Outcome Measures from Advanced Nursing Practice

The primary aim of this study is to determine whether advanced practice nurses' (APNs) delivered intervention promoting collaborative practice will improve military ward nurses' competency base and critical thinking skills, thus improving satisfaction with their practice environment. Secondary aims of the study are:

1. To evaluate general medical-surgical nurses' perceptions of autonomy and control of practice following APNs' delivered collaborative practice interventions.
   
   
2. To evaluate whether there is an improvement in general medical-surgical nurses' perceptions of collaborative behaviors following APNs' interventions.
   
   
3. To evaluate whether there is an improvement in patient practice-levels outcomes from APNs' interventions.

Studies show that ward nurses are generally dissatisfied with their practice environment. This dissatisfaction has a direct impact on recruitment and retention efforts. Multiple factors contribute to general medical-surgical nurses' dissatisfaction with their practice environment. Ill advised health care industry decisions to restrict and downsize the nursing work force, lack of support (mentoring), poor nurse-physician relationships, lack of autonomy and control of practice are factors often cited as contributing to dissatisfaction with the practice environment. This proposed clinical trial will use a two group randomized experimental design to test four hypotheses: 1) Military ward nurses' critical thinking skills and competency base will increase significantly following APNs' directed collaborative intervention as measured by scores on the Performance Base Development system; 2) Ward nurses' perceptions of autonomy and control of practice will increase significantly following a nurse delivered collaborative intervention, as measured by scores on the Nursing Work Index-R; 3) Ward nurses will perceive a significant increase in collaborative behaviors with physicians following APNs' delivered collaborative intervention, as measured by scores on the Collaborative Behavior Scale; and 4) There will be a significant improvement in patient practice-level outcomes following APNs' collaborative intervention compared to base-line measures using evidence-based guidelines. Data will be collected at baseline, six and 12 month intervals. Data will be analyzed using ANOVA with repeated measures and Chi square contingency tests.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2014101...