title: American Association of Critical-Care Nurses Demonstration Project: profile of excellence in critical care nursing.
abstract: The American Association of Critical-Care Nurses developed a Demonstration Project to document fiscal costs and patient care effectiveness of critical care nursing in a unit characterized by valued organizational attributes. Data were collected by interview, observation, and written surveys from 42 nurses, 68 physicians, and 192 patient admissions. Decentralized administration, participatory management, high rate of CCRN certification, all-registered nurse staff, and high nurse-physician collaboration were present. Organizational and clinical outcomes were positive: high satisfaction, low turnover, low mortality ratio, no new complications, high patient satisfaction. The proportion of charges for nursing-controlled factors was low compared with proportion of total stay spent in the unit. Aspects of structure, process, and outcome can be measured simultaneously in critical care; these measurements indicate that positive organizational and clinical outcomes coexist with valued aspects of the organizational environment.
authors.affiliation: Department of Physiological Nursing, University of Washington, Seattle 98195.
authors.forename: P H
authors.initials: PH
authors.lastname: Mitchell
authors.forename: S
authors.initials: S
authors.lastname: Armstrong
authors.forename: T F
authors.initials: TF
authors.lastname: Simpson
authors.forename: M
authors.initials: M
authors.lastname: Lentz
mesh_terms: D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D003422:Critical Care / Q000191:economics / Q000592:standards*; D003625:Data Collection; D006744:Hospital Bed Capacity, 100 to 299; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007400:Interprofessional Relations; D007588:Job Satisfaction / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D014481:United States; D014861:Washington