Nursing effort and the exchanging human response pattern.

Abstract

This descriptive, comparative study was done to determine the nursing effort required to treat actual and potential nursing diagnoses from the Exchanging Human Response Pattern in two patient care specialties: acute medical-surgical and postpartum. Patterns of diagnosis identification are described for the two groups, and differences in allocation of nursing resources (nursing effort) are examined. The sample included 200 observations (hospital days) for 50 patients: 33 postpartum patients, and 17 medical-surgical patients. Data were collected daily during the study period by nurses who provided direct care to the selected patients using an investigator-developed version of the Nurse-Patient Summary (NPS) nursing information and patient classification tool (Halloran, 1985). Potential nursing diagnoses received most of the nursing effort in the postpartum area (mean effort = 5.28), whereas actual nursing diagnoses in the Exchanging Human Response Pattern received a higher priority in the medical-surgical area (mean effort = 12.03). Statistically significant differences existed between groups in total nursing effort (t = -4.73, p less than .0001) and in nursing effort required to treat actual (t = -7.42, p less than .0001) and potential diagnoses (t = 3.99, p less than .0001) in the Exchanging Human Response Pattern. This study provides unique information about how nurses allocate their time to patients for the treatment of actual and potential nursing diagnoses, and outlines areas for further development in diagnosis-based patient classification.