Nursing Processes & Patient Outcomes in U.S. Army Hospitals


Name: Barbara Jo Foley

Rank: COL (ret), USA

Organization: University of North Carolina at Chapel Hill

Performance Site: Tripler Army Medical Center, Honolulu, HI; Womack Army Medical Center, Fort Bragg, NC

Year Published: 2002

Abstract Status: Final


The goal of this study is to provide a comprehensive portrait of nurses, nursing care, and patient outcomes in military hospitals. The proposed study will continue a study previously funded by the TriService Nursing Research Program (N98-053) by adding to the data set and comparing the findings to data collected in a civilian study that used the same data collection tools, as well as to other published findings from civilian hospitals. The research will examine hospital characteristics (total number of operating beds, patient mix of active duty personnel, retired military personnel and dependents, the number of physicians assigned to the hospital, and the number of physicians who are board certified in their specialty practice area), nursing organizational structures (nursing practice models, nursing skill mix, and the education and experience of nurses), nursing organizational processes (nurse job satisfaction as measured by level of autonomy and nurse/physician collaboration, and clinical expertise) and patient outcomes (occurrence of adverse events, patient satisfaction and functional health status). No studies have compared the study variables in military hospitals to the same variables in civilian hospitals. The comparisons will make it easier to identify the nursing care elements that are most advantageous to Army nurses and Army hospitals and should be preserved and the elements that might need refinement to enhance nursing care and patient outcomes. Military and civilian patient outcomes might differ due to unique characteristics in the military culture such as an emphasis on physical fitness, and military nurses having officer status. Data will be collected in specialty and mixed bed units in two Army medical centers. Data sources include patient medical records, patient and staff nurse responses to survey instruments, hospital administrator and unit head nurse interviews, and discharged patient responses to items on mailed surveys. Statistical analyses will include descriptive and correlational statistics. This data will be combined with data from the N98-053 study and a comparative analysis performed with data collected from a parallel study that used the same study design and instruments.


Final report is available on NTRL: