title: Improved quality of nursing documentation: results of a nursing diagnoses, interventions, and outcomes implementation study.
abstract: OBJECTIVE
  To evaluate the impact of the quality of nursing diagnoses, interventions, and outcomes in an acute care hospital following the implementation of an educational program.
  
  
  METHODS
  In a pretest-posttest experimental design study, nurses from 12 wards of a Swiss hospital received an educational intervention--an introductory class and consecutive classes, using a case discussion method--to implement nursing diagnoses, interventions, and outcomes. Two sets of 36 randomly selected nursing records were evaluated before and after implementation. The quality of documented nursing diagnoses, interventions, and nursing-sensitive patient outcomes was assessed by 29 Likert-type items with a 0-4 scale instrument, called Quality of Nursing Diagnoses, Interventions, and Outcomes (Q-DIO) and tested using t-tests.
  
  
  RESULTS
  Significant enhancements in the quality of documented nursing diagnoses, interventions, and outcomes were found following the implementation of a planned educational program.
  
  
  CONCLUSIONS
  The implementation of NANDA, NIC, and NOC (NNN) nursing diagnoses, interventions, and outcomes led to higher quality of nursing diagnosis documentation, etiology-specific nursing interventions, and nursing-sensitive patient outcomes.
  
  
  CONCLUSIONS
  Educational measures support nurses to improve documentation of diagnoses, interventions, and outcomes. The Q-DIO is a useful audit tool.
authors: Pflege PBS, Stettlerstrasse 15, CH-3006 Bern, Switzerland.
authors: Maria
authors: M
authors: Müller-Staub
authors: Ian
authors: I
authors: Needham
authors: Matthias
authors: M
authors: Odenbreit
authors: Mary Ann
authors: MA
authors: Lavin
authors: Theo
authors: T
authors: van Achterberg
mesh_terms: D004282:Documentation / Q000592:standards*; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D016347:Medical Records Systems, Computerized; D009731:Nursing Audit; D009733:Nursing Diagnosis / Q000458:organization & administration*; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D009737:Nursing Records / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000193:education*; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration; D015397:Program Evaluation; D013557:Switzerland; D017749:Total Quality Management; D018875:Vocabulary, Controlled