The impact of unit-based self-management by nurses on patient outcomes.

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OBJECTIVE. Patients discharged from a self-managed nursing unit are compared with patients from traditionally managed units on postdischarge outcomes. DATA SOURCES AND STUDY SETTING. Primary data were collected on patients discharged from eight nursing units in three clinical areas in one hospital from August through November 1990. STUDY DESIGN. A case series of eligible patients discharged from four self-managed nursing units (n = 140) are compared with patients from four matched traditionally managed units (n = 138) on postdischarge outcomes: perceived health status, perceived functional status, needs for care, unmet needs for care, unplanned health care visits, and readmissions to the hospital within 31 days of discharge. DATA COLLECTION METHODS. Patients were interviewed by telephone at approximately two weeks postdischarge, and data from hospital records were merged with interview data. PRINCIPAL FINDINGS. Bivariate and multiple logistic regression analyses showed no significant effects (either positive or negative) of self-managed units on the postdischarge outcomes studied. CONCLUSIONS. Self-managed nursing units, previously shown to improve nurses' work satisfaction and retention, have no impact on patient postdischarge outcomes.

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