This project uses Institutional Ethnography (IE) as a means of learning how and why off-peak work environments are different, and how they affect nurses’ work and patient care. IE¬†places nursing in the center of¬†this interdisciplinary approach. Two types of data will be collected. Level I data will be transcripts from individual and focus-group interviews with direct care nurses.¬†Level II data¬†will include managerial policies, documents, and other texts that are used to improve quality and efficiency of nursing care by standardizing and controlling the work of nurses. Level II data¬†will include research on texts that are part of the routine management of¬†the hospital – everything from administrative policy documents to¬†treatment protocols and the information systems used for reporting and decision-making.
This project will provide researchers with insight into how to account for temporal variations in nurses’ work environment when specifying causal models linking nursing care to patient outcomes. The project will also provide various stakeholders with materials that will help them identify, evaluate, and anticipate the effects of initiatives to improve efficiency, effectiveness, quality and cost on nursing care provided during off-peak periods.