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Measuring the context of care in an Australian acute care hospital: a nurse survey
BACKGROUND: This study set out to achieve three objectives: to test the application of a context assessment tool in an acute hospital in South Australia; to use the tool to compare context in wards that had undergone an evidence implementation process with control wards; and finally to test for rela...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923100/ https://www.ncbi.nlm.nih.gov/pubmed/20673373 http://dx.doi.org/10.1186/1748-5908-5-60 |
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author | Schultz, Timothy J Kitson, Alison L |
author_facet | Schultz, Timothy J Kitson, Alison L |
author_sort | Schultz, Timothy J |
collection | PubMed |
description | BACKGROUND: This study set out to achieve three objectives: to test the application of a context assessment tool in an acute hospital in South Australia; to use the tool to compare context in wards that had undergone an evidence implementation process with control wards; and finally to test for relationships between demographic variables (in particular experience) of nurses being studied (n = 422) with the dimensions of context. METHODS: The Alberta Context Tool (ACT) was administered to all nursing staff on six control and six intervention wards. A total of 217 (62%) were returned (67% from the intervention wards and 56% from control wards). Data were analysed using Stata (v9). The effect of the intervention was analysed using nested (hierarchical) analysis of variance; relationships between nurses' experience and context was examined using canonical correlation analysis. RESULTS: Results confirmed the adaptation and fit of the ACT to one acute care setting in South Australia. There was no difference in context scores between control and intervention wards. However, the tool identified significant variation between wards in many of the dimensions of context. Though significant, the relationship between nurses' experience and context was weak, suggesting that at the level of the individual nurse, few factors are related to context. CONCLUSIONS: Variables operating at the level of the individual showed little relationship with context. However, the study indicated that some dimensions of context (e.g., leadership, culture) vary at the ward level, whereas others (e.g., structural and electronic resources) do not. The ACT also raised a number of interesting speculative hypotheses around the relationship between a measure of context and the capability and capacity of staff to influence it. We propose that context be considered to be dependent on ward- and hospital-level factors. Additionally, questions need to be considered about the unit of measurement of context in studies of knowledge implementation--is individual (micro), ward (meso) or hospital-level (macro) data most appropriate? The preliminary results also raise questions about how best to utilise this instrument in knowledge translation research. |
format | Text |
id | pubmed-2923100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29231002010-08-18 Measuring the context of care in an Australian acute care hospital: a nurse survey Schultz, Timothy J Kitson, Alison L Implement Sci Research Article BACKGROUND: This study set out to achieve three objectives: to test the application of a context assessment tool in an acute hospital in South Australia; to use the tool to compare context in wards that had undergone an evidence implementation process with control wards; and finally to test for relationships between demographic variables (in particular experience) of nurses being studied (n = 422) with the dimensions of context. METHODS: The Alberta Context Tool (ACT) was administered to all nursing staff on six control and six intervention wards. A total of 217 (62%) were returned (67% from the intervention wards and 56% from control wards). Data were analysed using Stata (v9). The effect of the intervention was analysed using nested (hierarchical) analysis of variance; relationships between nurses' experience and context was examined using canonical correlation analysis. RESULTS: Results confirmed the adaptation and fit of the ACT to one acute care setting in South Australia. There was no difference in context scores between control and intervention wards. However, the tool identified significant variation between wards in many of the dimensions of context. Though significant, the relationship between nurses' experience and context was weak, suggesting that at the level of the individual nurse, few factors are related to context. CONCLUSIONS: Variables operating at the level of the individual showed little relationship with context. However, the study indicated that some dimensions of context (e.g., leadership, culture) vary at the ward level, whereas others (e.g., structural and electronic resources) do not. The ACT also raised a number of interesting speculative hypotheses around the relationship between a measure of context and the capability and capacity of staff to influence it. We propose that context be considered to be dependent on ward- and hospital-level factors. Additionally, questions need to be considered about the unit of measurement of context in studies of knowledge implementation--is individual (micro), ward (meso) or hospital-level (macro) data most appropriate? The preliminary results also raise questions about how best to utilise this instrument in knowledge translation research. BioMed Central 2010-08-02 /pmc/articles/PMC2923100/ /pubmed/20673373 http://dx.doi.org/10.1186/1748-5908-5-60 Text en Copyright ©2010 Schultz and Kitson; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Schultz, Timothy J Kitson, Alison L Measuring the context of care in an Australian acute care hospital: a nurse survey |
title | Measuring the context of care in an Australian acute care hospital: a nurse survey |
title_full | Measuring the context of care in an Australian acute care hospital: a nurse survey |
title_fullStr | Measuring the context of care in an Australian acute care hospital: a nurse survey |
title_full_unstemmed | Measuring the context of care in an Australian acute care hospital: a nurse survey |
title_short | Measuring the context of care in an Australian acute care hospital: a nurse survey |
title_sort | measuring the context of care in an australian acute care hospital: a nurse survey |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923100/ https://www.ncbi.nlm.nih.gov/pubmed/20673373 http://dx.doi.org/10.1186/1748-5908-5-60 |
work_keys_str_mv | AT schultztimothyj measuringthecontextofcareinanaustralianacutecarehospitalanursesurvey AT kitsonalisonl measuringthecontextofcareinanaustralianacutecarehospitalanursesurvey |