Lovett R B, Wagner L, McMillan S
J Pediatr Oncol Nurs. 1991 Jul;8(3):122-30. doi: 10.1177/104345429100800305.
Appropriate use of nursing resources in the pediatric hematology and oncology inpatient settings demands a patient acuity system that is easy to use and accurate, and that objectively measures nursing care needs of a specialized patient population. Structured survey of 13 comprehensive cancer centers and a review of the literature show no valid and reliable acuity tools for this pediatric population. The purpose of this project was to study the validity and reliability of a newly developed pediatric hematology and oncology acuity system designed to quantify patient care needs. A new acuity tool for this pediatric population was developed based on the patient classification tool used at Johns Hopkins Hospital Oncology Center (JHHOC). The levels of care from the JHHOC tool were adopted, with therapeutic indicators modified to reflect nursing diagnoses relevant to the pediatric inpatient. Nursing care hours required for each level of care were also identified. Validity was studied using a content validity index (CVI). Experts from the pediatric unit where the tool would be used were asked whether each therapeutic indicator was assigned to the correct level of care (1 thru 5) based on patient care hours. CVIs for items ranged from .5 to 1.0; the overall CVI for the tool was .93. Interrater reliability was studied using two raters from the unit. Data were collected for 150 patient observations on a 12-bed pediatric hematology and oncology inpatient and short-stay outpatient unit. The resulting Pearson correlation coefficient was r = .97 (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
在儿科血液学和肿瘤学住院环境中合理使用护理资源，需要一个易于使用且准确的患者 acuity 系统，该系统能客观衡量特定患者群体的护理需求。对 13 家综合癌症中心的结构化调查以及文献综述表明，针对该儿科人群没有有效的、可靠的 acuity 工具。本项目的目的是研究一种新开发的旨在量化患者护理需求的儿科血液学和肿瘤学 acuity 系统的有效性和可靠性。基于约翰霍普金斯医院肿瘤中心（JHHOC）使用的患者分类工具，为该儿科人群开发了一种新的 acuity 工具。采用了 JHHOC 工具的护理级别，并修改了治疗指标以反映与儿科住院患者相关的护理诊断。还确定了每个护理级别的所需护理时长。使用内容效度指数（CVI）研究有效性。询问了该工具使用科室的儿科专家，每个治疗指标是否根据患者护理时长被分配到正确的护理级别（1 至 5 级）。各项目的 CVI 范围为 0.5 至 1.0；该工具的总体 CVI 为 0.93。使用科室的两名评估者研究评分者间信度。在一个有 12 张床位的儿科血液学和肿瘤学住院及短期门诊科室，收集了 150 例患者观察数据。所得皮尔逊相关系数为 r = 0.97（P < 0.001）。（摘要截断于 250 字）
