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Hospital Nurses' Perception of the Geriatric Nurse Practice Environment

Authors

  • Marie Boltz,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Elizabeth Capezuti,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Susan Bowar-Ferres,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Robert Norman,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Michelle Secic,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Hongsoo Kim,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Susan Fairchild,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Mathy Mezey,

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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  • Terry Fulmer

    1. Marie Boltz, RN, PhD, CRNP, NHA, Assistant Professor, College of Nursing; Elizabeth Capezuti, RN, PhD, FAAN, Associate Professor and Co-Director, Hartford Institute for Geriatric Nursing, College of Nursing; Susan Bowar-Ferres, RN, PhD, CNAA-BC, Professor of Nursing and Nursing Administration and Senior Vice President & Chief Nursing Officer, Medical Center; Robert Norman, PhD, Research Associate Professor and Director of Biostatistics, College of Dentistry; all at New York University, New York, NY; Michelle Secic, MS, President and Independent Consultant Secic Statistical Consulting, Inc., Chardon, OH; Hongsoo Kim, RN, MPH, PhD, Assistant Professor, College of Nursing; Susan Fairchild, MPH, NICHE Program Evaluator, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Mathy Mezey, RN, EdD, FAAN, Professor and Director, John A. Hartford Foundation Institute for Geriatric Nursing, College of Nursing; Terry Fulmer, RN, PhD, FAAN, Dean and Erline Perkins McGriff Professor, College of Nursing; all at New York University, New York, NY. Correspondence to Dr. Boltz, New York University College of Nursing, 246 Greene Street, 6th Floor, New York, NY 10003–6677. E-mail: marie.boltz@nyu.edu
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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.

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