Date of Award

Spring 1987

Degree Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

The purpose of this study was to determine if there is a difference between the patient's classification when a nurse determines the patient's classification before the shift of care has been given, after the shift of care has been received, and according to the care documented as being given to the patient during the shift. This comparative study, based on the theory of classification and the management process, was to identify whether data from a patient classification system could be the productivity measure used by a department of nursing to carry out the management functions of planning, staffing, and controlling. The research was conducted in a 180 bed acute care pediatric hospital in a Midwestern metropolitan city. The data for the study were collected utilizing a convenience sampling method. The study included a total of 100 patients. Each of the 100 patients had a data set which included; a classification before the shift of care had been given, a classification after the shift of care had been received, and a classification according to the documentation of the care given to the patient during the shift. The data were analyzed using frequency distributions of the patient classification data sets. Findings demonstrated that in 69% of the total sample, 59% of the day shift sample, 73% of the evening shift sample, and 77% of the night shift sample the nurse's determination of the patient's classification was the same before the shift of care was given and after the shift of care had been received. No relationship was found when the nurse determined the patient's classification according to the documented care received by the patient. The results of this research study support the use of a patient classification system to determine nursing productivity goals, provide a basis for staffing, provide the data needed to evaluate the productivity goals, and provide a method that determines reimbursement for nursing care. Based on the findings and conclusions of this study, it is recommended that the study be replicated using different patient classification systems. Changes are also recommended in the nursing documentation system. Patient classification systems used to generate a productivity measure must also include the independent functions of nursing and must be audited regularly.

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