Academic journal article Journal of Nursing Measurement

Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

Academic journal article Journal of Nursing Measurement

Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

Article excerpt

Background and Purpose: Quality of nursing care measurement is essential in critical care units. The aim of this study was to develop a scale to measure the quality of nursing care in intensive care units (ICUs). Methods: The 68 items of nursing care standards in critical care settings were explored in a literature review. Then, 30 experts evaluated the items' content validity index (CVI) and content validity ratio (CVR). Items with a low CVI score (<0.78) and low CVR score (<0.33) were removed from the scale. Results: The 50 items remained in the scale. The Scale level-CVI and Scale level-CVR were 0.898 and 0.725, respectively. Conclusion: The nursing care scale in ICU (Quality of Nursing Care Scale-ICU) that was developed in this research had acceptable CVI and CVR.

Keywords: ICU; nursing care; quality measurement; scale

(ProQuest: ... denotes formulae omitted.)

Intensive care units (ICUs) are the most crucial and professional wards in every hospital (Lohr & Schroeder, 1990), and the potential risks of morbidity and mortality in ICUs are considerable (Berenholtz, Dorman, Ngo, & Pronovost, 2002). Nurses need to pay attention to both critical situation of patients and the complex equipment that are widely used in these settings, so preserving the quality of care and safety of patients are continuous challenges for nurses in every ICU (Lohr & Schroeder, 1990). It is estimated that every patient in an ICU receives 178 activities per day and that errors happen in 1% of these activities. Twenty-nine percent of these errors can cause significant harm (Gurses & Carayon, 2009). The high-quality nursing care can improve the patients' outcomes and reduce errors in these wards.

The ability to quantify the quality of care in ICUs and to evaluate its effects on the outcome improvements needs an effective measurement instruments (Carney, Aitken, & Bunneister, 2009). Nevertheless, there are limited numbers of scales designed for nursing care quality measurement in ICUs. In 2001(Binnekade, de Mol, Kesecioglu, & de Haan, 2001), the Critical Nursing Situation Index (CNSI) was designed for adult ICU patients, and then in 2009 (De Neef, Bos, & Tol, 2009), it was revised for use in pediatric ICU patients.

The CNSI is an observational tool and contains 84 items in eight domains that measure the quality of nursing care in ICUs. Then in 2008 (Camey et ah, 2009), Quality in Intensive Care Patient Care Scale has been designed for nursing care evaluation in Australia, but the details of this scale have not been published yet. The nursing profession needs more spe- cific scales for different settings in the hospitals. The development of a standard scale to quantify the quality of care in ICU settings seems to be essential, so the ahn of this study was to develop a scale to measure the quality of nursing care in ICUs.

CONCEPTUAL FRAMEWORK

Quality and safety are notable issues for health systems around the world. Reports about quality of care and patient safety are published in different parts of health system man- agement. For example, two landmark reports from the U.S. Institute of Medicine (IOM) in 1999 and 2001 highlighted deficiencies in quality of care and patient safety.

Although defining quality of care is not straightforward, the IOM adopted this defi- nition: "The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge" (Blumenthal, 1996).

For quality of health care measurement, more than 50 years ago, Donabedian suggested observation of three parts that includes structure, process, and clinical outcomes (Donabedian, 1966). Some experts believe that in a patient-centered approach, the evaluation of patient outcomes might be a more effective approach than other methods (Lee, 2007).

Quality of health care measurement is an interested field of study among health care pro- fessionals and health care managers. …

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