The Relationships Between the Geriatric Practice Environment, Nursing Practice, and the Quality of Hospitalized Older Adults’ Care

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Date

2018-07-26

Authors

Fox, Mary
McCague, Hugh
sidani, souraya
Butler, Jeffrey

Journal Title

Journal ISSN

Volume Title

Publisher

Journal of Nursing Scholarship

Abstract

Purpose. To test the relationships between the geriatric practice environment, geriatric nursing practice, and the overall quality of care for older adults and their families as reported by nurses working in hospitals, while controlling for nurse and hospital characteristics.

Design. A cross-sectional tailored survey design was employed. A questionnaire was mailed to a randomly selected sample of nurses whose primary practice area was medicine, surgery, geriatrics, emergency, or critical care in acute care hospitals in Ontario, Canada.

Methods. Participants (n = 2005) working in 148 hospitals responded to validated measures of the geriatric practice environment, geriatric nursing practice, overall quality of care for older adults and their families, and nurse and hospital characteristics. The relationships were tested using structural equation modeling.

Findings. Controlling for nurse and hospital characteristics, the geriatric practice environment had a statistically significant positive relationship of large magnitude with both geriatric nursing practice (β= 0.52) and overall quality of care (β= 0.92); however, the indirect relationship between the geriatric practice environment and overall quality of care, mediated by geriatric nursing practice, was not significant (β = -0.02). Final model fit was acceptable with the Root Mean Square Error of Approximation = 0.07, Comparative Fit Index = 0.93, and Tucker-Lewis Index = 0.87.

Conclusions. A strong geriatric practice environment positively and directly influences geriatric nursing practice and overall quality of care for older adults and their families but does not appear to influence overall quality of care indirectly through geriatric nursing practice.

Clinical relevance: The results can be used as the basis for promoting practice environments that support overall quality of care and geriatric nursing practice in acute care hospitals.

Description

This is the peer reviewed version of the following article: Fox, M. T., McCague, H., Sidani, S., & Butler, J. I. (2018). The Relationships Between the Geriatric Practice Environment, Nursing Practice, and the Quality of Hospitalized Older Adults’ Care. Journal of Nursing Scholarship, 50(5), 513–521. https://doi.org/10.1111/jnu.12414, which has been published in final form at https://doi.org/10.1111/jnu.12414. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

Keywords

Geriatrics, Nursing practice, Environment, Quality of care, Structure equation model

Citation

Fox, M. T., McCague, H., Sidani, S., & Butler, J. I. (2018). The Relationships Between the Geriatric Practice Environment, Nursing Practice, and the Quality of Hospitalized Older Adults’ Care. Journal of Nursing Scholarship, 50(5), 513–521. https://doi.org/10.1111/jnu.12414