Patient care outcomes and the relationship to staff nurses' perceptions of empowerment

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Christine Williams - Committee Chair


The purpose of this study was to examine the relationship between nurses' perceptions of workplace empowerment and nurses' knowledge of pressure ulcers on patient care outcomes among long-term care facilities. Rosabeth Moss Kanter (1993) first introduced the theory from which this relationship is proposed. Laschinger's model of Kanter's theory (Sabiston & Laschinger, 1995) takes into consideration that the organizational structure of individuals' locations within formal and informal systems influences access to the structural determinants of behavior in organizations, which are opportunity, power and proportions structure. The structural determinants of power are operationalized as access to resources, information and support, as well as opportunity.This study was a prospective, randomized, quasi-experimental, time series design with a non-equivalent no-treatment control group. The empowerment intervention consisted of a two-day education and organizational empowerment intervention that continued after implementation. The study utilized a three-phase design that took place over a four-month period. Study nurses in the intervention and control groups were assessed for pressure ulcer knowledge and feelings of organizational empowerment before and after the intervention.The sample facilities consisted of 27 long-term care facilities. All residents of the facilities were assessed at baseline and monthly for occurrence of pressure ulcers. A total of 8,491 (2,123 per data collection period) resident skin assessments were completed for the study. Facility and resident data collected included number of female and male residents, average ages, census and occupancy rates. For the four data collection times there were no statistical differences between groups. For the intervention group, total knowledge scores and empowerment subscales increased significantly following empowerment intervention and remained high for the study period. At two months following the intervention, residents in the intervention group experienced significantly fewer facility acquired Stage II pressure ulcers than did residents in the control group, (p = .008).The findings of this study are consistent with Kanter's (1993) assertion that organizational variables have a strong influence on behaviors and attitudes in the workplace, and these changes in attitudes have a positive impact on patient care outcomes. This study also examined changes in nurses' knowledge of pressure ulcer prevention and management. These findings highlight the importance of creating environments that provide access to organizational structures that empower nurses to succeed.


Health Sciences, Nursing

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