RUNNING HEAD: Current Issues - Patient Satisfaction 1

Current Issues -Patient Satisfaction

James Nichols

In Partial Completion of NURS 6313

Role of Nurse Administrator

Arkansas Tech University

Russellville, AR

April 27, 2015

Current Issues - Patient Satisfaction 2

Introduction

Jan Jones is a patient on the medical surgical unit at St. Elegias Hospital. Ms. Jones has

had an endoscopic retrograde cholangiopancreatography (ERCP). Ms. Jones has a very low

tolerance to pain as she is a former methamphetamine user and has a history of anxiety. After the

procedure the doctor agreed to administer 1 mg of morphine but thirty minutes after returning to

the floor from post anesthesia recovery the telemetry room contacted the nurse stating that Ms.

Jones oxygen level despite being on three liters of oxygen by nasal canal had decreased to the

low eighties. Ms. Jones’ nurse contacted the surgeon who stated to switch to a mask for oxygen

administration and to give Ms. Jones a bolus of 500 milligrams of normal saline. Ms. Jones thirty

minutes later is again agitated and demanding pain medication and Ms. Jones’ family is also

demanding that she be given pain medication. The surgeon states that the pain is normal, that her

vital signs are baseline and that due to her oxygen level to hold the pain medication for now.

Ms. Jones becomes angry stating that she will never use St. Elegias again and her family agrees.

This case is an example of how patient satisfaction is critical to the profitability and continuity of

modern hospitals. Ms. Jones will tell an average of ten people about a bad experience and never

mention a positive experience. Also, the patient satisfaction survey will affect the payment levels

of most government and private contracts as well as St. Elegias’s Magnet status and top ranking

in the state of Ohio. The question is how you can achieve patient satisfaction with the difficult

patient.

In today’s health care environment patient satisfaction is the key to success and

profitability. The new policies of government and private agencies tying patient satisfaction

scores to the level of payment combined with the consumer driven nature of the health care

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market with multiple sources of information require hospitals to achieve a relationship with the

client that resembles that of a four star hotel more than the hospitals of two decades ago.

Literature

A study of thirty eight patients with chronic disease management issues being treated by

Advanced Practice Nurses found that patient satisfaction scores were positively correlated with

the time, the communication skills of the nurse, the level of trust between the nurse – patient and

the level of trust between the parties (Mahomed, St. John, and Patterson, 2012). The Mohomed

study supported findings that patient’s previous experience in health care and expectations also

effect the patient satisfaction scores (Linder-Pelz 1982, Fitpatrick and Hopkins 1983, Calanan

1988). The Mohmed study also supported a positive correlation in the quality and time invested

in the nurse – patient relationship and the patient satisfaction scores supporting findings of earlier

studies (Grol, 1999, Baker, 2003, Bikker and Thompson, 2006, Polit and Polit 2006). Continuity

of care that is the same care giver providing care was also found to be a positive correlation in

this study as in earlier studies (Infante, 2004, Flynn, 2005). Another study by Cahill and Paley

found that psychotherapy patients found reassurance, problem clarification and client

involvement to be positive experiences in therapy (Cahill and Paley, 2013). This was a similar

finding to the studies above.

Findlik, Unsar and Sut in a 2010 study of 200 patients in a tertiary teaching hospital

found that patients in surgical units had higher satisfaction levels than patients in medical units

(82.3% to 80.9%); that male patients had higher satisfaction levels than female patients (82.4%

to 79.9%); and that patients with lower incomes were more satisfied than those with upper

incomes (82.1 to 80.2) (Findik, Sut & Usar, 2010). Findik et. Al. study supported two previous

studies one in 2005 by Almost, Hall, Lashinger and Pederson which established a positive

Current Issues - Patient Satisfaction 4

correlation between patient satisfaction and sex, education and income & another study in 2002

by Fridlund, Johonson and Oleni establishing the link between the type of ward the patient is

receiving care in and the level of patient satisfaction (Fridlund, Johonson and Oleni, 2002).

Findklik et al also found that patient satisfaction increased with length of stay (Findlik, Sut and

Unsar, 2010).

In a 2011 study by Nusair, Saleh, Saleh, Shloul and Zubadi of the increase in patient

satisfaction correlation to the implementation of hourly nurse rounding requirement in a major

teaching hospital found a 7.5% increase in patient satisfaction (Nusair, Saleh, Saleh, Shloul and

Zubadi, 2011). A literature review in 2014 by Forde-Johnston supported this relationship (Forde-

Johnston, 2014).

In a 2012 study by Boev found a correlation between the critical care nurses positive

perception of the work environment and positive patient satisfaction outcomes (Boev, 2012).

This was further supported by a 2013 study by Kvist, Mantynem, Vehvilainen and Voutilainen of

98 units in Finland which found a positive link between nursing job satisfaction and positive

patient satisfaction numbers (Kvist, Mantynem, Vehvilainen and Voutilainen, 2013).

In a 2015 study of 110 pre-term infant’s families Abadi, Bastani and Haghani found that

the introduction of family centered care increased patient satisfaction from 23% to 59% (Abadi,

Bastani and Haghani, 2015).

In a 2013 cross-sectional prospective study of 72 emergency department patients Elkwall

determined a major cause of low satisfaction scores to be disagreement between nurses and

patient on the level of acuity, level of scheduling priority, with the patient consistently believing

Current Issues - Patient Satisfaction 5

severity and importance of the injury to be significantly higher (Ekwall, 2013) (Boureaux, 2004);

It was also found in Ekwall’s study that 74% of patients wished to know their acuity/triage level

and that 40% of patients wanted input into their acuity/triage level in opposition nursing staff felt

patients should not be involved in the triage assessment (Ekwall, 2013). Further, Ekwall in 2009

study of 153 families in the emergency department determined that 67% of those interviewed

were satisfied with services rendered (Ekwall, 2009). In a 2013 systematic review of literature by

McLauglin of emergency room nurse interactions with family and patients it was determined that

families wished to witness codes involving the family member and wanted medical details

explained to them in understandable terms (McLauglin, 2013).

Emergency department satisfaction ratings in a 2005 study of 20,500 emergency

department patients in 123 emergency departments found a positive correlation between

satisfaction ratings and four factors; reduced wait times, polite staff, polite doctors and

professional competent doctors (Brown, Blakstien, Levinton and Sandavol, 2005).

Studies have found a positive correlation between anxiety and negative patient

satisfaction scores (Ekwall & Malmo, 2013). Another study in 2004 by Taylor and Benger

systematically reviewed seven controlled intervention and found a positive correlation between

satisfaction scores and patient compliance (Taylor and Benger 2004).

Decision Analysis Theory Applied to Patient Satisfaction

Decision Analysis Theory is a systematic approach to studying decision making. By

defining a problem, listing the alternative courses of action, identifying the outcomes of each of

these courses of action, determining the payoff or cost of each outcome, determining the

probabilities of each outcome occurring and then multiplying the payoff/cost of each outcome by

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the corresponding outcome we can determine the best or optimal course of action to carry out

(Render and Stair, 1990).

In order to apply this theory to patient satisfaction we must determine the problem. In this

case each suggestion above would be a separate problem. A list of which would look like this.

1. Implement hourly rounding?

2. Implement bedside rounds at shift change in order to increase patient, nurse & MD

interaction?

3. Implement resources to shorten wait times?

4. Implement new software to allow nurses to more closely monitor procedure wait

times?

5. Implement patient teaching about procedure pain levels and document pre-treatment

of pain?

6. Implement total family as patient policy?

7. Implement patient centered care?

8. Allow patients to watch patient codes?

9. Implement education to teach nurses to actively use simple language to explain issues

to patient and family?

10. Improve the physical work environment for nurses?

11. Improve the manager to nurse dynamic on the unit?

12. Implement the Daisy program to encourage courteous behavior?

After the list is made each decision should be set up as act or don’t act decision tree.

Implement hourly rounding? Yes

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NO

After which the positive outcome of the action should be determined by calculation of

the benefit of the outcome less the cost of implementation then the corresponding cost

of not acting should be calculated by determining the expense to the overall

organization and patient of not acting.

Implement hourly rounding? Yes cost $50.00 per night

NO cost $10,000 average cost per fall multiplied by

.05% chance of fall = $50.00

Note this outcome suggests no cost overall.

Finally each of these calculations should be compared to make a decision in each case. In

both cases a probability of a negative act occurring must be used in order to make an accurate

calculation. If the negative cost is $1000 but there is only 5% chance of that occurring the overall

cost is $50.

One of the problems with using decision analysis theory is that a low probability event

could be so costly that the outcome is catastrophic. In these cases insurance is purchased or

possibly futures in order to spread the risk among a larger pool and thus preserve the viability of

the organization or individual.

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The other issue is the accuracy of the numbers. But quality control has accurate numbers

on most of these issues such as fall percentages, average cost per fall etc.

The theory can be applied further by using it to determine alternative actions that can be

used to implement each decision in order to determine the best course of action.

Also, the changes in patient satisfaction can be changed to a dollar denomination for

further analysis by having quality control and marketing calculate a value factoring in the

increased possibility of a patient returning, the value of the patient’s positive comments about the

operation, the value of family / friends comments on the issues and the increased payments from

third parties.

Nursing Standard of Care, Ethics and Legal Issues of Patient Satisfaction

The fundamental ethics issue of patient satisfaction revolves around the patient’s right to

be actively involved in planning their own health care and making the relevant decisions. The

study of patient satisfaction more effectively allows the nurse to understand the issues and state

of mind of the patient (Yonder-Wise, 2014).

Provisions one of the Nursing Code of Ethics states that economic status cannot be a

factor in the treatment of any patient. This means that the above mentioned formula must not

take into consideration ability to pay. This will prevent discrimination and a reduction of care to

the indigent. Provision two of the Nursing Code of Ethics further reiterates this argument stating

that the nurse’s number one concern is the welfare of the patient either in the form of a person,

family or community. Implementation of a plan to optimize patient satisfaction is the very

essence of provision two as the wishes and welfare of the patient is the focus. Provision three of

the Nursing Code of Ethics states “The nurse promotes, advocates for, and strives to protect the

Current Issues - Patient Satisfaction 9

health, safety and rights of the patients” by monitoring the patient’s satisfaction level we in a

very quantifiable way measure the patient’s state of mind and opinion of his current state of

health and nursing can more carefully carry out his wishes. Provision four of the Nursing Code

of Ethics states “The nurse is responsible and accountable for the individual nursing practice and

determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide

optimal patient care”. The patient satisfaction numbers will include all services provided by the

hospital from housekeeping to the MD which will provide the big picture. Provision six of the

Nursing Code of Ethics states “The nurse participates in establishing, maintaining and improving

health care environments and conditions” this is the core of the patient satisfaction numbers.

Provision five and eight focus on the individual growth as a professional of the nurse and the

focus on national health care issues, with the information garnered from the patient satisfaction

focus allows for a more clear understanding of how to achieve both goals (American Nurses

Association, 2014). The Standards of Nurse Practice states the nurse’s responsibilities in the

areas of assessment, diagnosis, planning, implementation, evaluation, outcome identification,

education, professional practice evaluation, collegiality, collaboration, ethics and research. The

focus on patient satisfaction provides the information for professional practice evaluation and

evaluation of the patient’s outcome which allows for a better implementation of the ADPIE cycle

(Assessment, diagnosis, Planning, Implementation and Evaluation). The patient satisfaction

studies also allow for a better understanding and planning of the outcome identifications, patient

expectations and ethics issues. Finally the patient satisfaction studies allow nursing to better

understand the areas nurses need to focus on in education and research (American Nurses

Association, 2014).

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The primary reason for malpractice lawsuits is personal and emotional. The primary way

to avoid lawsuits is by acting in a courteous and professional manner and apologizing when you

are wrong (Beckman, 1995). By actively engaging the patient and opening the lines of

communications the nurse stands a much better chance of avoiding conflict and

misunderstanding with the patient.

Application to Practice and Management

Patients require privacy and time to talk with their nurse about the issues that concern

them in order to increase patient satisfaction levels (Mahomed ET. Al). The RN needs to adjust

their style to the needs and requirements of the patient to achieve patient satisfaction levels

(Mohomed et. Al.). The support of the MD is essential to establish trust in the nurse – patient

relationship (Mohomed et. Al). A study supporting the patients’ wish to involved was by Myers

and colleagues which found that patient families wished to witness the emergency treatment of a

patient and wanted medical information carefully reviewed with them in understandable

language (McLauglin, 2013).

The use of hourly rounding greatly increases patient safety, satisfaction and the bonding

between the patient and nurse (Nusair, Saleh, Saleh, Shloul and Zubadi, 2011) (Forde-Johnston,

2014).

Improving the physical work environment and encouraging positive interaction between

the manager and staff will increase the nursing staffs level of satisfaction and in return increase

the patient satisfaction level (Kvist, Mantynem, Vehvilainen and Voutilainen, 2013) (Boev,

2012).

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As demonstrated from Ekwall’s studies patient satisfaction numbers can be increased by

keeping patients aware of upcoming procedures, explaining that some procedures may cause

pain or discomfort and providing pain medication before the procedure. Patients should also be

informed of wait times and unexpected delays (Ekwall, 2013).

In his book “The Patient Will See You Now” Dr. Eric Topol MD a practicing cardiologist

states that the medical / hospital industry is shifting from a situation where the providers had the

market power to a situation in which the consumer has the market power. Dr. Topol also explains

that with the increased availability of information that the consumer has available via the

internet/online resources combined with the ability to network/reach out to other experts for

information combined with the patients unique and superior knowledge of their own health care

state that in the future providers at all levels will need to diligently and effectively communicate

with the patient in order to achieve patient satisfaction or be pushed out of the market (Topol,

2014). Topol compares this situation to the Arab Spring as explained in the book Revolution 2.0

where the governments in the Middle East were forced out by individuals networked by today’s

wireless technology (Ghonim, 2012). Topol illustrates this by describing how individuals after

life times of illness use the internet to self-diagnosis their conditions many of which were so

obscure that only five hundred people worldwide have them and networked in order to develop

care plans and treatments.

In another book “If Disney Ran Your Hospital, 9 ½ things you would do differently”

Fred Lee describes how hospitals will have to provide more patient centered levels of practice to

meet the expectation of the modern market and consumer. Lee explains that courtesy must be

more important than efficiency and that the ability to say yes must be moved to the lower levels

of the organization to empower the patient (Lee, 2014). Lee also stated like Disney hospitals

Current Issues - Patient Satisfaction 12

should harness the employees imagination and ability to make work more enjoyable by

reframing it as “theater”. A good example of this is Arkansas Children’s Hospital which in many

ways has implemented this policy and developed a powerful brand name with the related

powerful good will of the market and community (Arkansas Children’s Hospital, 2014).

The emphasis on patient centered care and patient empowerment is critical to the new

holistic health environment. The fact that hospitals no longer are paid for readmissions within

thirty days under almost all circumstances reinforces this fact. By using patient satisfaction data

combined with the other data sources available to nursing informatics a program to increase

patient satisfaction, patient outcomes and the long term financial viability of the hospital can be

accomplished.

Implications for Future Practice

Effective collection, analysis and application of the amount of information being

processed today is the key to success. Studies determining the most effective way to collect,

enter, communicate, process and analyze this information will be critical in achieving the goals

of the organization (Polit, 1996).

In order to do this cooperation between different professions will be critical. An example

of this is Arkansas Children’s Hospital where the charting software is developed in house by

programmers on site in order to achieve the optimal accuracy and efficiency (Arkansas

Children’s Hospital, 2014).

Conclusion

Patient satisfaction is complicated involving time, continuity of care, effective

communication, professionalism, efficiency, nursing knowledge, politeness and a positive nurse

Current Issues - Patient Satisfaction 13

patient dynamic (Mohmed et al. 2012). It is important that nurses take into account the

expectations of patients in patient centered care in order to increase patient satisfaction numbers

(Abdel, Hassna & Oweis, 2014).

Professionalism and courteous behavior by both nursing and other allied health staff is

the key to raising patient satisfaction scores (Brown, Blakstien, Levinton and Sandavol, 2005).

Nursing staff consistently appraising the patient and family of the expected wait times, results

and nature of upcoming procedures will greatly improve patient satisfaction levels (Ekwall,

2013) (Kamban & Svavaardottir, 2014) (McLauglin, 2013) (Ekwall, 2009) (Boureaux, 2004).

Also, keeping family and patient informed of the potential level of discomfort of upcoming

procedures will further increase the patient satisfaction (Ekwall, 2013).

Nursing must also provide for patient and family safety by carefully accessing the

psychological states of both patients and family in order to prevent violent and dangerous

behavior. Today’s nurse must carefully intervene in order to protect the patients, staff and family

and to help the individual in need to react with positive coping skills (Roberts, 2006).

While the patient is always “job one”, by using the patient satisfaction numbers in

conjunction with the information discerned by the nursing informatics department decision

analysis can be used to make the most effective decision in order to provide the patient with the

best and most economical care over the longest period of time.

Current Issues - Patient Satisfaction 14

Reference

Abadi, A., Bastani, F. & Haghani, H. (2015). Effects of Family-Centered Care on Improving

Parental Satisfaction and Reducing Readmission among Premature Infants: A

Randomized Controlled Trial. Journal of Clinical and Diagnostic Research. Research

Publications Limited. Boston, MA. www.cdr.net. Retrieved from:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=df3f47a7-8318-42ca-

b7c5-d113a0aaa465%40sessionmgr4001&vid=0&hid=4104

Abdel, A., Shawqui, F, & Oweis, A. (2012) Differences between Patients’ Expectations and

Satisfaction with Nursing Care. International Journal of Nursing Practice. Blackwell

Publishing. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=be4d1ce8-dbdf-4b18-

b181-280499505646%40sessionmgr4005&vid=0&hid=4104

Almost, J. Laschinger, H. & Penderson. L. (2005). A Psychometric Analysis of the Patient

Satisfaction with Nursing Care Quality Questionnaire: An Actionable Approach

Measuring Patient Satisfaction. Journal of Nursing Care Quality. Wolter Kluwer

Lippincott Williams and Wilkins. Philadelphia. PA. V. 5. Retrieved From:

http://journals.lww.com/jncqjournal/Abstract/2005/07000/A_Psychometric_Analysis_of_

the_Patient.6.aspx

American Nurses Association (2014) Guide to the Code of Ethics. Silver Springs. MA.

American Nurses Association (2014) Nursing Scope and Standards of Practice. Silver Springs.

MA.

Current Issues - Patient Satisfaction 15

Arkansas Children’s Hospital (2014) Arkansas Children’s Hospital. Little Rock. AR. retrieved

from: http://www.archildrens.org/?gclid=CMWiiLiIjcUCFUEV7AodkGIAIg

Baker, R., Gray. D., Love, M. & L. Mainous. (2003). Exploration of the Relationship between

Continuity, Trust in Regular Doctors and Patient Satisfaction with Consultation with the

Family Doctors. Scandinavian Journal of Primary Care V. 21. Stockholm. Sweden.

Retrieved From: http://www.google.com/url?

sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCgQFjAB&url=http%3A%2F

%2Finformahealthcare.com%2Fdoi%2Fpdf%2F10.1080%2F0283430310000528&ei=-

ZM2VbfsGYvQsAX85YDgCw&usg=AFQjCNG9Gpb-6b6ttZrDR2PvYelU-X3zNw

Beckman, J. (1995) Nursing Malpractice Implications for Clinical and Nursing Education.

University of Washington Press. Seattle. WA.

Bikker. A. & Thompson. A. (2006). Predicting and Comparing Patient Satisfaction in Four

Different Modes of Health Care across the Nation. Social Science and Medicine. V. 63.

Elsevier. St. Louis. MO. Retrieved From:

http://www.sciencedirect.com/science/article/pii/S0277953606001559

Boev, C. (2012) the Relationship between Nurses’ Perception of Work Environment and Patient

Satisfaction in Adult Critical Care. Journal of Nursing Scholarship. Wiley Publishing,

New York. NY. Retrieved from:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=f71d0fb0-f124-4556-878e-

cf45049b04cd%40sessionmgr112&vid=0&hid=101

Current Issues - Patient Satisfaction 16

Bourdreaux, E. (2004). Emergency Department Patient Satisfaction: Examining the Role of

Acuity. Academic Emergency Medicine. V. 11 N. 2. EBSCO. New York, N.Y. Retrieved

From: http://libcatalog.atu.edu:2080/ehost/command/detail?sid=3d72703c-2cc7-4fb7-

aa49-

7a02009d9a89%40sessionmgr115&vid=17&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl

2ZQ%3d%3d#db=cin20&AN=2004141066

Brown, A., Blakstein, P., Levinton, C., & Sandalov, G. (2005). Developing an Efficient Model to

Select Emergency Department Patient Satisfaction Strategies. Annals of Emergency

Nursing. V. 11 N. 2. EBSCO. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2080/ehost/command/detail?sid=3d72703c-2cc7-4fb7-aa49-

7a02009d9a89%40sessionmgr115&vid=19&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl

2ZQ%3d%3d#db=cin20&AN=2009015522

Byrne, A. Heyman, R. (1997). Patient Anxiety in the Accident and Emergency Department.

Journal of Clinical Nursing. V. 6. P 289-295. Elsevier. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2080/ehost/command/detail?sid=3d72703c-2cc7-4fb7-aa49-

7a02009d9a89%40sessionmgr115&vid=20&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl

2ZQ%3d%3d#db=cin20&AN=1997041759

Calnan. M. (1988). Towards a Conceptual Framework of Lay Evaluation of Health Care. Social

Science and Medicine. V. 27. Elsevier. St. Louis. Mo. Retrieved From:

http://www.sciencedirect.com/science/article/pii/0277953688902833

Cahill, J. & Paley, G. (2012) What do Patients Find Helpful in Psychotherapy? Implications for

the Therapeutic Relationship in Mental Health Nursing. Journal of Psychiatric and

Current Issues - Patient Satisfaction 17

Mental Health Nursing. V 20. Wiley. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?vid=4&sid=2b9ec021-633e-

4e55-a682-69c283700822%40sessionmgr4001&hid=4104

Ekwall, A, Gertz, M. & Manias, E. (2009). Anxiety as Factor Influencing Satisfaction with

Emergency Department Care: Perspectives of Accompanying Persons. Journal of

Clinical Nursing. V. 18, pp. 3489-3497. Blackwell Publishing. New York. NY. Retrieved

From: http://libcatalog.atu.edu:2080/ehost/pdfviewer/pdfviewer?vid=14&sid=3d72703c-

2cc7-4fb7-aa49-7a02009d9a89%40sessionmgr115&hid=123

Ekwall, A. (2013). Acuity and Anxiety from the Patient’s Perspective in the Emergency

Department. Journal of Emergency Nursing. V. 39, I 6, pp 534-538. Elsevier. New York.

NY. Retrieved From: http://libcatalog.atu.edu:2080/ehost/detail/detail?sid=66f0331c-

2392-49e1-8e1f-

f8e2f2c7baa5%40sessionmgr113&vid=0&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl2Z

Q%3d%3d#db=cin20&AN=2010934100

Findick, U., Sut, N. & Unsar, S. (2010). Patient Satisfaction with Nursing Care and Relationship

with Patient Characteristics. Nursing and Health Sciences. V. 12. Wiley. New York. NY.

Retrieved From: http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?

sid=681a874d-d4c0-4e1d-a455-

0112d69743d5%40sessionmgr4004&vid=0&hid=4104

Fitpatrick. R. & Hopkins, A. (1983). Problems in the Conceptual Framework of Patient

Satisfaction Research and Empirical Explorations, Sociology of Health and Illness, V. 5.

Current Issues - Patient Satisfaction 18

Wiley Publishing. New York. NY. Retrieved from:

http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.ep10491836/full

Flynn, S. (2005). Nursing Effectiveness: An Evaluation of Patient Satisfaction with a Nurse-Led

Orthopaedic Joint Replacement Review Clinic. Journal of Orthopedic Nursing. V. 5.

Wiley. New York. NY. Retrieved From:

http://www.sciencedirect.com/science/article/pii/S1361311105000567

Fridlund, B., Johonson, O. & Oleni. M. (2002). Patient Satisfaction with Nursing Care in the

Context of Health Care: A literature Review. Scandinavian Journal of Health. Wiley.

New York. NY, Retrieved from: http://onlinelibrary.wiley.com/doi/10.1046/j.1471-

6712.2002.00094.x/abstract?

deniedAccessCustomisedMessage=&userIsAuthenticated=false

Forde-Johnston, C. (2014). Intentional Rounding: A Review of the Literature. Nursing Standard.

V. 28. RCN Publishing. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=d0e4809c-e59d-4200-

b4a6-17e5b06c3d84%40sessionmgr4004&vid=0&hid=4104

Ghonim, W. (2012) Revolution 2.0. Houglton Mifllin Houglton. Boston. MA.

Grol, R., Mainz, J. Hearnshaw, H., Hjortdahol, P, Olsen, F., Ribacke, M., Spencer, T. &

Szecsencyi, J. (1999). Patients’ Priorities With Respect to General Practice Care: An

International Comparison. Family Practice. V. 16. Oxford Publishing, Oxford U.K.

Retrieved from: http://fampra.oxfordjournals.org/content/16/1/4.abstract

Current Issues - Patient Satisfaction 19

Hicks, D. (2015). Can Rounding Reduce Patient Falls in Acute Care? An Integrative Literature

Review. MedSurg Nursing. V. 24. Academy of Medical Surgical Nurses. New York. NY.

Retrieved From: http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=e3c518ee-

3cea-486c-9e7e-

Hostutler, J. (1999). Patient needs in the Emergency Department: Nurses’ and Patients’

Perceptions. Journal of Nursing Administration. V. 29. Pp. 43-50. Philadelphia, PA.

Retrieved from: http://libcatalog.atu.edu:2080/ehost/command/detail?sid=3d72703c-

2cc7-4fb7-aa49-

7a02009d9a89%40sessionmgr115&vid=23&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl

2ZQ%3d%3d#db=cin20&AN=1999034721

Infante, F. Proudfoot, J. (2004). How People With Chronic Illness View Their Care in General

Practice: A Qualitative Study. Medical Journal of Australia. V. 2. Melbourne, Australia.

Retrieved From: https://www.mja.com.au/journal/2004/181/2/how-people-chronic-

illnesses-view-their-care-general-practice-qualitative-study

Kvist, T., Mantynem, R., Vehvilainen, K. and Voutilainen, A. (2013) The Relationship between

Patient’s Perception of Care Quality and Three Factors: Nursing Staff Job Satisfaction,

Organizational Characteristics and Patient Age. Journal of Nursing Care Quality.

BioMed Central. New York. NY. Retrieved from:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=a83bcd68-4187-4e21-

8d4c-ded4d63278b8%40sessionmgr4002&vid=0&hid=4104

Lee, F. (2014) If Disney Ran Your Hospital. Second River HealthCare. Bozeman. MT. Retrieved

via Kindle from http:www.Amazon.com.

Current Issues - Patient Satisfaction 20

Linder-Pelz, S. (1982). Social Psychological Determinants of Patient Satisfaction: a Test of Five

Hypothesis. Social Science and Medicine. V. 24. Elsevier. St. Louis. MO. Retrieved

from: http://www.sciencedirect.com/science/article/pii/0277953682903124

McLaughlin, K (2013) Family Centered Care Review. Emergency Nurse. V. 20, N. 9. London,

UK. Retrieved From: //www.emergencynurse.co.uk

Mohomed, R. St. John, W, & Patterson, E. (2012) Understanding the Process of Patient

Satisfaction With Nurse Led Chronic Management in General Practice. Journal of

Advanced Nursing. Blackwell Publishing. Ltd. New York. NY. Retrieved from:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?vid=4&sid=d1d9e3a5-e131-

4fa7-a498-0a70ece9c1c1%40sessionmgr4003&hid=101

Nassair, H., Saleh, B., Saleh, U., & Shloul, S. (2011). The Nursing Rounds System: Effects on

Patient’s Call Light Use, Bed Sores, fall and Satisfaction Level. International Journal of

Nursing Practice. Blackwell. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2065/ehost/pdfviewer/pdfviewer?sid=d9c2519f-28fb-43c6-

996d-bf6502cf6985%40sessionmgr113&vid=0&hid=101

Polit, B. & Polit A. (2006). Patient Involvement in Clinical Decision Making. The Effect of GP

Attitude on Patient Satisfaction. Health Expectations. V. Wiley. New York. NY.

Retrieved from: http://onlinelibrary.wiley.com/doi/10.1111/j.1369-7625.2006.00385.x/

abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

Polit, D. (1996) Data Analysis and Statistics for Nursing Research. Appleton. New York. NY.

Render, B. & Stair R. (1990) Introduction to Management Science. Allyn and Bacon. Boston.

MA.

Current Issues - Patient Satisfaction 21

Roberts, A. (2006) Crisis Intervention Handbook 3rd. Oxford Press. London. UK.

Taylor, C. & Berger J. (2004) Patient Satisfaction in Emergency Medicine. Emergency Medicine

Journal. V. 21, pp. 528-532. Elsevier. New York. NY. Retrieved From:

http://libcatalog.atu.edu:2080/ehost/command/detail?sid=3d72703c-2cc7-4fb7-aa49-

7a02009d9a89%40sessionmgr115&vid=27&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl

2ZQ%3d%3d#db=cin20&AN=2005087365

Topol, E. (2014) The Patient Will See You Now. Basic Books. New York. NY. Retrieved Via

Kindle from http://www.amazon.com

Townsend, M. (2012). Psychiatric Mental Health Nursing 7th. F.A. Davis Publishing.

Philadelphia, PA.

Yonder-Wise, P. (2014) Beyond Nursing and Management-Nursing Administration for the

Future. Mosby. St. Louis. MO.