Determination of Nursing Sensitive Indicators for Intensive Care Units in Turkey: A Qualitative Study

Anahtar Kelimeler:

Intensive care, nursing, nursing-sensitive indicator

Determination of Nursing Sensitive Indicators for Intensive Care Units in Turkey: A Qualitative Study

Introduction: Assessment of the quality of health services continues to be one of the top research areas from past to present. The development of nursing-sensitive indicators is one of the critical elements in assessing the quality of nursing care. This study aims to determine the nursing-sensitive indicators for intensive care unit (ICU)s. Methods: This research was conducted between May 2017 and October 2017 using a descriptive qualitative research phenomenological design. The research was assessed by the qualitative research paradigm based on Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethics committee approval of the study and written permissions from the selected hospitals were obtained. The research was performed with in-depth face-to-face interviews with 12 participants from three different hospitals and nursing education institutions through a semi-structured interview form. During the interviews, voice recordings were taken with prior permission, and the recordings obtained were deciphered word by word and evaluated with content analysis. Results: As a result of the research, four main themes were created; the patient-focused outcome indicators, the nurse-focused outcome indicators, the nursing-focused process/intervention indicators, and the organizational-focused structural indicators. Under these main themes, nursing-sensitive indicators have been determined. Conclusion: Nosocomial infections and pressure ulcers were the two-leading nursing-sensitive indicators. This research suggests developing policies and procedures for forming a national database specific to nursing, including nursing-sensitive indicators.

Keywords:

Intensive care, nursing, nursing-sensitive indicator,

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[1] D. Edvardsson, E. Watt, F. Pearce, “Patient experiences of caring and person-centredness are associated with perceived nursing care quality”, J. Adv. Nurs., vol. 73, no. 1, pp. 217–27, 2016.
[2] C. A. Dubois, D. D'Amour, M. P. Pomey, F. Girard, I. Braul, “Conceptualizing performance of nursing care as a prerequisite for better measurement: A systematic and interpretive review”, BioMed Central Nursing, vol.12, no.7, pp. 1-20, 2013.
[3]S. Burston, W. Chaboyer, B. Gillespie, “Nurse-sensitive indicators suitable to reflect nursing care quality: A review and discussion of issues”, J. Clin. Nurs., vol. 23, pp. 1785–95, 2013.
[4] American Academy of Ambulatory Care Nursing, Nurse-sensitive indicators, 2019 [Access date: 10 January 2023], Access link: https://www.aaacn.org/practice-resources/ambulatory-care/nurse-sensitive- indicators#:~:text=Nurse%2Dsensitive%20indicators%20(NSIs)%20articulate%20the%20value%20of%20nursing' s,directly%20affected%20by%20nursing%20practice.
[5] L. Hesslop, S. Lu, X. Xu, “Nursing-sensitive indicators: a concept analysis”, J. Adv. Nurs., vol. 70, no. 11, pp. 2469- 82, Nov, 2014. doi: 10.1111/jan.12503.
[6] American Academy of Ambulatory Care Nursing, Scope & standards of practice for professional ambulatory care nursing, 9th ed. Pitman, N.J.: American Academy of Ambulatory Care Nursing, 2017.
[7] S. Yang, L-H. Huang, X-H. Zhao, M-Y. Xing, L-W. Shao, M-Y. Zhang, R-Y. Shao, J-H. Wei, C-H. Gao, “Using the Delphi method to establish nursing-sensitive quality indicators for ICU nursing in China”, Res. Nurs. Health, Vol. 42, no. 1, pp. 48–60, 2019. doi: 10.1002/nur.21925.
[8] E. Cho, D. L. Chin, S. Kim, O. Hong, “The relationships of nurse staffing level and work environment with patient adverse events”, J. Nurs. Scholarsh., vol. 48, no. 1, pp. 74-82, 2016.
[9] L-M. Liao, X-Y. Sun, H. Yu, J-W. Li, “The association of nurse educational preparation and patient outcomes: Systematic review and meta-analysis”, Nurse Educ. Today, vol. 42, pp. 9-16, 2016.
[10] A. D. Rao, A. Kumar, M. McHugh, “Better nurse autonomy decreases the odds of 30-day mortality and failure to rescue”, J. Nurs. Scholarsh., vol. 49, no. 1, pp. 73-9, 2017.
[11] L-A. Audet, P. Bourgault, C. M. Rochefort, “Associations between nurse education and experience and the risk of mortality and adverse events in acute care hospitals: A systematic review of observational studies”, Int. J. Nurs. Stud., vol. 80, pp. 128-46, 2018.
[12] A. Driscoll, M. J. Grant, D. Carroll, S. Dalton, C. Deaton, I. Jones, D. Lehwaldt, G. McKee, T. Munyombwe, F. Astin, “The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis”, Eur. J. Cardiovasc. Nurs., vol.17, no. 1, pp. 6-22, 2018. https://doi.org/10.1177/1474515117721561.
[13] H. Myers, J. D. Pugh, D. E. Twigg, “Identifying nurse-sensitive indicators for stand-alone high acuity areas: A systematic review”, Collegian, vol. 25, pp. 447–56, 2018.
[14] Türkiye Cumhuriyeti (T.C.) Sağlık Bakanlığı, Sağlık istatistikleri yıllığı 2021 haber bülteni, Ankara: Sağlık Bilgi Sistemleri Genel Müdürlüğü, 2022.
[15] Ş. Seren İntepeler, D. Soydemir, D. Güleç, “Hemşirelerin tıbbi hataya eğilimleri ve etkileyen faktörler”, Ege Üniversitesi Hemşirelik Fakültesi Dergisi, vol. 30, no. 1, pp. 1-18, 2014.
[16] F. Er, S. Altuntaş, “Hemşirelerin tıbbi hata yapma durumları ve nedenlerine yönelik görüşlerinin belirlenmesi”, Sağlık ve Hemşirelik Yönetimi Dergisi, vol. 3, no. 3, pp. 132-9, 2016.
[17] B. Ergan, M. E. Tokur, S. Çoban, S. Tursunoğlu, R. Ergün, D. Ergün, S. Çomoğlu, “Farklı yoğun bakım ünitelerinde hemşire iş yükünün yoğun bakım mortalitesi ile ilişkisi’, Yoğun Bakım Dergisi, vol. 7, pp. 21-7, 2016. DOI: 10.5152/dcbybd.2016.1154.
[18] Z. Akgün Şahin, F. Kardaş Özdemir, “Hemşirelerin tıbbi hata yapma eğilimlerinin incelenmesi”, Hemşirelikte Eğitim ve Araştırma Dergisi, vol. 12, no. 3, pp. 210-4, 2015.
[19] J. W. Creswell, Qualitative Inquiry and Research Design: Choosing Among Five Approaches, 2nd ed. Thousand Oaks, CA: Sage, 2007.
[20] A. Tong, P. Sainsbury, J. Craig, “Consolidated criteria for reporting qualitative research (COREQ): A 32- item checklist for interviews and focus groups”. International Journal for Quality in Health Care, vol. 19, no. 6, pp. 349- 57, 2007.
[21] A. Donabedian, Explorations in quality assessment and monitoring: The definition of quality and approaches to its assessment, Michigan: Health Administration Press, 1980.
[22] American Nurses Association, Nursing care report card for acute care, Washington, DC: American Nurses Publishing, 1995.
[23] National Quality Forum (USA), National voluntary consensus standards for nursing-sensitive care: An initial performance measure set, Washington: National Quality Forum, 2004.
[24] B. Oner, F. D. Zengul, N. Oner, N. V. Ivanova, A. Karadag, P. A. Patrician, “Nursing-sensitive indicators for nursing care: A systematic review (1997–2017)”, Nurs. Open, vol. 00, pp. 1-18, 2020.
[25] L. Chen, L-H. Huang, M-Y. Xing, Z-X. Feng, L-W. Shao, M-Y. Zhang, R-Y. Shao, “Using the Delphi method to develop nursing-sensitive quality indicators for the NICU”, J. Clin. Nurs., vol. 26, no. 3-4, pp. 502-13, Feb, 2017.
[26] D. Öztürk, A. Karadağ, “Stoma ve yara bakım hemşireliği’nin tarihsel gelişim süreci: Türkiye örneği”, Hemşirelikte Eğitim ve Araştırma Dergisi, vol. 16, no. 1, pp. 73-8, 2019.
[27] E. Top, Hasta düşmelerini önleyici hemşirelik girişimlerinin uygulanma durumu ve etkileyen faktörler, [Yüksek Lisans Tezi], Aydın: Aydın Adnan Menderes Üniversitesi, 2019.
[28] F. Kantek, H. Kartal, “The effects of job satisfaction on nurses' professional status: A meta-analysis”, J. Hum. Sci., vol. 13, no. 3, pp. 4268-77, 2016.
[29] S. Aydoğmuş, Hemşirelerin çalışma ortamlarının işten ayrılma niyeti ile ilişkisi, [Yüksek Lisans Tezi], Konya: Necmettin Erbakan Üniversitesi, 2017.
[30] C. Yüksel Kaçan, Öç Örsal, N. Köşgeroğlu, “Hemşirelerde tükenmişlik düzeyinin incelenmesi”, Cumhuriyet Hemşirelik Dergisi, vol. 5, no. 2, pp. 65-74, 2016.