Harwood Lori, Ridley Jane, Lawrence-Murphy Julie Ann, White Sharon, Spence-Laschinger Heather K, Bevan Joy, O'Brien Karen
Adam Linton Hemodialysis Unit, Victoria Hospital, London Health Sciences Centre, London, Ontario.
CANNT J. 2007 Apr-Jun;17(2):35-43.
The purpose of this study was to examine the effect of a renal nursing professional practice model (PPM) on nurses'perceptions of empowerment, characteristics of practice environments and the impact on nursing care outcomes in a university-based teaching hospital in Canada. Quantitative and qualitative methodologies were used. This paper will focus on the qualitative results. Content analysis was the data analysis method used. The following themes emerged: 1) Attunement, familiarity/knowing the patient, going the distance, 2) Patient outcomes, consistency and continuity of care, autonomy/taking the initiative, 3) Nurse rewards: satisfaction and accountability, empowerment/input, and 4) Facilitating systems: communication, support and assignment. The quantitative results had a significant (p = .005) improvement post-PPM implementation in the nursing foundations for quality of care subscale of the Practice Environment Scale of the Nursing Work Index (NWI-PES) and organizational relationships (p =.016) measured by the Conditions of Work Effectiveness II (CWEQ-II) questionnaires. This study provides evidence for PPMs and primary nursing as effective frameworks to positively impact nursing and patient outcomes in a hemodialysis unit.
本研究的目的是考察肾脏护理专业实践模式（PPM）对加拿大一所大学教学医院护士的赋权认知、实践环境特征以及护理结局的影响。研究采用了定量和定性方法。本文将聚焦于定性研究结果。数据分析方法为内容分析。出现了以下主题：1）协调、熟悉/了解患者、竭尽全力；2）患者结局、护理的一致性和连续性、自主性/主动采取行动；3）护士奖励：满意度和责任感、赋权/参与度；4）促进系统：沟通、支持和任务分配。在实施PPM后，通过护理工作指数实践环境量表（NWI-PES）护理基础质量子量表以及工作有效性条件II（CWEQ-II）问卷测量的组织关系方面，定量研究结果有显著改善（p = 0.005）。本研究为PPM和责任制护理作为对血液透析单元的护理和患者结局产生积极影响的有效框架提供了证据。
