A causal model for the quality of nursing care in Thailand.
Adult
Cross-Sectional Studies
Female
Humans
Job Satisfaction
Male
Middle Aged
Models, Statistical
Nursing Care
/ psychology
Nursing Staff, Hospital
/ psychology
Patient Satisfaction
/ statistics & numerical data
Quality of Health Care
/ statistics & numerical data
Surveys and Questionnaires
Thailand
Nurse-Patient Ratio
Nursing
Patient Satisfaction
Quality of Care
Skill Mix
Structural Equation Modelling
Thailand
Journal
International nursing review
ISSN: 1466-7657
Titre abrégé: Int Nurs Rev
Pays: England
ID NLM: 7808754
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
pubmed:
17
7
2018
medline:
27
6
2019
entrez:
17
7
2018
Statut:
ppublish
Résumé
A growing global nursing shortage has affected the quality of care (QOC) provision. To test the structure-process-outcome model for quality of nursing care in regional medical centres in Thailand. A cross-sectional study with multi-stage, proportional stratified random sampling. The sample comprised 136 units, 916 nurses and 943 patients from nine regional medical centres. Data were collected from six instruments in February-June 2016 and analysed with structural equation modelling. The modified model fitted the empirical data. The nurse practice environment (NPE) had a negative direct effect on pressure ulcer prevalence and a positive direct effect on patient satisfaction, perceived QOC and interpersonal processes of care (IPC). Increasing the patient-to-nurse ratio had a positive direct effect on catheter-associated urinary tract infections and pressure ulcer prevalence and had negative direct effects on patient satisfaction and perceived QOC. Skill mix had negative direct effects on the two former conditions but had a positive direct effect on patient satisfaction. The patient-to-nurse ratio and skill mix also had indirect effect on four outcomes via NPE. The generalizability of findings may be limited to settings similar to this study. We empirically demonstrated that NPE, patient-to-nurse- ratio and skill mix had direct effects on unfinished nursing care and four outcomes. Also, the IPC had significant influence on patient satisfaction. The findings add to increasing international evidence that favourable nurse working conditions, low nurse-to-patient ratio and richer skill mix result in positive patient outcomes. Health systems can foster nurses to perform high-quality care by improving work conditions, and providing sufficient nurses and resources.
Sections du résumé
BACKGROUND
BACKGROUND
A growing global nursing shortage has affected the quality of care (QOC) provision.
AIM
OBJECTIVE
To test the structure-process-outcome model for quality of nursing care in regional medical centres in Thailand.
METHODS
METHODS
A cross-sectional study with multi-stage, proportional stratified random sampling. The sample comprised 136 units, 916 nurses and 943 patients from nine regional medical centres. Data were collected from six instruments in February-June 2016 and analysed with structural equation modelling.
RESULTS
RESULTS
The modified model fitted the empirical data. The nurse practice environment (NPE) had a negative direct effect on pressure ulcer prevalence and a positive direct effect on patient satisfaction, perceived QOC and interpersonal processes of care (IPC). Increasing the patient-to-nurse ratio had a positive direct effect on catheter-associated urinary tract infections and pressure ulcer prevalence and had negative direct effects on patient satisfaction and perceived QOC. Skill mix had negative direct effects on the two former conditions but had a positive direct effect on patient satisfaction. The patient-to-nurse ratio and skill mix also had indirect effect on four outcomes via NPE.
LIMITATIONS
CONCLUSIONS
The generalizability of findings may be limited to settings similar to this study.
CONCLUSION
CONCLUSIONS
We empirically demonstrated that NPE, patient-to-nurse- ratio and skill mix had direct effects on unfinished nursing care and four outcomes. Also, the IPC had significant influence on patient satisfaction.
IMPLICATIONS FOR NURSING AND HEALTH POLICY
CONCLUSIONS
The findings add to increasing international evidence that favourable nurse working conditions, low nurse-to-patient ratio and richer skill mix result in positive patient outcomes. Health systems can foster nurses to perform high-quality care by improving work conditions, and providing sufficient nurses and resources.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
130-138Subventions
Organisme : National Research Council of Thailand
Informations de copyright
© 2018 International Council of Nurses.