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Relationships between Army nursing practice environments and patient outcomes.
Pauline A Swiger1, Lori A Loan2, Dheeraj Raju2
1US Army Nurse Corps, Landstuhl Regional Medical Center, Landstuhl, Germany.
Research in Nursing & Health
|January 23, 2018
Summary
A positive nursing practice environment, measured by the Practice Environment Scale of the Nursing Work Index (PES-NWI), is linked to better patient outcomes in military hospitals. This includes fewer patient falls and medication errors, and improved patient experiences.
Area of Science:
- Nursing
- Healthcare Management
- Military Health Systems
Background:
- Favorable nursing practice environments are linked to positive patient outcomes in civilian hospitals.
- Limited research exists on these associations within military healthcare settings.
Purpose of the Study:
- To examine the relationship between nursing practice environments and patient outcomes in Army hospitals.
- To assess if findings from civilian settings apply to military facilities.
Main Methods:
- Secondary data from 45 units in 10 Army hospitals over 4 years were analyzed.
- Generalized estimating equations were used to test associations between PES-NWI scores and patient outcomes.
- Outcomes included patient falls, medication errors, and patient experience.
Main Results:
- Four significant associations were identified between PES-NWI subscales and patient outcomes.
- Staffing and Resource Adequacy linked to patient falls.
- Collegial Nurse Physician Relations linked to medication errors.
- Nursing Foundations for Quality Care and Collegial Nurse Physician Relations linked to patient experience.
Conclusions:
- A positive nursing practice environment is associated with improved patient outcomes in military nursing units, mirroring findings in civilian hospitals.
- Specific environmental factors like adequate staffing and collegial relationships are crucial for patient safety and experience.
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