June H. Larrabee

Predicting registered nurse job satisfaction and intent to leave.

Background Nurse job dissatisfaction has been the primary predictor of intent to leave; however, although many predictors of job satisfaction have been identified, little is known about the influence of variable nurse attitudes, such as psychological empowerment and hardiness, on job satisfaction. Objective The purpose of this study was to investigate the relative influence of nurse attitudes, context of care, and structure of care on job satisfaction and intent to leave. Methods A nonexperimental, predictive design evaluated these relationships in a nonrandom sample of 90 registered staff nurses using instruments with known psychometric properties. Results The major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. Predictors of psychological empowerment were hardiness, transformational leadership style, nurse/physician collaboration, and group cohesion. Conclusions Results supported the influence of nurse attitude on job satisfaction relative to other contributing factors.

Defining Patient-Perceived Quality of Nursing Care

Many patient satisfaction instruments are not based on patient perceptions, theoretically limiting their validity. This qualitative study identified good nursing care from the patients perspective, using a convenience sample of 199 hospitalized adult patients in a public hospital in South Central United States. Content analysis yielded five themes: providing for my needs, treating me pleasantly, caring about me, being competent, and providing prompt care. Similarities and differences were found between these themes and themes identified in other qualitative studies, as well as instruments, for which item generation was based upon qualitative patient data. Implications for providers, administrators, and researchers are discussed.

Evaluation of a program to increase evidence-based practice change.

Objective: The study evaluated a nursing research program designed to achieve systematic evidence-based practice change. Specifically, change in nurse attitudes about use of research and research conduct, practice change projects, and nurse participation in research-related activities were evaluated. Background: Evidence indicates that successful evidence-based practice change in an organization requires senior leadership support and a systematic program for practice change. Evaluation of program effectiveness provides evidence about opportunities for further improvement. Methods: Quantitative evaluation used a pretest-posttest design. The site was an academic medical center in rural West Virginia. Participants were registered nurses from all inpatients units, perioperative services, and emergency departments. Surveys used Alcock et als Staff Nurses and Research Activities scale. Descriptive evaluation included the number of nurses who attended the workshop, practice change projects, scholarly products disseminated, and outcome of a Magnet review. Results: First, knowledge about the availability of support services increased between 1999 and 2002 and was associated with higher attitude scores about research and research utilization. Second, registered nurses who reported participating in research-related activities had more positive scores on all attitudes than registered nurses who reported not participating. Conclusions: Nurse leaders may improve participation and attitudes about research and research utilization by internally marketing the support available for research-related activities.

Phenomenological lived experience of patients with rheumatoid arthritis.

This phenomenological study explored (a) the lived experience of rheumatoid arthritis (RA), (b) the patients view of the nurses role, and (c) the patient as comanager of RA. The purposive sample consisted of 6 Caucasian women living in West Virginia. Using Colaizzis methodology, a rich, exhaustive description of living with RA emerged. Recommendations for nursing care quality focus on providing personalized, holistic, and humanistic care, which may ultimately improve the patients quality of life.

Advancing quality improvement through using the best evidence to change practice.

We are living in an exciting era in which we have a much more extensive body of nursing research than in the past decades on which to base nursing practice. Although there remain many aspects of patient care for which little research is available, our literature contains a wealth of knowledge applicable to practice. The purpose of this new column in the Journal of Nursing Care Quality is to present practical information for direct-care nurses and quality improvement leaders about using the best available evidence to change practice.

Women's perceptions of quality and benefits of postpartum care

Increased competition in the United States has led to increased interest in womens perceptions of their obstetric experience. Family-centered postpartum care (FCPPC) was originated to improve womens perceptions of care quality. This study examined differences in and the hypothesized relationship between quality and beneficence in a group receiving traditional postpartum care (TPPC) and a group receiving FCPPC in a safety-net hospital in West Tennessee. Both groups had high mean quality and beneficence scores; however, the FCPPC groups scores were significantly higher than those of the TPPC group. There was a relationship between quality and beneficence for the combined sample. The findings suggest that nurses should incorporate FCPPC approaches as a means of improving perceived quality and benefits.

Improving geriatric care knowledge, competency, and resourcefulness of home care nurses and aides.

Home care nurses aides have opportunities to support families caring for frail elders; however, most lack specialized geriatric knowledge, competence, and resourcefulness skills essential to caring for vulnerable elders and assisting their families. This study compares the pretest and posttest intervention scores of a geriatric care continuing education program for nurses and aides. Specific participant outcomes include increased geriatric knowledge, competency, and resourcefulness.

Tobacco ban within a psychiatric hospital.

We are living in an exciting era in which we have a much more extensive body of nursing research than in the past decades on which to base nursing practice. Although there remain many aspects of patient care for which little research is available, our literature contains a wealth of knowledge applicable to practice. The purpose of this column is to present practical information for direct-care nurses and quality improvement leaders about using the best available evidence to change practice. This column is coordinated by June H. Larrabee, PhD, RN, e-mail: jhlarrabee@adelphia.net.

Implementation of an evidence-based bladder scanner protocol.

URINARY TRACT INFECTIONS (UTIs) are the leading nosocomial infection and can increase hospital length of stay.1 The estimated cost of treating a UTI ranges from

A simultaneous analysis of nursing care quality and cost

500 to