Papers by Beatrice Kalisch
Applied Nursing Research, Feb 1, 2013
The aim of this cross-sectional study was to examine the relationship among hospital, patient uni... more The aim of this cross-sectional study was to examine the relationship among hospital, patient units, and staff characteristics and nursing teamwork. Using multiple linear regression analysis, we found that nursing role, shift, absenteeism, perceived adequacy of staffing, and unit type were significant predictors of teamwork.
Western Journal of Nursing Research, Mar 6, 2012
The aim of this study is to determine the relationship between the team and unit size and level o... more The aim of this study is to determine the relationship between the team and unit size and level of nursing teamwork. The sample for the study was 2,265 direct care nursing providers from 53 units in four hospitals. Pearson correlation coefficients were calculated to determine if five variables to measure unit size (average daily census, number of registered nurses, number of nursing assistants [NAs], and number of total staff) correlated with teamwork overall and with five teamwork subscales (trust, team orientation, backup, shared mental model, and leadership). A significant negative correlation was found between nursing teamwork overall and the number of NAs, and average daily census. To optimize nursing unit teamwork, consideration needs to be given to strategies to reduce the size of nursing teams.
Nursing Outlook, Sep 1, 2012
The objective of this study was to examine whether the amount, type, and reasons of missed nursin... more The objective of this study was to examine whether the amount, type, and reasons of missed nursing care differ between Magnet and non-Magnet hospitals. Data were collected from 124 medical-surgical, intermediate, intensive care, and rehabilitation units in 11 hospitals located in the Midwest and Western regions of the United States. A cross-sectional, descriptive study was conducted. The MISSCARE Survey was utilized to collect data on the level of perceived missed nursing care, and nursing staffing data was collected for each study unit. Missed nursing care showed significant differences according to Magnet status. Separate analysis showed no staffing-level difference between Magnet and non-Magnet hospitals. The authors concluded that efficiencies in operations, work environment, and culture characterized by Magnet hospitals should be promoted.
Journal of Nursing Care Quality, 2012
Cancer Nursing, Nov 1, 2013
Journal of Nursing Management, Nov 2, 2012
Staffing and job satisfaction: nurses and nursing assistants Aim The aim of this study was to exa... more Staffing and job satisfaction: nurses and nursing assistants Aim The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Background Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. Methods This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Results Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Conclusion Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Implications for Nursing Management Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career.
Journal of Nursing Scholarship, Jan 4, 2011
Purpose: To determine if nurse staffing predicts teamwork. Design: A cross-sectional, descriptive... more Purpose: To determine if nurse staffing predicts teamwork. Design: A cross-sectional, descriptive design with a sample of nursing staff (N = 2,545) on 52 patient care units in four hospitals was utilized. Methods: The Nursing Teamwork Survey was utilized to collect data on the level of perceived nursing teamwork on each of the study units. In addition, nursing staffing data were collected for each study unit. Findings: Higher levels of nurse staffing were related to better teamwork. Specifically, the greater the hours per patient day, the higher the level of overall teamwork on the unit (β = 0.417, p = .033). Also the greater the skill mix, the higher the level of overall teamwork on the unit (β = 0.436, p = .009). Conclusions: Adequate levels of staffing are needed to ensure nursing teamwork. Clinical Relevance: The ability to provide quality and safe care is associated with teamwork, which in turn requires adequate staffing.
Journal of Nursing Administration, Oct 1, 2012
The objective of this study was to test the congruence of the perceptions of unit-based nurse lea... more The objective of this study was to test the congruence of the perceptions of unit-based nurse leaders (managers, advanced practice nurses) and nursing staff members (registered nurses, nursing assistants, unit secretaries) in acute care hospitals as to the extent and type of missed nursing care and nursing teamwork. Based on the leader-member exchange congruence framework (LMX), nursing staff and nursing leaders completed the MISSCARE Survey, and a segment of the participants completed the Nursing Teamwork Survey. The findings of this study show a lack of LMX congruence between leaders and nursing staff members. Nursing staff report less missed care and lower teamwork than do leaders, and nursing staff list more problems with having adequate material and labor resources than do leaders. LMX congruence has been associated with positive organizational outcomes.
Applied Nursing Research, 2019
Background: Missed nursing care has been recognized as a universal patient care issue that affect... more Background: Missed nursing care has been recognized as a universal patient care issue that affects outcomes for patients, nurses, and healthcare institutions. The MISSCARE Survey was developed to measure and determine the reasons for missed nursing care episodes. An extensive literature review and expert nurse opinion revealed five additional reasons for missing care that the authors utilized to revise the Survey. Methods: The revised MISSCARE Survey was pilot tested with a group of 145 nursing staff from a public, nonprofit, acute care hospital in the Midwestern U.S. Results: Analysis indicated favorable results for the revised Survey's acceptability, reliability, and construct validity. Conclusion: Based on the initial pilot study results, the authors recommend further use and study of the revised MISSCARE Survey with other nursing populations and additional psychometric testing. 2.1. Instrument In the present study, we used a revised MISSCARE Survey tool. The revisions were made based on a review of the literature and expert nurse input. Electronic databases searched included MEDLINE, CINAHL, and
Journal of Nursing Care Quality, 2015
A total of 729 inpatients were surveyed using the MISSCARE Survey-Patient. Missed timeliness, pat... more A total of 729 inpatients were surveyed using the MISSCARE Survey-Patient. Missed timeliness, patient reports of the time it took for them to receive care from nursing staff, was negatively associated with total nursing staff hours of care per patient-day (r = −0.09, P = .015), registered nurse (RN) hours per patient-day (r = −0.14, P = .0002), and RN skill mix (r = −0.13, P = .0004). RN skill mix was also a predictor of missed timeliness (P = .01).
Nursing Outlook, Sep 1, 2010
Journal of Clinical Nursing, 2021
Aims and objectives: This study aimed to identify and compare missed nursing care types and reaso... more Aims and objectives: This study aimed to identify and compare missed nursing care types and reasons between South Korea and the United States of America. Background: Patient safety has become a significant task of the healthcare delivery systems worldwide. The omission of nursing care constitutes a growing concern because it threatens both patient safety and nursing care quality. Design: This study used a cross-sectional, descriptive and comparative design. Methods: Data were collected from registered nurses working in two universityaffiliated tertiary hospitals and a general hospital in Korea and a Midwest United States tertiary hospital. In addition, the STROBE checklist was used in this study. Results: While substantial, the level of missed nursing care reported by Korean nurses was lower than that of United States nurses. Only three nursing care activities, setting up meals, patient assessment and skin/wound care, did not significantly differed between two countries. More basic nursing care types such as ambulation, feeding and mouth care were missed more than others in both countries. The reasons for missed care differed between two countries. However, both Korean and US nurses reported labour resource problems as reasons for missed care. Conclusions: Although the types of missed nursing care differed significantly between countries, both Korean and US nurses reported labour resource problems for the top reasons for missed care. Thus, comparing missed nursing care could assist nursing administrators in developing strategies to improve care quality and patient safety. Relevance to clinical practice: The level and reasons for missed nursing care are very influential factors for patient outcomes and patient safety. Appropriate skill mix and staffing are needed to decrease extent of missed care, so that enhancing patient safety and quality of nursing care.
Western Journal of Nursing Research, 2014
The purpose of this study was to test the use of virtual simulation to improve teamwork among nur... more The purpose of this study was to test the use of virtual simulation to improve teamwork among nursing staff. Using a quasi-experimental design, nursing staff ( n = 43) from one patient care unit participated in a 1-hr session, which focused on common nursing teamwork problems. The overall mean teamwork scores improved from pre- ( M = 3.25, SD = 0.58) to post-intervention ( M = 3.49, SD = 0.67, p < .012). The intervention also had large (0.60 ≤ d ≤ 0.97) and significant effects on the measures of three teamwork subscales (i.e., trust, team orientation, and backup).
Nursing Management (Springhouse), 2012
Journal of Pain and Symptom Management, 2012
Despite decades of research, national mandates, and widespread implementation of guidelines, rece... more Despite decades of research, national mandates, and widespread implementation of guidelines, recent reports suggest that the quality of pain assessment and management in hospitalized children remains suboptimal. The mismatch between what is advocated and what is done in practice has led experts to argue for a conceptual shift in thinking, where the pain assessment process is viewed from a complex social communication or transaction framework. This article examines the empirical evidence from the recent pediatric pain assessment and decision-making literature that supports adaptation of Schiavenato and Craig's ''Pain Assessment as a Social Transaction'' model in explaining pediatric acute pain management decisions. Multiple factors contributing to children's pain experiences and expressions are explored, and some of the difficulties interpreting their pain scores are exposed. Gaps in knowledge related to nurses' clinical pain management decisions are identified, and the importance of children's and parents' preferences and roles and the influence of risks and adverse events on decision making are identified. This review highlights the complexity of pediatric nurses' pain management decisions toward the clinical goal of improving comfort while minimizing risk. Further study evaluating the propositions related to nurses' decisions to intervene is needed in pediatric clinical settings to better synthesize this model for children.
Journal of Nursing Care Quality, 2009
A qualitative study was conducted applying a theoretically based model of teamwork to determine r... more A qualitative study was conducted applying a theoretically based model of teamwork to determine relevant team processes among nurses. Nurses from 5 patient care units participated in focus groups, describing team processes in their daily work. Responses were analyzed in the Salas framework to develop a concrete conceptualization of teamwork within nursing teams. Results support the framework as a means for describing teamwork among nurses.
JONA: The Journal of Nursing Administration, 2011
Evidence points to the omission of required nursing care as a pervasive problem in acute care hos... more Evidence points to the omission of required nursing care as a pervasive problem in acute care hospitals. Labor and material resource constraints, increasing patient complexity, ineffective delegation, and poor communication have been identified as contributing factors. Nurse executives should examine the degree and causes of missed care in their organizations. Action plans should be developed based on identification of issues contributing to this serious concern, thus promoting safe patient care.
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Papers by Beatrice Kalisch