An evaluation of two patient classification systems as the determinants of a staffing pattern for medical patients

Chubbs, Judy A. (1994) An evaluation of two patient classification systems as the determinants of a staffing pattern for medical patients. Masters thesis, Memorial University of Newfoundland.

[English] PDF (Migrated (PDF/A Conversion) from original format: (application/pdf)) - Accepted Version Available under License - The author retains copyright ownership and moral rights in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission. Download (19MB) [English] PDF - Accepted Version Available under License - The author retains copyright ownership and moral rights in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission. (Original Version)

Abstract

A descriptive correlational study was conducted to (a) assess the psychometric properties of two patient classification systems, (b) explore the relationship between nursing care time and intensity and (c) integrate nursing care time and intensity data to predict a staffing pattern. Seventy-one medical patients representing 373 patient days constituted the sample. The Nursing Intensity Index (NII) and the GRASP instruments were used for data collection. Descriptive and inferential statistics were used for data analysis. -- High internal consistency and inter rater reliability were demonstrated for both the NII and GRASP. Factor analysis generated nine factors to explain 73.6% of the variance in GRASP and three factors to explain 59.4% of the variance in the NII. NII scores were significantly correlated with GRASP scores indicating a shared variability of 49%. Regression analysis indicated that seven NII items explained 55% of the total GRASP score, thus leaving 45% of the variability in nursing workload unexplained. Integration of GRASP and NII data produced a skill mix ratio of 80 percent RN to 20 percent RNA. However, this ratio was not supported by the perceptions of direct caregivers. Methodological and application problems may have influenced this result. More research is needed to identify other factors that may affect skill mix before firm conclusions can be made.

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