Page 420 - Encyclopedia of Nursing Research

PATIeNT SATISFACTION n 387

meta-analysis, patient and hospital charac- data, information, knowledge, and wisdom
teristics, including hospitals’ commitment in nursing practice is critical in helping
to the quality of care, are likely contributors design better work environments. Nursing P
to the causal mechanism of the relationship informatics research and practice is needed
between RN staffing and patient outcomes. for efforts aimed at promoting patient safety
A line of research with a broader focus in health care organizations. To this end,
than staffing levels is the investigations nursing informatics researchers and practi-
involving Magnet hospitals (i.e., hospitals tioners can play an important role in improv-
that attract nurses, hence the term Magnet). ing access to information (Currie et al., 2003;
When Magnet hospitals were matched with Newhouse, 2006), developing automated sur-
control hospitals, controlling for case mix, veillance for real-time error detection and
Aiken, Smith, and lake (1994) observed a prevention (McCartney, 2006; Weir, Hoffman,
Medicare mortality rate that was lower by 4.6 Nebeker, & Hurdle, 2005), facilitating com-
per 1,000 discharges (95% confidence inter- munication among members of the health
val, 0.9–9.4). However, besides the attainment care team (Kuziemsky et al., 2009), and devel-
of Magnet status, specifics were not identi- oping clinical decision support (Anderson &
fied. Magnet hospitals are known for higher Willson, 2008; Bakken, Cimino, & Hripcsak,
nurse-to-patient ratios, lower staff turnover 2004). Although the components of an infor-
rates, and higher rates of nursing satisfaction. matics infrastructure are widely available to
More recently, investigators found that nurses develop informatics applications that pro-
working in Magnet hospitals were signifi- mote patient safety, today only 1.5% of U.S.
cantly less likely to report jobs that included hospitals have a “comprehensive electronic-
mandatory overtime (Trinkoff et al., 2010). records system” (Jha et al., 2009).
Furthermore, other researchers have found Organizational and individual commit-
the use of overtime to be adversely related to ment to improving patient safety requires
patient safety (Stone et al., 2007). effective leadership and proactive interven-
Nurses are in the position of being “at tions. Patient safety improvements need
the sharp end” of health care interventions to draw from qualitative and quantitative
by being the patient’s advocate, providing research describing work processes and
care that may result in an error, or witness- responsibilities, methods to improve perfor-
ing the error(s) of other clinicians. Accidents, mance respecting human limitations, and
errors, and adverse outcomes result from a designs of patient safety supportive commu-
chain of events involving human decisions nication and team approaches to health care
and actions associated with active failures delivery.
and latent failures. Many of these failures are
associated with individual performance that Patricia W. Stone
is impaired by stress, distractions/interrup- Arlene Smaldone
tions, and fatigue. Robert Lucero
Information technology was identi-
fied by the IOM Committee on Quality of
Health Care in America as critical in design-
ing a health system that produces care that Patient satisfaCtion
is safe, effective, patient centered, timely,
efficient, and equitable (IOM, 2001). Nursing
informatics defined by the American Nurses Patient satisfaction is a compelling topic in
Association (2008) as the integration of nurs- the current health care environment when
ing science, computer science, and informa- cost, financial viability of organizations,
tion science to manage and communicate quality, and empowerment of consumers are