Physical and emotional patient safety. A different look at nursing-sensitive outcomes.

Outcomes management for nursing practice 4(4):159-65; quiz 165-6.
Source: PubMed

ABSTRACT Data on nursing-sensitive outcomes, beyond traditional isolated indicators such as pressure ulcers, are often unavailable for nurses to evaluate the overall quality of their care. This article describes a quality improvement effort to provide nurses with both a positive and a negative patient outcomes score. The approach can make visible the often invisible role of nurses in the growing field of patient safety.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: An integrative literature review was conducted to investigate studies on adverse events reported in medical, health services, and nursing literature. The review was guided by the method proposed by Jackson (1980) and Ganong (1987). Three questions shaped the review: (a) What terms are used to denote adverse events? (b) What purposes drive adverse events research? and (c) What data sources are used to study adverse events? Adverse events was the dominant term, the study of adverse events as an outcome variable was the prevailing research purpose, and monitoring or screening the patient clinical record and self-reported incidents by health care professionals were the main data sources. Future research is recommended to conceptualize and study adverse events.
    Research in Nursing & Health 11/2003; 26(5):398-408. · 1.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Performance of nurses has a direct effect on the quality and safety of care that is delivered. Fatigue has been identified as a factor that leads to performance decrements in healthcare workers, especially nurses. Determining associations between dimensions of fatigue and performance is imperative to better understanding fatigue in nurses and the potential implications for both patient and provider safety. This article identifies associations between ranges of fatigue levels and significant differences in perceived performance, and analyzes interactions between fatigue dimensions in relation to perceived performance scores. Overall, mental fatigue tended to have higher perceived performance decrements than physical and total fatigue in the highest fatigue ranges. As physical fatigue begins to develop in nurses, physical exertion rather than discomfort is more critical to perceived performance. As acute fatigue levels increase, perceived performance levels continue to decrease, whereas the role of chronic fatigue is relatively constant. Minimizing the development of acute fatigue may help in maintaining higher performance levels. The findings from this study provide valuable information in quantifying the changes in perceived performance with regard to specific fatigue levels, as well as an initial understanding of how the individual dimensions and states of fatigue vary in their association with perceived performance decrements.
    Journal for Healthcare Quality 08/2011; 34(5):22-30.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the critical role of nursing care in determining high-performing healthcare delivery, performance science in this area is still at an early stage of development and nursing's contribution most often remains invisible to policy-makers and managers. The objectives of this study were: 1) to develop a theoretically based framework to conceptualize nursing care performance; 2) to analyze how the different components of the framework have been operationalized in the literature; and 3) to develop a pool of indicators sensitive to various aspects of nursing care that can be used as a basis for designing a performance measurement system. We carried out a systematic review of published literature across three databases (MEDLINE, EMBASE and CINAHL), focusing on literature between 1990 and 2008. Screening of 2,103 papers resulted in final selection of 101 papers. A detailed template was used to extract the data. For the analysis, we used the method of interpretive synthesis, focusing first on 31 papers with theoretical or conceptual frameworks; the remaining 70 articles were used to strengthen and consolidate the findings. Current conceptualizations of nursing care performance mostly reflect a system perspective that builds on system theory, Donabedian's earlier works on healthcare organization, and Parsons' theory of social action. Drawing on these foundational works and the evidence collated, the Nursing Care Performance Framework (NCPF) we developed conceptualizes nursing care performance as resulting from three nursing subsystems that operate together to achieve three key functions: (1) acquiring, deploying and maintaining nursing resources, (2) transforming nursing resources into nursing services, and (3) producing changes in patients' conditions. Based on the literature review, these three functions are operationalized through 14 dimensions that cover 51 variables. The NCPF not only specifies core aspects of nursing performance, it also provides decision-makers with a conceptual tool to serve as a common ground from which to define performance, devise a common and balanced set of performance indicators for a given sector of nursing care, and derive benchmarks for this sector. The NCPF provides a comprehensive, integrated and theoretically based model that allows performance evaluation of both the overall nursing system and its subsystems. Such an approach widens the view of nursing performance to embrace a multidimensional perspective that encompasses the diverse aspects of nursing care.
    BMC Nursing 01/2013; 12:7.