School of Nursing and Midwifery, National University Ireland Galway, Galway, Ireland.
Nursing and Midwifery Planning and Development Unit, Health Services Executive, North-West, Dublin, Ireland.
BMC Health Serv Res. 2022 Mar 16;22(1):350. doi: 10.1186/s12913-022-07659-2.
The Irish Office of Nursing & Midwifery Services Director (ONMSD) commissioned the development an updated suite of mental health nursing metrics and indicators for implementation in Irish mental health clinical settings. While measuring care processes does offer the potential to improve care quality, the choice of which mental health nursing metrics to measure presents a significant challenge, both in Ireland and internationally. The provision of safe and high-quality mental health nursing care stems from nurses' expertise, skills and overall capacity to provide recovery focused care across a range of health care settings. Accordingly, efforts to measure what mental health nurses do depends on the identification of those care processes that contribute to mental health nursing practice. This paper reports on the identification, development and prioritisation of a national suite of Quality Care Metrics (QCM), along with their associated indicators, for mental health nursing care processes in Ireland.
The study was undertaken over four phases; i) a systematic literature review to identify mental health care process metrics and their associated indicators of measurement; ii) a two-round, online Delphi survey of mental health nurses to develop consensus on the suit of mental health nursing care process metrics; iii) a two-round online Delphi survey of mental health nurses to develop consensus on the indicators to be used to measure the agreed metrics; and iv) a face-to-face consensus meeting with mental health nurses and service user representatives to develop consensus on the final suite of metrics and indicators.
Following these four phases 9 metrics and their 71 associated indicators were agreed for inclusion in the final suite of Mental Health Nursing QCM. These metrics are applicable across the life span and the range of mental health nursing health care settings.
The development of this suite of Mental Health Nursing QCM and their indicators represents an opportunity for the measurement of safe and high-quality mental health nursing care for application in Ireland and internationally. This initial development of metrics and indicators should be followed by a rigorous baseline review of QCM uptake and implementation amongst mental health nurses as part of an ongoing evaluation.
爱尔兰护理和助产服务办公室主任 (ONMSD) 委托开发一套更新的精神科护理指标和衡量标准，以便在爱尔兰精神科临床环境中实施。虽然衡量护理过程确实有潜力提高护理质量，但在爱尔兰和国际上，选择衡量哪些精神科护理指标都是一个重大挑战。提供安全和高质量的精神科护理源于护士的专业知识、技能和整体能力，以在一系列医疗保健环境中提供以康复为重点的护理。因此，衡量精神科护士所做工作的努力取决于确定有助于精神科护理实践的护理过程。本文报告了在爱尔兰确定、制定和优先考虑一套全国性的优质护理衡量标准 (QCM)，以及与其相关的精神科护理过程指标。
该研究分四个阶段进行; i) 系统文献回顾，以确定精神卫生保健过程指标及其相关的衡量指标；ii) 对精神科护士进行两轮在线德尔菲调查，以就精神科护理过程指标达成共识；iii) 对精神科护士进行两轮在线德尔菲调查，以就用于衡量商定指标的指标达成共识；iv) 与精神科护士和服务用户代表进行面对面的共识会议，就最终的一套指标和指标达成共识。
经过这四个阶段，确定了 9 项指标及其 71 项相关指标，纳入最终的精神科护理 QCM 套件。这些指标适用于整个生命周期和各种精神科护理保健环境。
开发这一套精神科护理 QCM 及其指标为衡量安全和高质量的精神科护理提供了机会，可在爱尔兰和国际上应用。在对精神科护士进行 QCM 采用和实施的严格基线审查之后，应作为持续评估的一部分，对指标进行初步开发。
