Economic and Patient Outcomes of the Nurse-Patient Relationship

Purpose: The purpose of this research was to study qualitatively and quantitatively the nurse-patient caring relationship in relation to economic and patient outcomes in five civilian medical centers and one military medical treatment facility.

Design: A mixed-method, qualitative and quantitative research design, was selected for generation of data and tool development and economic and patient outcome data correlations in all organizational cultures.

Sample: Questionnaires were distributed to patients, nurses, and administrators at seven hospital sites. Four hospitals provided economic and patient outcome data.

Methods, Instrumentation, and Analysis: Qualitative data were generated from patients, nurses, and administrators via Grounded Theory methodology to strengthen the caring and economic subscales of professional and patient questionnaires and refinement of the Relational Caring Complexity Theory that had been developed in previous nurse-patient relationship economic studies. Quantitative data analysis included psychometric testing for reliability and validity of questionnaire. By means of hierarchical linear modeling, questionnaire data were correlated with economic and patient outcomes.

Findings: The instrument development process led to the development of final professional and patient questionnaires that are reliable and valid.

Nursing Implications: Although placing an exact economic value on the human caring dimension in dollars and cents is not easy, it is considered a powerful dimension in terms of what is valued with respect to patient and economic outcomes as well as an indicator of quality of care. Patient satisfaction, nurse satisfaction, and quality of care are inextricably linked. Understanding the influence of human and organizational caring on patient and economic outcomes is imperative. These results showed that no health care organization can exist without an economic point of reference and that no health care organization can be recognized as committed to excellence without a point of reference for the human caring dimension of nursing.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2007107263.xhtml