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Western Journal of Nursing Research, Vol. 27, No. 8, 1040-1058 (2005)
DOI: 10.1177/0193945905278587
© 2005 SAGE Publications

Nursing Structure, Processes, and Patient Outcomes in Army Medical Centers

Carolyn C. Kee

Byrdine F. Lewis School of Nursing, Georgia State University

Barbara Jo Foley

School of Nursing, University of North Carolina Chapel Hill

William N. Dudley

College of Nursing, University of Utah

Bonnie M. Jennings

Ptlene Minick

Byrdine F. Lewis School of Nursing, Georgia State University

Susan S. Harvey

Queens University of Charlotte.

The purpose of this study was to describe patient outcomes in Army Medical Centers, identify differences in outcomes between mixed medical-surgical bed and specialty intensive care units (ICUs), and explore predictive models for outcomes attributable to nursing structure and processes. Data were collected from 138 patients and 103 nurses in four medical-surgical and four ICUs in two Army Medical Centers. Significant differences for unit type were found for length of stay and patient satisfaction with nursing care. Outcome predictive models were modest (adjusted R2 = .16 to .24) and significant for length of stay, satisfaction with nursing care, satisfaction with pain management, and health status following discharge. Exploring differences and commonalities between military and civilian hospitals will ultimately provide insight into ways of improving patient outcomes and bettering the work environment of nurses.

Key Words: military nursing • nursing structure • nursing processes • patient outcomes • patient satisfaction


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