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.

OBJECTIVES

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.

DISCUSSION

The findings suggest that nurses are able to collect data on nursing-sensitive patient outcomes in a reliable and valid way.