THE IMPACT OF ORGANIZATIONAL STRUCTURE ON THE COST OF NURSING PRACTICE AND NURSE SATISFACTION IN THE HOSPITAL SETTING.
Contributors: Seton Hall University, School Of Education.
Published: 1988
Number of pages: 145
Subjects: Health Sciences, Health Care Management.; Health Sciences, Nursing.
Description: A case study was undertaken to measure the cost effectiveness of an alternate nursing care delivery system. The investigational delivery system was carried out in parallel to the traditional primary nursing system for a homogeneous group of patients. Both systems were run simultaneously until cost data for 50 cases was collected for each group.

In the traditional system, the nurses practiced in keeping with institutional requirements of eight hour days and forty hours of practice per week. In the investigational model, nurses provided nursing care based on the needs of patients, devoid of time schedules or time requirements.

Three categories were used for data analysis: cost variations between the two systems of care; nurse satisfaction derived from practice in each modality and the ability to maintain quality control in the investigational model.

The results of study indicated that the cost of nursing practice was less in the investigational model. The reductions of nursing hours and hence, the cost of care was found to be statistically significant at the 5% level of confidence based on a two-tailed T-test. The nurses' perception of satisfaction with both the traditional and investigational systems was measured by a Likert-type scale developed by the investigator. Paired T-tests indicated that nurses experienced more freedom and control in nursing practice in the investigational model.

Quality control was maintained according to set standards in both systems but the investigational model scored higher in nursing care planning and depth of documentation.

The study has implications for hospital and nursing administration is so far as cost effectiveness and nurse satisfaction are concerned. Recommendations include the need for further studies in the use of this system in alternate patient care areas. There is a need to investigate the system and the resultant nurse satisfaction when institutionalization of nursing practice is minimized and professional freedom and control in practice is maximized. Finally nurse educators need to examine curricula to assure that the tenets of bureaucracy are not superimposed on and interwoven in the teaching of the principles of nursing theory and practice.
Notes: Source: Dissertation Abstracts International, Volume: 49-06, Section: B, page: 2112.

Thesis (ED.D.)--SETON HALL UNIVERSITY, SCHOOL OF EDUCATION, 1988.

School code: 0869.