地区护理中护士敏感结局：德尔菲研究。
Nurse-sensitive outcomes in district nursing care: A Delphi study.
机构信息
Research Centre for Healthy and Sustainable Living, Faculty of Health Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.
Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
出版信息
PLoS One. 2021 May 13;16(5):e0251546. doi: 10.1371/journal.pone.0251546. eCollection 2021.
OBJECTIVES
To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses' scope and domain of practice and that are influenced by nursing inputs and interventions.
DESIGN
A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection.
SETTING
District nursing care in the community care setting in the Netherlands.
PARTICIPANTS
Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing.
MAIN OUTCOME MEASURES
Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement.
RESULTS
In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient's autonomy, the patient's ability to make decisions regarding the provision of care, the patient's satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care.
CONCLUSIONS
This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.
目的
确定社区居住老年人的地区护理中护士敏感的结果。护士敏感的结果被定义为基于护士的范围和实践领域相关的患者结果，并且受护理投入和干预的影响。
设计
遵循 RAND/UCLA 适宜性方法的德尔菲研究，共进行了两轮数据收集。
地点
荷兰社区护理环境中的地区护理。
参与者
具有当前或近期临床经验的地区护士专家，以及在地区护理领域的研究、教学、实践或政策方面的专业知识。
主要观察指标
专家通过对每个结果的相关性和结果受护理影响的能力（可影响性）对潜在的护士敏感结果进行护理敏感性评估。每个结果的相关性和可影响性均在 9 分制的李克特量表上进行评分。7 到 9 的组中位数表示该结果被评估为相关和/或可影响。为了衡量专家之间的一致性，使用分歧指数进行衡量，得分<1 表示一致。
结果
在德尔菲第二轮中，11 名专家评估了 46 个结果。共有 26 个结果（56.5%）被评估为护士敏感。在相关性和可影响性方面得分最高的护士敏感结果是患者的自主性、患者对护理提供的决策能力、患者对所提供的地区护理的满意度、临终和死亡的质量以及患者对所需护理的依从性。
结论
本研究基于地区护理专家的集体意见，确定了 26 个社区居住老年人地区护理的护士敏感结果。这一见解可以为地区护理的质量指标制定提供指导。需要进一步研究来使结果具体化，并确定哪些结果与特定亚组相关。
Zotero 插件