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Refining and validating a conceptual model of Clinical Nurse Leader integrated care delivery.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Feb2017, Vol. 73 Issue 2, p448-464, 17p
- Publication Year :
- 2017
-
Abstract
- Aims To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. Background There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Design Sequential mixed methods. Methods A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Results Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. Conclusions The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHI-squared test
CLINICAL competence
STATISTICAL correlation
DELPHI method
FACTOR analysis
HEALTH care teams
INTEGRATED health care delivery
INTERPROFESSIONAL relations
LEADERSHIP
RESEARCH methodology
NURSE practitioners
NURSES
NURSING models
NURSING specialties
PERSONNEL management
RESEARCH evaluation
RESEARCH funding
STATISTICAL sampling
SURVEYS
WORK design
TEAMS in the workplace
QUALITATIVE research
OCCUPATIONAL roles
QUANTITATIVE research
EDUCATIONAL attainment
STRUCTURAL equation modeling
REPEATED measures design
DATA analysis software
WORK experience (Employment)
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 73
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 120598623
- Full Text :
- https://doi.org/10.1111/jan.13113