INFORMATION PROCESSING STYLES OF NURSES AND NURSE MANAGERS - PowerPoint PPT Presentation

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INFORMATION PROCESSING STYLES OF NURSES AND NURSE MANAGERS

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Title: INFORMATION PROCESSING STYLES OF NURSES AND NURSE MANAGERS


1
INFORMATION PROCESSING STYLES OF NURSES AND NURSE
MANAGERS
  • Presented by
  • Beatrice J. Kalisch
  • Titus Distinguished Professor of Nursing and
  • Director, Nursing Business and Health Systems
  • University of Michigan
  • Ann Arbor, Michigan

2
CONCEPTUAL FRAMEWORK
Gary Salton, "Organizational Engineering"
3
Information Processing Model
TRANSMISSION FOLLOWS BASIC MODEL
LEARNER
4
Information Processing
5
Input-Output Strategies Graph
REACTIVESTIMULATOR
LOGICALPROCESSOR
RELATIONAL INNOVATOR
HYPOTHETICAL ANALYZER
6
Changers
Performers
Perfectors
Conservators
HYPOTHETICAL ANALYZER Structured Thought
7
RS Characterization
METHOD Unpatterned
MODE Action
OBSERVABLE BEHAVIORS Fast execution Low
rule/norm compliance Intense Exciting/excited Focu
s on when Low tolerance for routine
8
HA Characterization
METHOD Structured
MODE Thought
OBSERVABLE BEHAVIORS High conceptual planning
and clarity Thoughtful Unhurried Focus on
why Low tolerance for forced action/decision
making
9
LP Characterization
METHOD Structured
MODE Action
OBSERVABLE BEHAVIORS Decisive High operational
clarity Stable/steady Focus on how Low
tolerance for uncertainty
10
RI Characterization
METHOD Unpatterned
MODE Thought
OBSERVABLE BEHAVIORS Mission level
horizon Variable intensity Innovation
creativity Enthusiastic Focus on what Low
tolerance for confined decisions
11
STUDY QUESTIONS
12
STUDY QUESTIONS
  • Do the information processing styles of nurses
    differ
  • from the general population (i.e. school
    teachers, engineers, IT staff, customer service
    staff, etc.)?
  • by specialty (i.e., medical-surgical, intensive
    care, emergency department, surgery etc.) ?
  • by staff role (i.e. registered nurses, licensed
    practical nurses, nursing assistants, unit
    secretaries)?
  • Do the information processing styles of nursing
    staff differ from nursing managers?

13
STUDY METHOD
14
STUDY METHOD
  • Sample
  • 578 nursing staff in two hospitals (210 bed
    community hospital and 98 bed Veterans
    Administration hospital)
  • RNs 344
  • LPNs 41
  • Nursing Assistants (NA) 101
  • Unit Secretaries 40
  • Nursing Management 52

15
STUDY METHOD (continued)
  • Instrument I-Opt Survey
  • Validity
  • Face validity50 professionals 14,655 survey
    results found less than 1 disagreement (n128,
    0.87)
  • Construct validity Different populations 75
    distinct groups, 887 people compared to database
    population (n8700) p.0152
  • Content validity84-92 of survey responses were
    traced directly to a specific dimension of the
    underlying theory 100 of 50 member expert panel
    agreed that response structure in survey not
    contaminated by respondent misunderstanding

16
STUDY METHOD (continued)
  • Validity (continued)
  • Convergent validity19 similar companies, 188
    people no significant differences plt.05
  • Discriminate validitycluster analysis
    discriminated among three groups that should be
    different
  • Concurrent validityexpert panel felt number of
    inaccurate reports was zero
  • Conclusion validitytests satisfy criteria of
    identical dispersions, equality of variances etc.
  • Reliabilitypairwise combinations for 1994-1999
    using Kruskal-Wallis test no significant
    differences in the data between years

17
STUDY FINDINGS
18
STUDY FINDINGS
  • Populations Comparison of two facilities
  • RNs More RIs at VA than community hospital
    (p.045, df576)

Question 1 Nurses vs. non-nurses
19
  • Nurses (N396) vs.Plant Operators (N591)
  • More nurses are Processors (LP)
  • No Difference in Analyzer (HA)
  • More plant operators are Innovators (RI) and
    Stimulators (RS)
  • Nurses (N396) vs. Engineers (N938)
  • More nurses are Processors (LP) and Analyzers
    (HA)
  • More engineers are Innovators (RI) and
    Stimulators (RS)

p-value df
RI .000 985
RS .000 985
LP .000 985
HA .064 985
p-value df
RI .000 1332
RS .000 1332
LP .000 1332
HA .002 1332
plt.05
plt.05
20
  • Nurses (N396) vs.
  • School Teachers (N606)
  • More nurses are Analyzers (HA) and Processors
    (LP)
  • More school teachers are Innovators (RI) and
    Stimulators (RS)

p-value df
RI .000 1000
RS .000 1000
LP .000 1000
HA .064 1000
plt.05
21
Relational Innovators
22
Reactive Stimulators
23
STUDY FINDINGS (continued)
  • Question 2 Differences by nursing specialty
    No significant differences
  • Question 3 Differences by role
  • RNs vs. LPNs
  • RNs higher on Innovator (RI) (p.009, df383)
  • RNs lower on Processor (LP) (p.000, df383)
  • RNs vs. NAs
  • RNs higher on Innovator (RI ) (p.032, df443)
  • NAs higher on Processor (LP) (p.000, df443) and
    HA (p.011, df443)

24
STUDY FINDINGS (continued)
  • Question 3 Differences by role (continued)
  • RNs and US
  • RNs higher on Stimulator (RS) (p.038, df382)
  • USs higher on Processor (LP) (p.009, df382)
  • No statistical difference among
  • LPNs, NAs, Unit Secretaries

25
EXAMPLE UNIT A
Reactive Stimulator
Relational Innovator
Logical Processor
Hypothetical Analyzer
MOSTLY DAYS
MOSTLY NIGHTS
26
EXAMPLE UNIT B
Reactive Stimulator
Relational Innovator
MOSTLY NIGHTS
Logical Processor
Hypothetical Analyzer
MOSTLY EVENINGS
MOSTLY DAYS
27
EXAMPLE UNIT C
Reactive Stimulator
Logical Processor
Relational Innovator
Hypothetical Analyzer
MOSTLY DAYS
MOSTLY NIGHTS
28
HOSPITAL LEADERSHIP GROUP
Reactive Stimulator
Relational Innovator
Logical Processor
Hypothetical Analyzer
29
Nurses vs. Administrators
HOSPITAL ADMINISTRATORS
NURSES
30
STUDY FINDINGS (continued)
  • Question 4 Nursing staff vs. nurse managers

Information Processing Style p-value df 95 Confidence Interval of the Difference Lower 95 Confidence Interval of the Difference Upper
Innovator (RI) .000 394 -5.800 -2.741
Stimulator (RS) .000 394 -5.959 -2.535
Processor (LP) .000 394 2.103 6.659
Analyzer (HA) .000 394 2.469 6.112
plt.05
31
Changers
Performers
Nurse Managers
RNs, LPNs, NAs, USs
Perfectors
Conservators
HYPOTHETICAL ANALYZER Structured InputThought
Output
32
DISCUSSION OF FINDINGS
33
DISCUSSION OF FINDINGS (continued)
  • Vast majority nursing staff are HAs and LPs very
    few RIs and RSs
  • Strengths
  • Ideally suited to stable environments which value
    carrying out existing processes/procedures
  • Performs at a consistent rate and with unvarying
    quality
  • Precisely executes established programs

34
DISCUSSION OF FINDINGS (continued)
  • Vast majority nursing staff are HAs and LPs few
    RIs and RSs (continued)
  • Vulnerabilities
  • Limited action (RS) resources
  • Lack of out of the box idea generation
  • Advantages of unpatterned thinking are lost
  • Lowest of any group studied
  • High resistance to change
  • Lack of capacity to take risks over-cautious
  • Intolerant of uncertainty
  • Meeting ones obligations is the definition of
    success

35
DISCUSSION OF FINDINGS (continued)
  • Staff nurses look very much alikevery few nurses
    outside the conservator quadrant
  • Why is this? education, practice settings?
  • RS and RI nurses move to management, academics
    etc.
  • Are nurse commodities? (Commodities are all
    alike you always buy the cheapest)
  • Is this consistent with a professional?
  • Professionals have ideas that drive improvement
    nurses appear to not have or express many
  • Is the stability, clear expectations, functional
    regularity etc. contributing to low prestige?

36
DISCUSSION OF FINDINGS (continued)
  • Coalitions of same thinking nursing staff
    dominate decision making
  • Everyone should be just like me only way is my
    way
  • If you come up with a different way of doing
    something, I will not trust you
  • The rare RI/RS are probably not be heard
  • Dominant teams orientation may be blind to
    viable options that do not conform to the teams
    preferences

37
DISCUSSION OF FINDINGS (continued)
  • Nurses work as individuals, not team members
    (varying strengths)
  • Nurse managers looks like managers in other
    fields but the group they are managing doesnt
    look like any other group managers are facing
  • It is much tougher
  • Nothing is being done to help managers meet this
    challenge
  • Wonder why staff wont change
  • Need to approach it differently

38
IMPLICATIONS
39
RECOMMENDATIONS
  • For nursing education
  • Team training
  • Special effort to retain and develop the
    Stimulators (RSs) and Innovators (RIs)
  • For practice settings
  • Measure style present to staff strategize how
    they will overcome their vulnerabilities
  • Develop culture that utilizes the skills and
    knowledge of Innovators (RIs) and Stimulators
    (RSs) and keeps them engaged

40
RECOMMENDATIONS (continued)
  • For nursing management
  • Training to assist managers to deal effectively
    with LPs and Has, particularly in terms of change
  • It will take a long time
  • Must be presented with extensive detail
  • Staff need to feel there is a strong likelihood
    for success
  • Easier to incrementally improve existing
    processes

41
FURTHER RESEARCH
  • Does nursing (the educational program and/or the
    practice setting) attract LP/HAs or do RI/RSs
    leave nursing/nursing programs?
  • How can we recruit for and retain the RI/RS
    capability in nursing?

42
The End
  • QUESTIONS?
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