Hospital nurses' perception of the geriatric nurse practice environment

Abstract

Purpose: To test the relationship between nurses' perceptions of the geriatric nurse practice environment (GNPE) and perceptions of geriatric-care delivery, and geriatric nursing knowledge.

Design: A secondary analysis of data collected by the New York University Hartford Institute Benchmarking Service staff using a retrospective, cross-sectional, design.

Methods: Responses of 9,802 direct-care registered nurses from 75 acute-care hospitals in the US that administered the GIAP (Geriatric Institutional Assessment Profile) from January 1997 to December 2005 were analyzed using linear mixed effects modeling to explore associations between variables while controlling for potential covariates.

Findings: Controlling for hospital and nurse characteristics, a positive geriatric nurse practice environment was associated with positive geriatric care delivery (F=4,686, p<.0001) but not geriatric nursing knowledge. The independent contribution of all three dimensions of the geriatric nurse practice environment (resource availability, institutional values, and capacity for collaboration) influences care delivery for hospitalized older-adult patients.

Conclusions: Organizational support for geriatric nursing is an important influence upon quality of geriatric care.

Clinical relevance: Hospitals that utilize an organizational approach addressing the multifaceted nature of the GNPE are more likely to improve the hospital experience of older adults.