Factorial Validity of the Decisional Involvement Scale as a Measure of Content and Context of Nursing Practice.

Decisional involvement is widely recognized as an essential component of a professional nursing practice environment. In recent years, researchers have added to the conceptualization of nurses' role in decision-making to differentiate between the content and context of nursing practice. Yet, instruments that clearly distinguish between these two dimensions of practice are lacking.

Quality and strength of patient safety climate on medical-surgical units.

Background: Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units.

Purposes: Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate.

Bridging the gap between problem recognition and treatment: the use of proactive work behaviors by experienced critical care nurses.

Delayed access to physicians has been identified as a factor in preventable adverse patient events during hospitalization. Nurses as front-line providers are well positioned to provide a timely response to the needs of patients. Yet legal regulations and hospital policies limit the actions nurses can initiate without physician authorization.

Organizational influences on patient perceptions of symptom management.

We tested a theoretical model of the relationships of hospital context, nursing unit structure, and patient characteristics to patients' perceptions of the extent to which nurses met their expectations for management of troubling symptoms. In our sample of 2,720 patients randomly selected from 278 nursing units in 143 hospitals, we found that patient age was positively associated with patients' perceptions of symptom management. The proportion of registered nurses as caregivers on the unit was not a significant predictor of symptom management, but better work conditions on the unit (nurses' autonomy, participation in decision-making, and collaboration with other disciplines [relational coordination]) significantly contributed to patients' perceptions of better symptom management.

Quality and strength of patient safety climate on medical-surgical units.

Background: Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units.

Purposes: Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate.

Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

Problem: Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects.

Fitting in or standing out: nursing workgroup diversity and unit-level outcomes.

Background: Despite growing diversity in the nursing workforce, there has been limited investigation of the implications of diversity to the performance of nursing workgroups.

Objectives: The aim of this study was to examine relationships among two categories of nursing workgroup diversity (highly visible and job related), intervening workgroup processes (workgroup cohesion and initiative), and workgroup performance (affective and cognitive).

Methods: A descriptive design with path analysis was used to test two models derived from Pelled's intervening process theory.

Evaluation of an informal peer group experience on baccalaureate nursing students' emotional well-being and professional socialization.

Although studies have documented the importance of the academic environment in promoting positive outcomes among students, few quantitative studies in nursing have been performed to identify strategies through which a nurturing learning environment can be created. A randomized two-group pretest-posttest design was used to investigate effects of an informal peer group experience on baccalaureate nursing students' emotional well-being and professional socialization as caring practitioners. Groups did not differ significantly on the outcomes measured in this study.

Describing an episode of home nursing care for elderly postsurgical cancer patients.

Background: While studies have documented the beneficial effect of home care for cancer patients, the actual interventions implemented during these studies have not been well described.

Objectives: Purposes of this study were to analyze interventions documented in narrative form by advanced practice nurses during a four-week episode of home care and describe intervention type, frequency, range, and variation over time in intervention emphasis and dose intensity.

Methods: Chart audits were performed on records kept for 148 postsurgical cancer patients who were assigned to the experimental group in a randomized clinical trial to evaluate the effect of home care on quality of life outcomes (McCorkle et al.