| This study examines the concepts of technology transfer and change from a cross-cultural perspective using Eveland's model for innovation implementation in the context of a medical unit of three wards in a 325 bed National Health Service community hospital in Maidstone, Kent, England. There were three clusters of goals: (1) to develop a method for interrelating quality compliance, patient volume, and the use of nursing resources; (2) to increase job satisfaction and the professional identity of the nursing staff; and (3) to maintain patient satisfaction with the nursing care provided. The researcher was a participant-observer on Cornwallis, the experimental ward, and served to facilitate change. An external interviewer interviewed the staff of all three wards at four intervals over the course of the study. Nurse work survey tools were administered to all nurses before and after the implementation of the study for demographic data and to determine the nurses' job satisfaction. Every fifth discharged patient on both the experimental and comparison wards was given a questionnaire to determine patient satisfaction. Initially, on Cornwallis, the sessions focused on teaching advanced nursing practice, and then a ward-based quality assurance program was established. Computerization of the management resource information occurred mid-study.; A process was developed to calculate quality effectiveness and quality efficiency by interrelating workload data with quality assessment scores. Although the interviews were not conclusive in reporting increases in job satisfaction and professional identity, nursing staff turnover declined on the experimental ward. In addition, the post-study nurse work survey tools reported an increased likelihood of the Cornwallis ward nurses staying in nursing for three years in contrast to the comparison wards. The patient questionnaires demonstrated no change in the patients' perspective of satisfaction with nursing care received. A 20% sample of all the patients' records hospitalized on the study wards in the pre-study month of April 1988 was compared to the post-study month of July 1989 on audit with demonstrative improvement on the experimental ward.; Eveland's model for innovation implementation proved to be effective as a methodology for cross-cultural technology transfer which would applicable in settings other than nursing. |
