Moore Marsha, Hastings Clare
National Institutes of Health, Clinical Center, Bethesda, MD, USA.
J Nurs Adm. 2006 May;36(5):241-8. doi: 10.1097/00005110-200605000-00017.
To establish a methodology for developing a user-friendly, environmentally specific nursing intensity measurement tool.
Nursing intensity measurement systems assess the demand for nursing care in a given setting and must adapt to changes in technology, patient populations, and treatment profiles. Nowhere is this more evident than in a clinical research setting where demands for nursing care are driven by changing patient populations and new biomedical research protocols. This article traces the extension of an adult oncology ambulatory nursing intensity system at the Clinical Center, National Institutes of Health, into 3 day hospitals: medical surgical, pediatrics, and hematology/oncology.
A team of stakeholders including nurse managers, clinical nurse specialists, and senior clinical research nurses was assembled. Descriptions of clinical research care for each day hospital were developed and organized into 6 levels with their associated time frames. Descriptions were reviewed by 2 content specialists, and a content validity index quantified the extent of their agreement. A weighted kappa statistic was used to measure interrater reliability.
A content validity index of .87 indicated a high level of agreement between specialists. The weighted kappa statistic was .80, demonstrating substantial agreement between 2 raters.
This ambulatory nursing intensity tool proved to be adaptable to heterogeneous patient populations.
建立一种方法，以开发一种用户友好的、针对特定环境的护理强度测量工具。
护理强度测量系统评估特定环境下的护理需求，并且必须适应技术、患者群体和治疗方案的变化。这一点在临床研究环境中最为明显，在该环境中，护理需求受到不断变化的患者群体和新的生物医学研究方案的驱动。本文追溯了美国国立卫生研究院临床中心的成人肿瘤门诊护理强度系统在3家日间医院（内科外科、儿科和血液学/肿瘤学）的扩展情况。
组建了一个由护士经理、临床护理专家和高级临床研究护士组成的利益相关者团队。制定了每家日间医院临床研究护理的描述，并将其组织成6个级别及其相关的时间框架。由2名内容专家对描述进行审查，内容效度指数量化了他们的一致程度。使用加权kappa统计量来测量评分者间的信度。
内容效度指数为0.87，表明专家之间高度一致。加权kappa统计量为0.80，表明两名评分者之间有实质性的一致性。
这种门诊护理强度工具被证明适用于不同的患者群体。
