Nursing Surveillance in the Acute Care Setting: Latent Variable Development and Analysis

Persistent Link:
http://hdl.handle.net/10150/193636
Title:
Nursing Surveillance in the Acute Care Setting: Latent Variable Development and Analysis
Author:
Kelly, Lesly Ann
Issue Date:
2009
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The nursing profession has utilized a variety of terms to describe the work that nurses do, such as observing, monitoring, and critical thinking. Nursing surveillance is a term emerging in the research and clinical environment to describe the care, both seen and unseen, by professional registered nurses. It has been described as a complex, multi-dimensional concept that influences patient outcomes, yet little research has been done to examine the concept, how it is measured, and its role in outcomes.The surveillance process includes ongoing data collection, interpretation, and synthesis for decision making. This research proposes that nursing surveillance is comprised of five dimensions: actions, expertise, early recognition, intuition, and decision making. The purpose of this study is to examine the dimensions of nursing surveillance in the acute care setting.This study used a descriptive design to survey nurses on the dimensions of nursing surveillance. The survey consisted of four existing instruments measuring expertise, early recognition, intuition, and decision making, and one new instrument measuring activities associated with nursing surveillance. A content review panel was used to develop the new Nursing Surveillance Activities Scale. A sample of 158 medical-surgical nurses participated in completing the full Nursing Surveillance Survey.The goal of the analysis was to determine how well the dimensions represented the surveillance variable; however, based on sample size, revisions to the methods were made. Factor analysis was used to analyze each instrument's items and total representation of the variable. The instruments performed adequately in psychometric testing, and modifications were made so composite development could be achieved. The dimensions were factored as a composite variable and four of the five dimensions loaded onto a single variable, while the activities dimensions loaded separately. These results can be explained through a theoretical difference between the dimensions or limitations with the newly created Nursing Surveillance Activities Scale.This study identified a relationship between the four cognitive dimensions of nursing surveillance and their representation of the variable. Future research in nursing surveillance should analyze the role of the nursing surveillance variable, including the relationship to nursing outcomes.
Type:
text; Electronic Dissertation
Keywords:
Early recognition skills; Expertise; Failure-to-rescue; Nursing activities; Surveillance; Systems Research Organizing Model
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Vincent, Deborah
Committee Chair:
Vincent, Deborah

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleNursing Surveillance in the Acute Care Setting: Latent Variable Development and Analysisen_US
dc.creatorKelly, Lesly Annen_US
dc.contributor.authorKelly, Lesly Annen_US
dc.date.issued2009en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe nursing profession has utilized a variety of terms to describe the work that nurses do, such as observing, monitoring, and critical thinking. Nursing surveillance is a term emerging in the research and clinical environment to describe the care, both seen and unseen, by professional registered nurses. It has been described as a complex, multi-dimensional concept that influences patient outcomes, yet little research has been done to examine the concept, how it is measured, and its role in outcomes.The surveillance process includes ongoing data collection, interpretation, and synthesis for decision making. This research proposes that nursing surveillance is comprised of five dimensions: actions, expertise, early recognition, intuition, and decision making. The purpose of this study is to examine the dimensions of nursing surveillance in the acute care setting.This study used a descriptive design to survey nurses on the dimensions of nursing surveillance. The survey consisted of four existing instruments measuring expertise, early recognition, intuition, and decision making, and one new instrument measuring activities associated with nursing surveillance. A content review panel was used to develop the new Nursing Surveillance Activities Scale. A sample of 158 medical-surgical nurses participated in completing the full Nursing Surveillance Survey.The goal of the analysis was to determine how well the dimensions represented the surveillance variable; however, based on sample size, revisions to the methods were made. Factor analysis was used to analyze each instrument's items and total representation of the variable. The instruments performed adequately in psychometric testing, and modifications were made so composite development could be achieved. The dimensions were factored as a composite variable and four of the five dimensions loaded onto a single variable, while the activities dimensions loaded separately. These results can be explained through a theoretical difference between the dimensions or limitations with the newly created Nursing Surveillance Activities Scale.This study identified a relationship between the four cognitive dimensions of nursing surveillance and their representation of the variable. Future research in nursing surveillance should analyze the role of the nursing surveillance variable, including the relationship to nursing outcomes.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectEarly recognition skillsen_US
dc.subjectExpertiseen_US
dc.subjectFailure-to-rescueen_US
dc.subjectNursing activitiesen_US
dc.subjectSurveillanceen_US
dc.subjectSystems Research Organizing Modelen_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorVincent, Deborahen_US
dc.contributor.chairVincent, Deborahen_US
dc.contributor.committeememberVincent, Deborahen_US
dc.contributor.committeememberEffken, Judith A.en_US
dc.contributor.committeememberReed, Pamela G.en_US
dc.contributor.committeememberVerran, Joyce A.en_US
dc.identifier.proquest10614en_US
dc.identifier.oclc659752382en_US
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