PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of hsresearchLink to Publisher's site
 
Health Serv Res. 1994 October; 29(4): 415–433.
PMCID: PMC1070015

The impact of unit-based self-management by nurses on patient outcomes.

Abstract

OBJECTIVE. Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING. Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through November 1990. STUDY DESIGN. A case series of eligible patients discharged from four self-managed nursing units (n = 140) are compared with patients from four matched traditionally managed units (n = 138) on postdischarge outcomes: perceived health status, perceived functional status, needs for care, unmet needs for care, unplanned health care visits, and readmissions to the hospital within 31 days of discharge. DATA COLLECTION METHODS. Patients were interviewed by telephone at approximately two weeks postdischarge, and data from hospital records were merged with interview data. PRINCIPAL FINDINGS. Bivariate and multiple logistic regression analyses showed no significant effects (either positive or negative) of self-managed units on the postdischarge outcomes studied. CONCLUSIONS. Self-managed nursing units, previously shown to improve nurses' work satisfaction and retention, have no impact on patient postdischarge outcomes.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Daley J, Jencks S, Draper D, Lenhart G, Thomas N, Walker J. Predicting hospital-associated mortality for Medicare patients. A method for patients with stroke, pneumonia, acute myocardial infarction, and congestive heart failure. JAMA. 1988 Dec 23;260(24):3617–3624. [PubMed]
  • Dear MR, Weisman CS, O'Keefe S. Evaluation of a contract model for professional nursing practice. Health Care Manage Rev. 1985 Spring;10(2):65–77. [PubMed]
  • Epstein AM, Bogen J, Dreyer P, Thorpe KE. Trends in length of stay and rates of readmission in Massachusetts: implications for monitoring quality of care. Inquiry. 1991 Spring;28(1):19–28. [PubMed]
  • Hinshaw AS, Smeltzer CH, Atwood JR. Innovative retention strategies for nursing staff. J Nurs Adm. 1987 Jun;17(6):8–16. [PubMed]
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818–829. [PubMed]
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986 Mar;104(3):410–418. [PubMed]
  • Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989 Jul 22;2(8656):201–205. [PubMed]
  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed]
  • Mamon J, Steinwachs DM, Fahey M, Bone LR, Oktay J, Klein L. Impact of hospital discharge planning on meeting patient needs after returning home. Health Serv Res. 1992 Jun;27(2):155–175. [PMC free article] [PubMed]
  • Mor V, Allen SM, Siegel K, Houts P. Determinants of need and unmet need among cancer patients residing at home. Health Serv Res. 1992 Aug;27(3):337–360. [PMC free article] [PubMed]
  • Naylor MD. Comprehensive discharge planning for hospitalized elderly: a pilot study. Nurs Res. 1990 May-Jun;39(3):156–161. [PubMed]
  • Rubenstein LZ, Josephson KR, Wieland GD, English PA, Sayre JA, Kane RL. Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med. 1984 Dec 27;311(26):1664–1670. [PubMed]
  • Thomas JW, Holloway JJ. Investigating early readmission as an indicator for quality of care studies. Med Care. 1991 Apr;29(4):377–394. [PubMed]
  • Wagner DP, Knaus WA, Draper EA. Physiologic abnormalities and outcome from acute disease. Evidence for a predictable relationship. Arch Intern Med. 1986 Jul;146(7):1389–1396. [PubMed]
  • Weisman CS, Alexander CS, Chase GA. Determinants of hospital staff nurse turnover. Med Care. 1981 Apr;19(4):431–443. [PubMed]
  • Weisman CS, Gordon DL, Cassard SD, Bergner M, Wong R. The effects of unit self-management on hospital nurses' work process, work satisfaction, and retention. Med Care. 1993 May;31(5):381–393. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust