Creating a safety culture is the focus in the current healthcare environment. An inhouse,
around-the-clock laborist service delivery model has been associated with positive
outcomes, but little is known about the laborist structure’s contribution to the labor-anddelivery
working environment. The purpose of this descriptive correlational study was to
explore the effects of physician service delivery model on safety culture, nurse-physician
collaboration, and nurses’ job satisfaction. An additional purpose was to examine
associations between nurses’ perceptions of safety culture, nurse-physician collaboration,
and job satisfaction. Ray’s (1981, 1989) Theory of Bureaucratic Caring and Homan’s
(1974) Social Exchange Theory guided this study. A survey consisting of demographic
questions, the Collaborative Practice Scale (Weiss & Davis, 1985), the Hospital Survey
on Patient Safety Culture (Agency for Healthcare Research and Quality, 2015;
HSOPSC), and the McCloskey and Mueller Satisfaction Scale (McCloskey & Mueller,
1990) was distributed to registered nurses (RNs) nationwide. The results indicated that nurses in facilities using the around-the-clock model had higher perceptions of nursephysician
collaboration, but not of safety culture or job satisfaction in relation to the
physician service-delivery model. Significant moderate-to-strong correlations between
nurses’ perceptions of patient safety and job satisfaction, and a weak correlation between
bedside nurses’ perceptions of nurse-physician collaboration and job satisfaction were
demonstrated. Additional significant correlations were found between the instrument
subscales. Control/responsibility in the MMSS scale was positively associated with both
management support for patient safety, supervisors’ and managers’ expectations and
actions promoting patient safety, and overall perceptions of safety in the HSOPSC scale.
Praise and recognition in the MMSS scale were positively associated with
supervisor/manager expectations and actions promoting patient safety in the HSOPSC
scale.
Further appraisal is needed to understand the mechanism by which the laborist
model affects patient care and work environment. Recommendations for future research
include replicating the study with a larger sample sizes in specific groups based on the
role and scheduled shift, conducting the study in a single system or location to mitigate
the effects of other variables; and exploring physicians’ perspectives on the variables
being studied. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection
| Identifer | oai:union.ndltd.org:fau.edu/oai:fau.digital.flvc.org:fau_39815 |
| Contributors | Abiri, Olga (author), Sherman, Rose O. (Thesis advisor), Florida Atlantic University (Degree grantor), Christine E. Lynn College of Nursing |
| Publisher | Florida Atlantic University |
| Source Sets | Florida Atlantic University |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation, Text |
| Format | 203 p., application/pdf |
| Rights | Copyright © is held by the author, with permission granted to Florida Atlantic University to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder., http://rightsstatements.org/vocab/InC/1.0/ |
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