Planning and evaluating innovations in nursing practice by measuring the ward atmosphere

A controlled evaluation of nurses' and patients' perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice.