Amatt Natalie G, Marufu Takawira C, Boardman Rachel, Reilly Lesley, Manning Joseph C
Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Children and Young People Health Research, School of Health Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK.
Int Nurs Rev. 2023 Jun;70(2):160-174. doi: 10.1111/inr.12805. Epub 2022 Oct 23.
Nurse-sensitive outcomes are measures for improvement and evaluation of the quality of nursing care delivered. The specific outcomes that need to be measured will be determined by the patient population, as well as the field and scope of practice, in which nursing care is being delivered. Currently, there is no internationally agreed upon set of nurse-sensitive outcomes for pediatric nursing, which provides specialist care to infants, children, and young people.
To identify and evaluate nurse-sensitive outcomes for pediatric nursing.
A systematic review was conducted. Five electronic databases (British Nursing Index, CINAHL, EMBASE, MEDLINE, and EMCARE) were searched in the period up to February 2022. Studies were selected for inclusion using title and abstract screening using predetermined criteria. The Critical Appraisal Skills Programme tool was used for quality assessment. A narrative synthesis of the results was performed.
A total of 633 studies were identified from online searches, with 14 studies meeting the inclusion criteria. All studies had moderate to high methodological strength. A total of 57 nurse-sensitive outcomes were identified from all included studies. Using the nurse-sensitive outcome conceptual analysis framework, 25 (45%) of the items were classified as outcome attributes, 20 (35%) as process attributes, and 13 (23%) as structure attributes. The most frequently reported nurse-sensitive outcomes included pressure ulcers, nosocomial infections, hospital-acquired infections, peripheral intravenous infiltration, failure to rescue, and staffing levels.
This review provides an up-to-date and comprehensive list of nurse-sensitive outcomes for use in pediatric nursing and describes their frequency of use. However, further work is required to achieve consensus for an international core nurse-sensitive outcome set for pediatric nursing with policy recommendations to ensure agreed-upon minimum standards.
Policy initiatives and guideline recommendations on nurse-sensitive outcome frameworks as part of patient safety should be a part of key priorities for policy makers. The commonly reported nurse-sensitive outcomes should be incorporated into daily bedside pediatric clinical nursing practice as a mechanism to evaluate and improve the quality of care, enhancement of patient safety, and better outcomes.
护理敏感指标是用于改善和评估所提供护理质量的衡量标准。需要衡量的具体指标将由患者群体以及提供护理服务的专业领域和实践范围来决定。目前，对于为婴儿、儿童和青少年提供专科护理的儿科护理，尚无国际公认的护理敏感指标集。
识别和评估儿科护理的护理敏感指标。
进行了一项系统综述。截至2022年2月，检索了五个电子数据库（英国护理索引、护理学与健康领域数据库、医学与健康领域数据库、医学文献数据库和循证医学护理数据库）。使用预先确定的标准，通过标题和摘要筛选来选择纳入研究。采用批判性评估技能计划工具进行质量评估。对结果进行了叙述性综合分析。
通过在线检索共识别出633项研究，其中14项研究符合纳入标准。所有研究的方法学强度为中等至高。从所有纳入研究中总共识别出57项护理敏感指标。使用护理敏感指标概念分析框架，其中25项（45%）指标被归类为结果属性，20项（35%）为过程属性，13项（23%）为结构属性。报告最频繁的护理敏感指标包括压疮、医院感染、医院获得性感染、外周静脉渗漏、未能成功抢救以及人员配备水平。
本综述提供了一份最新且全面的儿科护理护理敏感指标清单，并描述了它们的使用频率。然而，需要进一步开展工作，以就儿科护理的国际核心护理敏感指标集达成共识，并提出政策建议，以确保商定的最低标准。
作为患者安全一部分的护理敏感指标框架的政策举措和指南建议应成为政策制定者的关键优先事项。常见的护理敏感指标应纳入日常床边儿科临床护理实践，作为评估和改善护理质量、增强患者安全及取得更好结果的一种机制。
