To ensure quality patient care hospitals invest in nursing intellectual capital by allocating financial, human and material resources for nurses to acquire the knowledge and skills necessary to provide safe patient care. This study’s purpose was to test selected propositions of the middle-range theory of nursing intellectual capital which provides a conceptualization of the influence of nurses’ knowledge, skills and experience (nursing human capital) to patient and organizational outcomes. The theory was systematically developed after a critical review of the literature. It proposes that nursing human capital (registered nurses’ experience, and knowledge and skills acquired from continuing professional development including university courses, conferences, workshops, in-services, specialty certification) is related to variables within the work environment (nurse staffing, employer support for nurse continuing professional development), which in turn, is associated with the quality of patient care (adverse events) and the recruitment and retention of nurses. The theory also proposes that nursing structural capital, nursing knowledge available within practice guidelines, is associated with the quality of patient care. A cross-sectional design was used to test the proposed relationships. The study took place in 6 acute care hospitals in two provinces of Canada. Financial, human resource and risk management data were collected from hospital departmental databases and a survey of unit managers. Data from 91 inpatient units were used with structural equation modeling to test the theory’s propositions. The results indicated that nurses’ knowledge and skills represented by the proportion of RNs with degrees and proportion of RNs with specialty certification were directly associated with low hospital-acquired infection rates. Nurse experience, measured as mean years RN professional experience and RN unit tenure, was found to be significantly related to higher RN recruitment and retention. The proportion of RNs with degrees was found to partially mediate the influence of nurse staffing on hospital-acquired infections. The results provide preliminary evidence of the association of nursing intellectual capital with patient and organizational outcomes. The findings may assist administrators with fiscal and human resource decision-making related to the education of nurses within acute care hospitals, and professional organizations with policies governing nursing education and continuing professional development.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/29692 |
| Date | 30 August 2011 |
| Creators | Covell, Christine Lynn |
| Contributors | Sidani, Souraya |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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