Desenvolvimento e validação de indicadores de processo da qualidade da assistência de enfermagem ao idoso

Introdução: Os indicadores de qualidades são aspectos importantes na gestão dos serviços. No entanto, na atenção primária, há escassez de indicadores especificamente no que concerne à população idosa. Objetivo: Construir e validar indicadores de processo da qualidade da assistência de enfermagem ao idoso. Métodos: Trata-se de uma pesquisa metodológica, sendo as etapas baseadas nas propostas da National Database of Nursing Quality Indicators e da Agency for Healthcare Research and Quality. Os indicadores foram avaliados segundo os critérios de: validade de face, terminologia, necessidade, validade de conteúdo, confiabilidade, viabilidade, utilidade e usabilidade. Participaram do painel de especialistas nove enfermeiros sendo profissionais que prestavam assistência na atenção primária, pesquisadores na área de atenção à saúde do idoso e membros de organizações brasileiras relacionadas à saúde. Foi utilizado o Método de Adequação desenvolvido pela Research and Development da University of California Los Angeles. Os dados foram analisados por meio da mediana, Índice de Validade de Conteúdo e Kappa. Resultados: Foram validados 22 indicadores. Todas as medidas foram consideradas apropriadas, com validade de conteúdo e obtiveram acordo acerca da terminologia e necessidade. Dentre os 22 indicadores, apenas quatro foram avaliados como não disponíveis e não viáveis para serem coletados. Treze indicadores não foram considerados úteis para determinar o recebimento de incentivos financeiros. Na avaliação sobre a usabilidade para comparar os relatórios públicos, seis indicadores obtiveram pontuação relativamente baixa. Conclusão: Os indicadores podem contribuir para o monitoramento da qualidade da assistência ao idoso, identificando oportunidades de melhoria nas ações realizadas pelo enfermeiro na atenção primária.

Generational Differences in Nurses’ Intention to Leave

There are many studies about nurses’ intention to leave their jobs and contributing factors. However, there is a lack of research about generational differences in nurses’ intention to leave. This evidence may help with workforce planning and targeting specific generations of nurses with retention interventions. Using the National Database of Nursing Quality Indicators 2018 Annual Registered Nurse Survey, we used descriptive statistics and multivariate logistic regression to examine the prevalence of and reasons for nurses’ intention to leave in the next year by generational age group. Our sample included 207,636 hospital nurses from across the United States. We found that 21% of nurses ( n = 44,082) reported intention to leave. When comparing generations, there were differences in intention to leave, as well as differences in potentially preventable, career advancement, and personal intention to leave reasons. Workload/staffing was a common reason across generations, indicating that certain interventions may be applicable regardless of generation.

Research on the Application Value of Comfort Nursing Intervention in the Nursing of Senile Chronic Heart Failure

<p><strong>Objective</strong><strong>:</strong> To analyze the application value of comfort nursing intervention in senile chronic heart failure nursing. <strong>Methods:</strong> The 120 heart failures discharged from our hospital in 2018 and 2019 were selected. The changes in nursing satisfaction, specialty nursing quality indicators and the incidence of pressure ulcers in hospitalized patients were compared and analyzed between the two groups. <strong>Results:</strong> The average satisfaction degree of the two groups was 97.48% and 97.22% respectively, and the difference between the groups was statistically significant (P&lt;0.05). The correct rates of acute left heart failure in the two groups were 99.56% and 98.13%, and the difference between the groups was statistically significant (P&lt;0.05), and two groups of patients with cardiac Ⅲ class above intake control accuracy was 99.95% and 99.99%, and the difference between groups was statistically significant (P&gt;0.05), and the incidence of pressure ulcer was 0.18‰ and 0, and there was no significant difference between the two groups. <strong>Conclusion:</strong> Comfort nursing intervention has achieved good nursing satisfaction and clinical effect in elderly patients with heart failure.</p>

Assessment of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database using a data quality index

A comprehensive data quality assessment is necessary to expand a nursing database that is designed for evaluating the impact of implementing Best Practice Guidelines (BPG) developed by the Registered Nurses’ Association of Ontario (RNAO). This case report presents a method to standardize data quality assessments of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database by developing a data quality framework (DQF) and assessing key dimensions of the framework using a data quality index (DQI). The data quality index is a single key performance metric for assessing the quality of the database. The aims of sharing this case report are 2-fold: (1) to promote best practices for assessing data quality by developing and implementing a data quality framework and (2) to demonstrate an unprecedented method of assessing the data quality of a nursing database.

Classification of Injurious Fall Severity in Hospitalized Adults

Background Many hospital systems in the United States report injurious inpatient falls using the National Database of Nursing Quality Indicators categories: None, Minor, Moderate, Major, and Death. The Major category is imprecise, including injuries ranging from a wrist fracture to potentially fatal subdural hematoma. The purpose of this project was to refine the Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Methods Based on published literature and ranking of injurious fall incident reports (n = 85) from a large Academic Medical Center, we divided the National Database of Nursing Quality Indicators Major category into three subcategories: Major A—injuries that caused temporary functional impairment (eg, wrist fracture), major facial injury without internal injury (eg, nasal bone fracture), or disruption of a surgical wound; Major B—injuries that caused long-term functional impairment or had the potential risk of increased mortality (eg, multiple rib fractures); and Major C—injuries that had a well-established risk of mortality (eg, hip fracture). Based on the literature and expert opinion, our research team reached consensus on an administration manual to promote accurate classification of Major injuries into one of the three subcategories. Results The team tested and validated each of the categories which resulted in excellent interrater reliability (kappa = .96). Of the Major injuries, the distribution of Major A, B, and C was 40.3%, 16.1%, and 43.6%, respectively. Conclusions These subcategories enhance the National Database of Nursing Quality Indicators categorization. Using the administration manual, trained personnel can classify injurious fall severity with excellent reliability.