REGISTERED NURSE ACADEMIC PREPARATION AND ORGANIZATIONAL STRUCTURE AS PREDICTORS OF NURSING PRODUCTIVITY, PATIENT LENGTH-OF-STAY, AND NURSING COSTS.
Contributors: University of Virginia.
Published: 1990
Number of pages: 264
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: In a health care environment plagued by severe fiscal and manpower constraints, organizational survival for nursing requires an understanding of how to cost effectively utilize nurses of varying educational backgrounds. This study addressed the following question: What effect does the academic preparation of registered nurses, have on nursing productivity, patient length of stay (LOS), and the cost of providing nursing care on primary and nonprimary nursing care units? It was hypothesized that care coordination, health promotion and knowledge development productivity would increase while, direct client care, patient LOS, and nursing costs would decrease as the level of nursing education increased. The Nurse Resource Utilization Form (NRUF), a self reporting work sample log assessed the relationships among these variables in two acute, tertiary care, medical centers in the Southeast. Multivariate test results indicated that among 16 nonbaccalaureate and 18 baccalaureate prepared nurses working on nonprimary and primary nursing care units, there were no statistically significant differences in nursing productivity, costs, and patient LOS levels. These results suggest that (a) there may be no differences in how nurses of varying academic preparations allocated their time among patients with similar nursing care needs and (b) clinical performance may not be related to the organizational model for delivery of care.

With further study, this research may suggest the use of nonbaccalaureate prepared nurses for the delivery of hospital nursing care. The more costly and lengthy baccalaureate nursing education might be reserved for the smaller numbers of nurses required for case manager roles or outpatient services. Education may be the link between quality and cost when supported by a practice structure that capitalizes on the strengths of the nurses providing care.

Recommendations are made for replication of the study with procedures being modified to insure less attrition among subjects. Future research should focus on how to best utilize the competencies of baccalaureate and nonbaccalaureate nurses in meeting nursing's social obligation to provide a quality service that will preserve both social and economic order.
Notes: Source: Dissertation Abstracts International, Volume: 51-05, Section: B, page: 2283.

Thesis (PH.D.)--UNIVERSITY OF VIRGINIA, 1990.

School code: 0246.