This is a revised competing renewal continuation application which is built on research conducted in a multisite, multipurpose study of inpatient AIDS care. The previous study was a comparative, observational study of 40 inpatient units in 20 hospitals in 11 cities in which matching was employed at the hospital level to introduce the control elements of a quasi-experimental design. Data collected included information on organizational attributes of the units and the hospitals, extensive information on nurses, and an array of information on a consecutive sample of AIDS patients including interviews, nurses' clinical assessments, extensive medical record extractions, discharge summaries, posthospital survival status, and billing information. That research effort confirmed a number of positive benefits of dedicated AIDS units over scattered-bed arrangements for AIDS care and offered a number of new and important areas for additional research. In the present study, the Investigator proposes to pursue four new areas: (1) to examine the impact of dedicated AIDS units on care outcomes across hospital type in order to assess the potential of unit level reorganization to improve care in distressed hospitals; (2) to extend the study to a third organizational model--the hospital-wide professional nurse practice model or magnet hospital--which requires additional data collection in six hospitals; (3) to document empirically the operant mechanisms linking variation in hospital organization to patient outcomes; and (4) to estimate the effects of different patient characteristics on the odds on being in a dedicated AIDS unit, and the implications for access to care.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR002280-06
Application #
2771828
Study Section
AIDS and Related Research Study Section 6 (ARRF)
Program Officer
Hare, Martha L
Project Start
1990-03-01
Project End
2000-08-31
Budget Start
1998-09-01
Budget End
2000-08-31
Support Year
6
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Type
Schools of Nursing
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Lake, Eileen T; Friese, Christopher R (2006) Variations in nursing practice environments: relation to staffing and hospital characteristics. Nurs Res 55:1-9
Friese, Christopher R (2005) Nurse practice environments and outcomes: implications for oncology nursing. Oncol Nurs Forum 32:765-72
Vahey, Doris C; Aiken, Linda H; Sloane, Douglas M et al. (2004) Nurse burnout and patient satisfaction. Med Care 42:II57-66
Clarke, Sean P; Rockett, Joan L; Sloane, Douglas M et al. (2002) Organizational climate, staffing, and safety equipment as predictors of needlestick injuries and near-misses in hospital nurses. Am J Infect Control 30:207-16
Flynn, Linda; Aiken, Linda H (2002) Does international nurse recruitment influence practice values in U.S. hospitals? J Nurs Scholarsh 34:67-73
Clarke, Sean P; Sloane, Douglas M; Aiken, Linda H (2002) Effects of hospital staffing and organizational climate on needlestick injuries to nurses. Am J Public Health 92:1115-9
Aiken, L H; Patrician, P A (2000) Measuring organizational traits of hospitals: the Revised Nursing Work Index. Nurs Res 49:146-53
Aiken, L H; Sloane, D M; Lake, E T et al. (1999) Organization and outcomes of inpatient AIDS care. Med Care 37:760-72
Aiken, L H; Sloane, D M (1997) Effects of specialization and client differentiation on the status of nurses: the case of AIDS. J Health Soc Behav 38:203-22
Aiken, L H; Sochalski, J; Lake, E T (1997) Studying outcomes of organizational change in health services. Med Care 35:NS6-18

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