Nursing-sensitive outcomes data collection in acute care and long-term-care settings.
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.
Doran
Diane M
DM
Faculty of Nursing, Nursing Health Services Research Unit, University of Toronto, #215-155 College Street, Toronto, Ontario, Canada M5T 1P8. diane.doran@utoronto.ca
Harrison
Margaret B
MB
Laschinger
Heather S
HS
Hirdes
John P
JP
Rukholm
Ellen
E
Sidani
Souraya
S
Hall
Linda McGillis
LM
Tourangeau
Ann E
AE
D000368:Aged; D016208:Databases, Factual / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008134:Long-Term Care / Q000592:standards; D008297:Male; D009731:Nursing Audit / Q000379:methods*; D015403:Nursing Evaluation Research / Q000379:methods*; D009735:Nursing Homes / Q000592:standards; D009738:Nursing Service, Hospital / Q000592:standards; D009864:Ontario; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012648:Self Care; D012680:Sensitivity and Specificity