Clinical specialty and organizational features of acute hospital wards


  • Ann Adams PhD BA MSc RN,

    1. Research Fellow, Postgraduate Research School, European Institute of Health and Medical Sciences, Stag Hill Campus, University of Surrey, Guildford
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  • Senga Bond PhD RN FRCN

    1. Professor of Nursing Research, Centre for Health Services Research, School of Health Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, England
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Ward clinical specialty is a variable which has been largely ignored in studies of nursing organization and effectiveness. Analysis of data collected from a nationally representative sample of 83 acute medical, surgical and orthopaedic hospital wards demonstrates that while wards had similar staffing resources, differences exist in the likelihood of adopting a nursing organizational system with devolved authority, in nurses' views of prevailing hierarchical attitudes, and their perceived influence over a range of organizational features of the ward. Medical wards were more likely to have developed organizational practices associated with increasing nursing autonomy.