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Biomedical subjects

M K Anthony

Publications and source records attributed to M K Anthony.

7 recordsLinked to original sources
PubMed2001

Benefits and outcomes of staff nurses' participation in decision making.

OBJECTIVES: To investigate the relations among staff nurses' participation in phases of the decision-making process related to decisions in nursing practice, competencies of nurse manager leadership, and nurse-physician collaboration. METHODS: This study is a secondary analysis of the Variations in Nursing Practice Model study. The data were derived from the responses of staff nurses to a questionnaire asking about their participation in decision making, their perception of the competency of nurse manager leadership, and their collaboration with physicians. RESULTS: Nurse-physician collaboration contributed to greater participation in all phases of both caregiving and condition-of-work decisions. The competency of nurse manager leadership had a small but significant positive correlation with participation in decision making, but it did not have a significant effect on phases of participation in both types of decisions. CONCLUSIONS: The study findings provide evidence to support the relations among an organizational structure, an organizational process, and a provider process of healthcare. Further research is needed to clarify the relation among structure, process, and specific outcomes.

Adult↗
PubMed2000

Measuring Nursing Practice Models using Multi-Attribute Utility theory.

Nursing Practice Models (NPMs) represent the structural and contextual features that exist within any group practice of nursing. Currently, measurement of NPMs relies on costly and nonreproducible global judgments by experts. Quantitative measurement techniques are needed to provide a useful evaluation of nursing practice. Guided by Multi-Attribute Utility theory (MAU theory), an expert panel identified 24 factors representative of N PMs. The factors became elements in a computational index that, when summed, assigns a score to a given nursing unit reflecting the extent to which that unit's nursing practice model achieves the nursing professional ideal. Initial validation of the index and its elements consisted of comparing assessments of 40 nursing units generated by the index with a global evaluation provided by each of the expert panelists who proposed the model factors. Pearson correlations between the index-generated scores and the global assigned scores provided evidence supporting the preliminary validation of the index.

Delivery of Health Care↗
PubMed2000

Factors influencing outcomes after delegation to unlicensed assistive personnel.

The authors discuss a national survey of licensed nurses that describes factors associated with patient outcomes when nursing activities are delegated to unlicensed assistive personnel (UAP). Licensed nurses' overall experience and UAP's experience in the current work setting were associated with more positive events. When the outcome of the delegated activity was determined by routine observation, more positive events occurred. However, when there was no direct supervision of the UAP, more negative events occurred. Recognition of the importance of the supervisory process has implications for educational opportunities that focus on strengthening licensed nurses' delegation competencies.

Adult↗
PubMed1999

The relationship of authority to decision-making behavior: implications for redesign.

Redesigning health care environments has occurred in response to cost and quality pressures. Efforts to redesign the nursing practice environment have focused on the structure and process of nursing care delivery. When redesign efforts address the structure of nursing practice systems to facilitate one important process, nurses' participation in decision making, better patient and organizational outcomes are expected. The purpose of this study was to determine if two dimensions of structure: administrative (decentralization) and professional authority (expertise) influence the process of participation in decision making for two kinds of decisions (caregiving and condition-of-work) that nurses make. The stratified sample consisted of 300 registered nurses working on medical-surgical units. Administrative and professional authority accounted for a small but significant amount of variation in participation in decision making. Because the extent of explained variation was small, the findings may challenge the prevailing assumption that greater authority for decision making results in the exercise of that authority. Redesign of the practice environment therefore must incorporate multiple factors in achieving greater participation in decision making.

Adult↗
PubMed1998

Successful patient discharge. A comprehensive model of facilitators and barriers.

The need for effective discharge planning by nurses has become more urgent and complex in light of recent healthcare initiatives. In response to better understanding discharge planning, four focus groups were held to describe a comprehensive framework of factors needed for effective discharge that are relevant to multiple nursing specialties across practice sites. Through content analysis, four themes--common across sites and specialties--were identified as important to discharge.

Adult↗
PubMedDate not supplied

The congruence of nursing diagnoses and supporting clinical evidence.

In this secondary analysis, 890 patients 40 years of age and older were assessed within 24 hours of transfer from intensive care to medical/surgical units. Nursing diagnoses documented in the hospital record were compared to supporting clinical evidence obtained from subjects, the hospital record, and interviews with subjects and nurse caregivers. The congruence, based on the kappa statistic, between the nursing diagnosis and clinical evidence ranged from 0.1% for altered thought processes to 10% for impaired gas exchange, impaired physical mobility, and potential for injury, while no diagnoses were made for self-care deficits or sensory alterations, visual, when clinical evidence for them was available.

Adult↗