The Transformation of Nursing Practice in the Acute Care Hospital
Review TypeNone: Degree-based Submission
Repository Posting Date2019-03-01T20:56:09Z
Author(s)Forget, Bernadette M
Author DetailsBernadette Maguire Forget
Lead Author Sigma AffliationDelta Mu
Level of EvidenceOther
Research ApproachQualitative Research
CINAHL HeadingsNursing Practice -- Trends; Acute Care; Hospitals; Health Care Reform -- Trends; Delphi Technique; Nursing Practice; Health Care Reform
The Delphi method elicited the opinions of 12 expert nurses regarding the knowledge, skills, relationships, and resources that were most important to the transformation of nursing practice in the acute care hospital. Five open-ended questions in Round I generated 230 statements for the Round II survey. Participants rated the Round II statements for importance on a four-point Likert scale. The ratings in Round II were included in the Round III survey which asked participants to again rate each statement for importance on the four-point Likert scale. Eighty-two statements achieved consensus (ratings greater than 70%) in Round III. The 82 statements were analyzed for content related to the study categories of knowledge, skills, relationships, and resources, the futuristic characteristics of the consensus statements, and the relationship of the consensus statements to transition, the conceptual framework of the study. Findings indicated that health care reform was changing the work of the nurse in the acute care hospital. Professional, ethical, and personal dimensions of nursing practice were identified within the context of knowledge, skills, relationships, and resources. Eighteen statements, characterized as futuristic, were related to the implications of the Nursing 2020 study--autonomy, new opportunities, and patient rights. Leadership, new competencies, resource utilization, and quality of life were important futuristic themes. Transition, the conceptual framework for the study, incorporated subjective, behavioral, and interpersonal aspects that promoted individual, group, and organizational health. Eighty of the 82 consensus statements were related to the conditions of transitions. This suggested that participants understood the evolving environment and had begun the transitions within their practices that would sustain change in the acute care hospital. The range of important issues also indicated that participants experienced transition as a personal phenomenon. Transition was an "organizing concept" that supported new ways of thinking about the work of the nurse. Implications related to role development, leadership, and learning. Suggestions for further research centered on the concept of transition, the new work of the nurse, teamwork, perceptions of quality care, and implementation of new roles.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9734058; ProQuest document ID: 304344285. The author still retains copyright.
Degree GrantorColumbia University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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