Thomas Sarah, Quirk Lindsay, Blevins Cheri, Quatrara Beth, Letzkus Lisa
Sarah Thomas, MSN, RN, CCRN, ACNPC-AG, is a clinical nurse, University of Virginia Health System, Charlottesville. Lindsay Quirk, BSN, RN, CCRN, is a clinical nurse, University of Virginia Health System, Charlottesville. Cheri Blevins, MSN, RN, CCRN, CNS, is an advanced practice nurse, University of Virginia Health System, Charlottesville. Beth Quatrara, DNP, RN, CMSRN, ACNS-BC, is a director of nursing research, University of Virginia Health System, Charlottesville. Lisa Letzkus, PhD, RN, CPNP-AC, CCRN, is the codirector of nursing research, University of Virginia Health System, Charlottesville.
Dimens Crit Care Nurs. 2017 Nov/Dec;36(6):349-354. doi: 10.1097/DCC.0000000000000267.
Patient satisfaction is at the forefront of quality care and patient outcomes. The literature identifies the discrepancy between nurse and patient perceptions in a variety of care settings; few studies have investigated the perceptions of care in a critical care unit. Understanding the perceptions in a critical care unit is necessary to optimize organizational performance related to quality, safety, patient-centered care, and efficiency.
The purpose of the study was to determine whether a discrepancy exists between what patients and families perceive as satisfaction with their care as compared with the nurses' perception of what constitutes positive patient satisfaction in a medical critical care unit.
A cross-sectional, prospective study was conducted to assess patient-perceived satisfaction with nursing care versus nursing perceptions in the medical intensive care unit. A convenience sample of patients and/or family members and the nurses providing their care was conducted. The validated Patient Satisfaction with Nursing Care Quality Questionnaire and Nurse's Assessment of the Patient's Expectations Questionnaire were used to assess perceptions. Patients and/or their family members and nurses' responses were evaluated as matched pairs. The data were analyzed using Spearman correlation.
Forty-eight matched pairs of questionnaires were completed. There was not a correlation (r = 0.135; 95% confidence interval, -0.16 to 0.41; P = .363) between the overall patient and nurse averages for common questions. The analysis of the individual patient and nurse items revealed statistically significant correlations between only 2 of the 19 items, information given (P = .027) and recognition of opinions (P = .043).Correlations within patient questionnaires were noted in some areas such as patients' perception of quality of care and expectations, overall quality of nursing care, and patient expectations and patients' likelihood to recommend the hospital to family and friends. Patient satisfaction was influenced by a number of factors, most notably patient expectations.
Nurses' perceptions of positive patient satisfaction in critical care are incongruent with patients' perceptions. Improving nurses' awareness of the patient experience could improve patient satisfaction. Further studies examining patient expectations could be beneficial in improving patient satisfaction in the critical care setting.
患者满意度是优质护理和患者治疗效果的首要考量因素。文献指出，在各种护理环境中，护士与患者的认知存在差异；很少有研究调查重症监护病房的护理认知情况。了解重症监护病房的认知情况对于优化与质量、安全、以患者为中心的护理以及效率相关的组织绩效至关重要。
本研究的目的是确定在医疗重症监护病房中，患者和家属对护理满意度的认知与护士对构成积极患者满意度的认知之间是否存在差异。
进行了一项横断面前瞻性研究，以评估医疗重症监护病房中患者对护理的感知满意度与护士的认知情况。选取了患者和/或家属以及提供护理的护士作为便利样本。使用经过验证的《患者对护理质量满意度问卷》和《护士对患者期望的评估问卷》来评估认知情况。将患者和/或其家属以及护士的回答作为配对进行评估。数据采用Spearman相关性分析。
完成了48对配对问卷。常见问题的患者总体平均分与护士总体平均分之间不存在相关性（r = 0.135；95%置信区间，-0.16至0.41；P = 0.363）。对单个患者和护士项目的分析显示，19个项目中只有2个项目在统计学上具有显著相关性，即提供的信息（P = 0.027）和对意见的认可（P = 0.043）。在患者问卷的某些领域发现了相关性，例如患者对护理质量和期望的感知、护理总体质量以及患者期望和患者向家人及朋友推荐医院的可能性。患者满意度受到多种因素的影响，最显著的是患者期望。
护士对重症监护中积极患者满意度的认知与患者的认知不一致。提高护士对患者体验的认识可以提高患者满意度。进一步研究患者期望可能有助于提高重症监护环境中的患者满意度。
