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Nursing-sensitive outcomes data collection in acute care and long-term-care settings. 2006

Diane M Doran, and Margaret B Harrison, and Heather S Laschinger, and John P Hirdes, and Ellen Rukholm, and Souraya Sidani, and Linda McGillis Hall, and Ann E Tourangeau
Faculty of Nursing, Nursing Health Services Research Unit, University of Toronto, #215-155 College Street, Toronto, Ontario, Canada M5T 1P8. diane.doran@utoronto.ca

BACKGROUND Most administrative databases do not contain good information about nursing-sensitive outcomes. OBJECTIVE To determine (a) the reliability of the instruments measuring nursing-sensitive outcomes, (b) whether the outcome measures are sensitive to changes in patients' health, and (c) whether the outcome measures are associated with nursing interventions. METHODS The sample consisted of 890 patients from acute care hospitals and long-term-care facilities. A repeated measures design was used. Functional status was assessed on admission and discharge using Minimum Data Set 2.0 items. Symptom (pain, nausea, dyspnea, fatigue) frequency and severity were assessed with 4-point and 11-point numeric scales, respectively. Therapeutic self-care was assessed on discharge from acute care. Nursing interventions were assessed by documentation review. RESULTS The outcome measures demonstrated very good interrater reliability with weighted Kappa ranging from .64 to .93. The internal consistency reliability was high for functional status and therapeutic self-care. The outcome tools were sensitive to change in patient condition. Select nursing interventions were related to functional status, therapeutic self-care, and symptom outcomes. CONCLUSIONS The findings suggest that nurses are able to collect data on nursing-sensitive patient outcomes in a reliable and valid way.

UI MeSH Term Description Entries
D008134 Long-Term Care Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. Care, Long-Term,Long Term Care
D008297 Male Males
D009731 Nursing Audit A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of nursing care. Audit, Nursing,Audits, Nursing,Nursing Audits
D009735 Nursing Homes Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization. Homes, Nursing,Nursing Home
D009738 Nursing Service, Hospital The hospital department which is responsible for the organization and administration of nursing activities. Hospital Nursing Service,Service, Hospital Nursing,Hospital Nursing Services,Nursing Services, Hospital,Services, Hospital Nursing
D009864 Ontario A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)
D010043 Outcome and Process Assessment, Health Care Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically. Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D005240 Feasibility Studies Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project. Feasibility Study,Studies, Feasibility,Study, Feasibility
D005260 Female Females
D006304 Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. General Health,General Health Level,General Health Status,Level of Health,Overall Health,Overall Health Status,General Health Levels,Health Level,Health Level, General,Health Levels,Health Status, General,Health Status, Overall,Health, General,Health, Overall,Level, General Health,Levels, General Health,Status, General Health,Status, Health,Status, Overall Health

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