The relationship between professional care environments, nurse-rated quality of care, service utilization and functional status of patients with heart failure receiving Medicare certified home health services
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Title
The relationship between professional care environments, nurse-rated quality of care, service utilization and functional status of patients with heart failure receiving Medicare certified home health services
Heart failure (HF) is one of the leading causes of death and disability in the United States and it has grown to near-epidemic proportions. Among the costly sequela of HF are functional impairments. If not reversed, these functional limitations may lead to increased risk of hospitalization. Left untreated, functional impairments are a significant predictor of mortality among elderly persons living at home. Consequently, HF patients represent the largest group of patients receiving home health nursing services, and impaired functional status remains the most frequent predictor of home health need. The overarching conceptual framework for this study was the Nursing Organization and Outcomes Model (Aiken et al., 2002). This study examined the relationship between nurse-rated quality of care, the nursing practice environment, service utilization and functional outcomes in patients receiving Medicare certified home health care services, as well as nurse practice environment, service utilization and nurse-rated quality of care in patients receiving Medicare certified home health care services. Data were analyzed from 364 nurses working in 53 home health offices. Major findings indicate a correlation between a supportive care environment and nurse-rated quality of care. The number of occupational therapy visits provided was found to be associated with a decline in functional status at time of discharge from home health services. In addition, patient age was found to be negatively correlated with functional status at time of discharge form home health services. Findings also suggest a competent and supportive front line manager may contribute to nurse-rated quality of care, suggesting investment in nurse manager development may be beneficial to the organization.
Subject (authority = RUETD)
Topic
Nursing
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_5587
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Form (authority = gmd)
electronic resource
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application/pdf
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text/xml
Extent
vii, 96 p. : ill.
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = vita)
Includes vita
Note (type = statement of responsibility)
by Elizabeth Kleber
Subject (authority = ETD-LCSH)
Topic
Heart failure
Subject (authority = ETD-LCSH)
Topic
Medicare beneficiaries--Medical care
Subject (authority = ETD-LCSH)
Topic
Older people--Home care
RelatedItem (type = host)
TitleInfo
Title
Graduate School - Newark Electronic Theses and Dissertations
Identifier (type = local)
rucore10002600001
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PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.