Measurement of Quality of Nursing Practice in Congenital Cardiac Care.
作者信息
Connor Jean Anne, Mott Sandra, Green Angela, Larson Carol, Hickey Patricia
机构信息
Jean Anne Connor is director of nursing research, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children's Hospital, Boston, Massachusetts, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sandra Mott is a nurse scientist research consultant, Boston Children's Hospital. Angela Green is vice president of performance improvement, Arkansas Children's Hospital, Little Rock, Arkansas. Carol Larson is a quality improvement consultant, Department of Cardiology, Boston Children's Hospital. Patricia Hickey is vice president, Cardiovascular and Critical Care Services, associate chief nursing officer, Department of Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School.
出版信息
Am J Crit Care. 2016 Mar;25(2):128-35. doi: 10.4037/ajcc2016708.
BACKGROUND
The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States.
METHODS
A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis.
RESULTS
Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data.
CONCLUSION
External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks.
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