Problem-orientation: an experimental study to test its heuristic value

Using a two-group before--after experimental design, this study explored the effect of problem-orientation on a nursing staff's ability to identify underlying patient problems. Nursing service staff members (registered nurses, licensed vocational nurses, and corps personnel) from two small naval hospitals who met the criteria for inclusion and consented to participate were utilized. Because of staff turnover, the composition of the groups differed from preto posttesting phases. The pretest sample consisted of 47 control/48 experimental subjects; the posttest sample included 38 control/39 experimental subjects. The experimental group was instructed on the independent variable, problem-orientation, by the investigator through a six-hour workshop on the problem-oriented nursing record after which the system was instituted in the experimental setting. After a five-month period posttesting was done to determine if changes had occurred. Analysis of the data supported the hypothesis that problem-orientation does, in fact, substantially increase a nursing staff's ability to identify patient problems. The incorporation of this system into nursing services could provide a vehicle for pinpointing underlying patient problems and dealing with them in a systematic way, thereby upgrading patient care.