NURSING TECHNOLOGY, ORGANIZATIONAL CONTROL STRUCTURES AND NURSE PRACTITIONER PRACTICE ACTIVITIES.
Contributors: University of Maryland at Baltimore.
Published: 1985
Number of pages: 178
Subjects: Health Sciences, Nursing.
Description: Theoretical and empirical literature on complex organizations suggests that the control structures utilized in an organization are dependent upon the nature of the work technology in the setting. The purpose of this study was to explore the relative influence of nursing technology and organization control structures on the clinical and supportive tasks of Nurse Practitioners in health care settings.

Five major variables were examined in the study: nursing technology in the setting; the organizational control structures of centralization, standardization and differentiation; and the proportion of clinical and supportive NP tasks performed. A 36 - item self administered questionnaire was used in a cross sectional mailed survey of 122 NP practicing in health care settings in a single southeastern state.

Differentiation, the numbers of other types of care providers in the setting, was the single best predictor of NP practice activities. The greater the organizational differentiation, the greater the proportion of clinical tasks performed. Centralization, the participation by the NP in organizational decision making, was the second best predictor of NP practice activities. The greater the NP participation in organizational decision making, the greater the proportion of supportive tasks performed. Standardization, the existence of written guidelines for practice in the setting, did not significantly influence NP practice activities. Nursing technology, the workflow and individual task routineness and variability of nursing work, did not significantly influence the proportion of clinical and supportive tasks performed by NPs.

The theoretical and empirical linkages between organizational technology and control structures were also explored for the health care settings where the 122 respondents practiced. The more variable and nonroutine the nursing technology in the practice setting, the less standardization and differentiation and the more centralized the decision making.

Practice settings were divided into four general categories: hospital inpatient, hospital outpatient, private practices and community based clinics. These settings differed in their relative amounts of organizational differentiation and in nursing technology. Hospital inpatient units were the most differentiated and had the most variable and non-routine nursing technology.

While some of the predictor variables examined were related to NP practice, they explained less than 10 percent of the variance in NP tasks or nursing technology, indicating that other organizational and individual variables also influence NP practice. (Abstract shortened with permission of author.).
Notes: Source: Dissertation Abstracts International, Volume: 47-02, Section: B, page: 0568.

Thesis (PH.D.)--UNIVERSITY OF MARYLAND AT BALTIMORE, 1985.

School code: 0373.