Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Department of Clinical Nursing Science, Kantonsspital Aarau AG, Aarau, Switzerland.
J Adv Nurs. 2020 Dec;76(12):3483-3494. doi: 10.1111/jan.14560. Epub 2020 Oct 3.
To identify indicators of nursing care performance by identifying structures, processes, and outcomes that are relevant, feasible and have the potential for benchmarking in Swiss acute hospitals.
A modified Delphi-Consensus Technique.
We examined 19 indicators based on the current evidence and that were pre-selected by nursing scientists. Between August-October 2019, a consortium of experts (representatives of different cantons, hospitals, and healthcare roles in Switzerland) determined the relevance, feasibility, and suitability for benchmarking these indicators in two-round modus of digital survey. Consensus was defined a priori by at least 75% agreement on the highest level of a 3-point Likert-type scale.
The response rate was 70.4% in the first and 68.4% in the second round. In round one consensus was reached for three indicators on relevance but for none of the indicators regarding feasibility or potential for benchmarking. For round two, the experts suggested two additional indicators (new total of 21 indicators). Of 21 indicators, consensus was reached on twelve regarding relevance, seven regarding feasibility, and two regarding the potential for benchmarking.
A national expert consortium defined 12 of 21 nursing care indicators as relevant. Feasibility, however, was estimated only among seven indicators and a consensus on suitability for benchmarking was reached for two nursing-sensitive indicators.
The results show how the indicators to evaluate nursing care performance, which have been identified as priority by Canadian nursing scientists, are assessed in a different setting. There are many overlaps, but also some differences in the assessment of the indicators between the different settings. Different health systems prioritize the indicators to evaluate nursing care performance differently, which is why national surveys are important for the compilation of their own (priority) indicator sets.
通过确定相关、可行且具有基准比较潜力的结构、过程和结果，确定瑞士急性医院护理绩效的指标。
改良德尔菲共识技术。
我们根据当前证据检查了 19 个指标，并由护理科学家预先选择。在 2019 年 8 月至 10 月期间，一个由专家组成的联盟（代表瑞士不同的州、医院和医疗保健角色）通过数字调查的两轮模式确定了这些指标的相关性、可行性和基准比较适用性。共识是通过至少 75%的专家在 3 点李克特量表的最高水平上达成一致来预先定义的。
第一轮的回复率为 70.4%，第二轮为 68.4%。在第一轮中，就三个指标的相关性达成共识，但就可行性或基准比较的潜力而言，没有一个指标达成共识。在第二轮中，专家们提出了另外两个指标（总共 21 个指标）。在 21 个指标中，有 12 个指标的相关性、7 个指标的可行性和 2 个指标的基准比较潜力得到了共识。
一个国家专家联盟确定了 21 个护理指标中的 12 个为相关。然而，可行性仅在七个指标中进行了评估，并且只有两个护理敏感指标达成了基准比较适用性的共识。
研究结果表明，加拿大护理科学家确定的评估护理绩效的指标，在不同的环境下是如何进行评估的。虽然有许多重叠，但在不同环境下对这些指标的评估也存在一些差异。不同的卫生系统对评估护理绩效的指标有不同的优先级，这就是为什么国家调查对于编制自己的（优先）指标集很重要。
