Young W B, Minnick A F, Marcantonio R
College of Nursing, University of Illinois at Chicago, USA.
J Nurs Adm. 1996 May;26(5):15-20. doi: 10.1097/00005110-199605000-00005.
The authors determine the importance that patients, nurses, and nurse managers place on aspects of care and measure nurses' care values based on their perceptions of their patients and nurse manager care values and their desire to meet these care expectations.
The literature has documented gaps in how nurses and patients define quality and value specific care aspects, but little is known about the situation in the current continuous quality improvement and patient-centered care environment, which emphasizes a customer focus. Misunderstanding patients' values and expectations may impede service improvement. Information about any existing gaps could help managers begin to devise patient satisfaction improvement strategies.
Two thousand fifty-one medical-surgical patients, 1264 staff members, and 97 nurse managers from 17 randomly selected hospitals participated in study activities related to selected aspects of patient care. Trained interviewers surveyed patients by telephone within 26 days of discharge using a pretested instrument. Staff members and managers completed a coordinated written tool. Descriptive and correlational statistics were used in individual and unit-level analyses.
Staff members perceive correctly that patients value differently various aspects of care but do not agree with their managers on patients' value of aspects of care. Unit staff members' and managers' beliefs regarding patients' care values did not match those of their patients (-14 to 0.11 and -0.01 to 0.06 zero order correlations, respectively).
A unit's errors in defining patients' values may be self-reinforcing. Strategies to reorient personnel, including adoption of those suggested by the diffusion of innovation literature, may help bridge the gap and change practice.
作者确定患者、护士和护士长对护理各方面的重视程度，并根据护士对患者和护士长护理价值观的认知以及他们满足这些护理期望的愿望来衡量护士的护理价值观。
文献记载了护士和患者在如何定义特定护理方面的质量和价值上存在差距，但对于当前强调以客户为中心的持续质量改进和以患者为中心的护理环境中的情况知之甚少。误解患者的价值观和期望可能会阻碍服务改进。有关任何现有差距的信息可以帮助管理人员开始制定提高患者满意度的策略。
来自17家随机选择医院的2511名内科-外科患者、1264名工作人员和97名护士长参与了与患者护理选定方面相关的研究活动。经过培训的访谈员在患者出院后26天内通过电话使用经过预测试的工具对患者进行调查。工作人员和管理人员完成了一份协调一致的书面工具。描述性和相关性统计用于个体和单位层面的分析。
工作人员正确地认识到患者对护理各方面的重视程度不同，但在患者对护理方面的重视程度上与他们的护士长意见不一致。单位工作人员和护士长关于患者护理价值观的信念与患者的信念不匹配（零阶相关性分别为-14至0.11和-0.01至0.06）。
一个单位在定义患者价值观方面的错误可能会自我强化。重新调整人员的策略，包括采用创新文献传播中建议的那些策略，可能有助于弥合差距并改变实践。
