Milani A, Mauri S, Gandini S, Magon G
European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy.
Ecancermedicalscience. 2013 Sep 2;7:345. doi: 10.3332/ecancer.2013.345. eCollection 2013.
The nursing minimum data set (NMDS) was created in 1977 in the United States to collect uniform standardised data that could be comparable among different nursing areas or patients. So far, in the literature, an NMDS in an oncology setting has not yet been described. Considering an oncology nursing minimum data set (ONMDS), which data could be chosen to define this tool regarding cancer patient care?
At the European Institute of Oncology (IEO), 20 experienced oncology nurses representing surgical, medical, and critical areas participated in a nursing record working group. All nurses followed an educational course on NMDS, and they shared clinical experiences to find which data common among different areas could be useful to care. To identify these data, nurses considered three issues: what is nursing care for nurses in the IEO? What is the nurses' responsibility in the IEO? What is the organisational nursing model in the IEO? Nurses in the IEO are autonomous in decision making and recognised by patients and by a multi-professional team; the organisational nursing model is primary nursing with patient-centred care. Nursing data must therefore show the quality and results of this care. With this in mind, the working group decided to orient the ONMDS toward nursing-sensitive outcomes (NSOs), meeting also with psychologists, physiotherapists, and dieticians. Nurses analysed Oncology Nursing Society outcomes, and through focus groups, experiential meetings, role playing, and case studies, they integrated them with other NSOs.
The ONMDS is composed of 49 NSOs recognised as the most common and frequent oncologic outcomes regardless of the treatment that the patient undergoes. These outcomes were clustered into 15 categories. The categories are: gastrointestinal outcomes, genitourinary outcomes, respiratory outcomes, skin outcomes, fluid and electrolyte balance outcomes, neurological outcomes, security, functional status, vascular access outcomes, nutritional status, pain, psychosocial discomfort, activities of daily living (ADL), instrumental activities daily living (IADL), and self-care outcomes.
Efforts to identify an ONMDS based on NSOs allow us to develop an tool that can standardise language, assessment, and intervention, but overall could be used to measure nursing care. To evaluate these potentialities, the ONMDS was introduced into nursing records, and it was tested with a pre-post research study.
护理最小数据集（NMDS）于1977年在美国创建，用于收集可在不同护理领域或患者之间进行比较的统一标准化数据。到目前为止，文献中尚未描述肿瘤学环境中的NMDS。考虑到肿瘤护理最小数据集（ONMDS），可以选择哪些数据来定义这个关于癌症患者护理的工具呢？
在欧洲肿瘤研究所（IEO），20名来自外科、内科和重症领域的经验丰富的肿瘤护士参加了护理记录工作组。所有护士都参加了关于NMDS的培训课程，他们分享临床经验，以找出不同领域中共同的数据，这些数据可能对护理有用。为了确定这些数据，护士们考虑了三个问题：IEO护士的护理工作是什么？IEO护士的职责是什么？IEO的组织护理模式是什么？IEO的护士在决策方面是自主的，并得到患者和多专业团队的认可；组织护理模式是以患者为中心的初级护理。因此，护理数据必须显示这种护理的质量和结果。考虑到这一点，工作组决定将ONMDS导向护理敏感结局（NSO），并与心理学家、物理治疗师和营养师进行了会面。护士们分析了肿瘤护理协会的结局，并通过焦点小组、经验交流会、角色扮演和案例研究，将它们与其他NSO整合在一起。
ONMDS由49个NSO组成，这些NSO被认为是最常见和最频繁出现的肿瘤学结局，无论患者接受何种治疗。这些结局被归为15个类别。这些类别是：胃肠道结局、泌尿生殖系统结局、呼吸系统结局、皮肤结局、液体和电解质平衡结局、神经学结局、安全性、功能状态、血管通路结局、营养状况、疼痛、心理社会不适、日常生活活动（ADL）、日常生活工具性活动（IADL）和自我护理结局。
基于NSO确定ONMDS的努力使我们能够开发一种工具，该工具可以标准化语言、评估和干预，但总体上可用于衡量护理质量。为了评估这些潜力，ONMDS被引入护理记录中，并通过前后研究进行了测试。
