Dissertation
THE EFFECT OF THE PRACTICE ENVIRONMENT ON THE IMPLEMENTATION OF FAMILY PRESENCE IN ADULT CRITICAL CARE
Doctor of Philosophy (PhD), Washington State University
01/2014
Handle:
https://hdl.handle.net/2376/110975
Abstract
The benefits of family presence (FP) in adult critical care are well-established and FP is promoted as best practice by professional organizations; however, FP is not consistently implemented in Intensive Care Units (ICUs). Previous studies suggested that nurses' decisions and interventions are grounded in assessments of the practice environment; however, no published study has investigated the relationship of ICU practice environment characteristics to FP implementation. The purpose of this study, guided by the Complex Adaptive Systems Model, was to explore how select characteristics of the practice environment relate to nurses' perceptions of FP, and the effect of these relationships on their decisions to offer FP.
The study sample (n=745) was a convenience sample of critical care RNs. The study was conducted in two phases. During phase one, the reliability and validity of revised instruments used to measure nurses' perceptions of FP were confirmed. In phase two, multiple regression was used to determine if the self-reported implementation of FP could be predicted based on the relationship between the nurses' perceptions of FP and specific characteristics of their ICU practice environment. A significant amount (16%) of the variability in the percent of time FP was offered was explained, F change (3, 620) = 41.72, p < .001, where nurses' perception of risk/benefit (B = .272, p < .001) and their self-confidence (B = .148; p < .001) predicted percent FP. Practice environment characteristics were not predictive of percent FP when the measures of nurses' perceptions of FP were added to the regression analysis, however, further analysis results supported full mediation of the effect of the practice environment characteristics on percent FP implementation by the nurses' perceptions of FP.
The results of this study contribute significantly to FP science by providing valid and reliable measures for FP concepts. Further, this is the first study to use valid measures to examine characteristics of the complex ICU environment with nurses' perceptions and to determine their effect on decision-making regarding FP. It provides a rigorous study design that can be replicated for comparison of results across unit types.
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Details
- Title
- THE EFFECT OF THE PRACTICE ENVIRONMENT ON THE IMPLEMENTATION OF FAMILY PRESENCE IN ADULT CRITICAL CARE
- Creators
- Debra Wise Stauffer
- Contributors
- Cynthia E Fitzgerald (Advisor)Cynthia Corbett (Committee Member)Celestina Barbosa-Leiker (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- Nursing, College of
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Number of pages
- 146
- Identifiers
- 99900581644801842
- Language
- English
- Resource Type
- Dissertation