Patient satisfaction is a key outcome measure being examined by researchers exploring the relationships between patient outcomes and hospital structure and care processes. Only a few non-generalizable studies, however, have explored the relationship of nurse staffing and patient satisfaction with nursing care in emergency departments of hospitals. This dissertation aims to address that gap. Using more than 182,000 patient satisfaction surveys collected over a five-year period from 153 emergency departments (EDs) in 107 hospitals throughout Ontario, this study explores the relationship between nurse staffing and patient perceptions of nursing care in a range of Canadian ED settings, including urban and rural, community and academic, and small and large healthcare institutions with varying sizes and case mix.
Using an established conceptual framework for investigating the relationship between nurse staffing and patient outcomes, nineteen nurse staffing variables were initially investigated. Ultimately, however, only five staffing variables were used in the multi-level regression analyzes. These five variables included registered nurse (RN) proportion, RN agency proportion, percent full-time nurse worked hours, RN worked hours per patient length of stay and registered practical nurse (RPN) worked hours per length of stay. Emergency department case mix index, patient age and gender, hospital peer group, size, wait times, cleanliness of the emergency department, physician courtesy, and year of measurement were controlled to account for their effect on the relationship between nursing staffing and patient satisfaction in the ED.
The study revealed a subset of six patient satisfaction variables representing the overall variation in patient satisfaction with nursing care in the ED. Although RN proportion and RPN worked hours per length of stay were found to have a statistical association with patient satisfaction in the ED, the association was weak and not administratively actionable. Interpersonal and environmental factors such as physician and nurse courtesy, ED cleanliness and timeliness, however, were areas which hospital administrators should consider since they were highly associated with patient satisfaction in EDs.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/32693 |
| Date | 21 August 2012 |
| Creators | Daniel, Imtiaz |
| Contributors | Barnsley, Janet |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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