Human factors and institutional culture are key to ensuring safety in health care. The purpose of this study is to investigate organizational climate for nursing practice as a predictor of patient and nurse safety problems using existing anonymized patient and nurse data from all of the hospitals in Pennsylvania in 1999. The working hypothesis is that higher levels of resource adequacy, physician-nurse relations, and administrative support for nursing practice will be associated with lower levels of adverse outcomes for patients (in the form of potentially-preventable complications of care) and nurses (in the form of needlestick injuries). The proposed study will also examine protocols for deriving a number of quality indicators other than risk-adjusted mortality using patient discharge abstracts and study the interrelationships of these indices, including complication measures developed by the Agency for healthcare Research and Quality and the American Nurses' Association and a measure called failure to rescue. The research and training plans will be carried out at the Center for Health Outcomes and Policy research at the University of Pennsylvania, a leading research group, under the mentorship of internationally-recognized experts in nursing outcomes research involving organizational features. My goals for this Research Career Award are to: (1) gain expertise in the construction of patient outcome measures relevant to nursing practice from large administrative datasets; (2) develop an ability to use statistical methods and computer applications necessary for doing large-scale patient outcomes studies examining organization context; (3) conduct the proposed study; (4) gain further experience in planning and managing large-scale primary data collections; (5) disseminate the results of the proposed study in peer-reviewed forums; and to, (6) develop and submit investigator-initiated proposals to extend this work.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01NR007895-02
Application #
6640374
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Bryan, Yvonne E
Project Start
2002-07-01
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2004-06-30
Support Year
2
Fiscal Year
2003
Total Cost
$90,396
Indirect Cost
Name
University of Pennsylvania
Department
Administration
Type
Schools of Nursing
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Clarke, Sean P (2007) Hospital work environments, nurse characteristics, and sharps injuries. Am J Infect Control 35:302-9
Clarke, Sean P; Schubert, Maria; Korner, Thorsten (2007) Sharp-device injuries to hospital staff nurses in 4 countries. Infect Control Hosp Epidemiol 28:473-8
Clarke, Sean P (2006) Organizational climate and culture factors. Annu Rev Nurs Res 24:255-72
Clarke, Sean P (2004) Failure to rescue: lessons from missed opportunities in care. Nurs Inq 11:67-71