University of Kansas Hospital, University of Kansas School of Nursing, 3901 Rainbow Blvd., Kansas City, KS 66160, United States.
Int J Nurs Stud. 2013 Jul;50(7):924-32. doi: 10.1016/j.ijnurstu.2012.07.012. Epub 2012 Aug 5.
The nursing care hour has become an international standard unit of measure in research where nurse staffing is a key variable. Until now, there have been no studies verifying whether nursing care hours obtained from hospital data sources can be collected reliably.
To examine the processes used by hospitals to generate nursing care hour data and to evaluate inter-rater reliability and guideline compliance with standards of the National Database of Nursing Quality Indicators(®) (NDNQI(®)) and the National Quality Forum.
Two-phase descriptive study of all NDNQI hospitals that submitted data in third quarter of 2007.
Data for phase I came from an online survey created by the authors to ascertain the processes used by hospitals to collect nursing care hours and their compliance with standardized data collection guidelines. In phase II, inter-rater reliability was measured using intra-class correlations between nursing care hours generated from clock hour files submitted to the study team by participants' payroll/accounting departments and aggregated data submitted previously.
Phase I data were obtained from a total of 714 respondents. Nearly half (48%) of all sites use payroll records to obtain nursing care hour data and 70% use one of the standardized methods for converting the bi-weekly hours into months. Unit secretaries were reportedly included in NCH by 17.4% of respondents and only 26.2% of sites could accurately identify the point at which newly hired nurses should be included. The phase II findings (n=11) support the ability of two independent raters to obtain similar results when calculating total nursing care hours according to standard guidelines (ICC=0.76-0.99).
Although barriers exist, this study found support for hospitals' abilities to collect reliable nursing care hour data.
护理工时已成为研究中护士人力配置这一关键变量的国际标准计量单位。迄今为止，尚无研究验证从医院数据源获得的护理工时数据是否可以可靠收集。
检查医院生成护理工时数据的流程，并评估其内部一致性和与国家护理质量指标数据库（NDNQI（R））和国家质量论坛标准的一致性。
对所有在 2007 年第三季度提交数据的 NDNQI 医院进行两阶段描述性研究。
第一阶段的数据来自作者创建的在线调查，以确定医院收集护理工时的流程及其对标准化数据收集指南的遵守情况。在第二阶段，使用参与者的工资单/会计部门提交给研究小组的时钟小时文件生成的护理工时和之前提交的汇总数据之间的组内相关系数来衡量内部一致性。
第一阶段的数据来自总共 714 名受访者。近一半（48%）的所有站点使用工资记录获取护理工时数据，70%的站点使用将双周工时转换为月的标准化方法之一。据报道，17.4%的受访者将单位秘书纳入了 NCH，只有 26.2%的站点能够准确确定新雇用护士应包含的时间点。第二阶段的发现（n=11）支持两名独立评估者根据标准指南计算总护理工时时获得相似结果的能力（ICC=0.76-0.99）。
尽管存在障碍，但本研究发现医院有能力收集可靠的护理工时数据。
