title: Nursing structure, processes, and patient outcomes in army medical centers.
abstract: The purpose of this study was to describe patient outcomes in Army Medical Centers, identify differences in outcomes between mixed medical-surgical bed and specialty intensive care units (ICUs), and explore predictive models for outcomes attributable to nursing structure and processes. Data were collected from 138 patients and 103 nurses in four medical-surgical and four ICUs in two Army Medical Centers. Significant differences for unit type were found for length of stay and patient satisfaction with nursing care. Outcome predictive models were modest (adjusted R2 = .16 to .24) and significant for length of stay, satisfaction with nursing care, satisfaction with pain management, and health status following discharge. Exploring differences and commonalities between military and civilian hospitals will ultimately provide insight into ways of improving patient outcomes and bettering the work environment of nurses.
authors.affiliation: Byrdine F. Lewis School of Nursing, Georgia State University, USA.
authors.forename: Carolyn C
authors.initials: CC
authors.lastname: Kee
authors.forename: Barbara Jo
authors.initials: BJ
authors.lastname: Foley
authors.forename: William N
authors.initials: WN
authors.lastname: Dudley
authors.forename: Bonnie M
authors.initials: BM
authors.lastname: Jennings
authors.forename: Ptlene
authors.initials: P
authors.lastname: Minick
authors.forename: Susan S
authors.initials: SS
authors.lastname: Harvey
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006757:Hospital Units / Q000458:organization & administration*; D006772:Hospitals, Military / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008888:Military Nursing / Q000193:education / Q000458:organization & administration; D015403:Nursing Evaluation Research; D009736:Nursing Process / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D017009:Professional Autonomy; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D014481:United States