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Nursing sensitive outcomes - Essay Example

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Summary
With increasing awareness in healthcare outcomes in the 20th and the present century, nurses have also been placed under the purview of best practice principles. Presently, they are being increasingly expected to contribute to patient outcomes through their own practice (Doran et al, 2002)…
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Variables studied under this paper vary from the sophisticated constructs comprised of a combination of nurse and patient variables mediated by the 'Nursing Role Effectiveness Model (Doran et al, 2002) derived as per the researchers from Nursing Economics, 1998: 16; 58-64; 87. The same complexity of variables is derived from Titler et al, 2006, wherein the researchers utilize a construct model comprised of patient characteristics, clinical conditions, nursing unit characteristics and medical, pharmacy and nursing interventions related to the outcome of discharge disposition.

Other less complexly structured but as legitimate variables studied herein are nurses' spirituality (Chung et al, 2007), nurses' effective usage of physical touch in care (Rombalski, 2003) and special nursing intervention practices such as slow-breathing relaxation exercise as a prelude to the usage of opioids as a means to pain management during chest tube removal for patients who had undergone coronary bypass surgery (Friesner et al, 2006). The paper shall now study the degree of effectiveness as assessed by the individual sets of researchers for the aforementioned variables to determine their relative contributions to nursing role performance.

Doran et la, 2002, utilized the Nursing Role Effectivene. The cross-sectional design of NREM is a set of structure, process and outcome variables. Patient structural variables include medical diagnosis, gender, age and education (Doran et al, 2002). Nurse structural variables include educational preparation and hospital experience. Unit structural variables include the adequacy of time to provide, autonomy and role tension (Doran et al, 2002). Nurses' independent role performance was assessed by patient report on perceptions of quality of nurses' care.

Interdependent nurses' role performance was assessed by nurses' report on quality of nurses' communication and co-ordination of care (Doran et al, 2002).Patient outcome variables include patients' therapeutic self-care ability, functional status and mood disturbance at the time of hospital discharge assessed by patient self-report.It is distinctly significant that the quality of nurses' independent role performance mediated to a greater degree patient outcomes. Patient functional status was much better and degree of mood disturbance at discharge much less when nurses' independent role performance proved of better quality.

Interestingly also, this independent nursing role performance proved of better quality in units where there was less autonomy and more time for care. Interdependent role performance variables like care co-ordination proved of better quality in units where there was less autonomy and role tension and more nurse education and experience (Doran et al, 2002). The other nursing role interdependent variable, nurses' communication, proved of better quality in units where nurses were afforded more autonomy and had higher degrees of education but were less experienced and

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