity. A number of recommendations were made for future research.