Hemşirelerin “Hemşirelik Bakımına Duyarlı Kalite Göstergeleri” Hakkındaki Görüşleri

Yıl 2022, , 286 - 299, 01.08.2022

Burçin Irmak , Hülya Bulut

https://doi.org/10.25279/sak.767033

Öz

Giriş: Hemşireliğe duyarlı kalite göstergeleri, hemşirelik uygulamalarını görünür kılmıştır. Amaç: Araştırma, hemşirelerin “hemşirelik bakımına duyarlı kalite göstergeleri” hakkındaki görüşlerinin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı tipteki bu araştırma, Orta Karadeniz Bölgesi’nde yer alan bir üniversite ile bir devlet hastanesinin dahili ve cerrahi kliniklerinde çalışan toplam 144 hemşire ile gerçekleştirilmiştir. Araştırma verileri 15 Şubat-15 Mayıs 2018 tarihleri arasında toplanmıştır. Araştırmaya başlamadan önce etik kurul izni, kurum izni ve hemşirelerden sözel onam alınmıştır. Veriler, araştırmacılar tarafından geliştirilen anket formu aracılığıyla toplanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistiksel yöntemler ve nonparametrik testler kullanılmıştır. Bulgular: Araştırmaya katılan hemşirelerin bakım kalite göstergeleri tanımlamalarının %46.4’ü hemşirelik, %38.1’i sağlık kurumu ve %15.5’i hasta ile ilgilidir. Hemşireler tarafından en fazla belirtilen hemşirelik bakımına duyarlı kalite göstergeleri; enfeksiyon oranı (%76.8), basınç yaralanması oranı (%59.4), hasta düşme oranı (%44.9), hasta memnuniyet düzeyi (%33.3) ve hemşire memnuniyet düzeyidir (%15.9). Hemşirelere bazı kalite göstergelerinin hemşirelik bakımına duyarlı olup olmadığı sorulduğunda; hemşire eğitim düzeyi (8.09±2.69), hasta memnuniyeti (8±2.28) ve hasta bakımına ayrılan süre (7.72±3.09) en fazla bakım kalitesi ile ilişkilendirilen göstergeler olarak belirlenmiştir. Sonuç ve Öneriler: Araştırmada hemşirelerin çoğunun hemşirelik bakımına duyarlı kalite göstergeleri hakkında görüş sahibi olduğu ve bazı ilave kalite göstergeleri önerdikleri belirlenmiştir. Bu sonuçlara göre sağlık kurumlarında hemşirelik bakım uygulamalarının etkinliğinin düzenli olarak değerlendirilmesi önerilmektedir.

Anahtar Kelimeler

Hemşire, Hemşirelik bakımı, Kalite göstergeleri

Views of Nurses About “Nursing-Sensitive Quality Indicators”

Öz

ObjecIntroduction: Nursing-sensitive quality indicators have made the nursing practices visible. Aim: The aim of this research was to determine the views of the nurses about “nursing-sensitive quality indicators”. Methods: This descriptive study were carried out in the internal and surgical units of a university hospital with 144 nurses. Data were collected using a questionnaire developed by researchers. Descriptive statistical methods and nonparametrics tests were used to evaluate the data. Results: Nurses participating in the study was determined that 46.4% of the nurses' definitions of care quality indicators are related to nursing, 38.1% of them are health institutions and 15.5% of them are related to the patient. Nursing care-sensitive quality indicators most frequently cited by the nurses; infection rate (76.8%), pressure injury rate (59.4%), patient falling rate (44.9%), patient satisfaction level (33.3%) and nurse satisfaction level (15.9%). When nurses were asked whether some quality indicators were sensitive to nursing care; nurse education level (8.09±2.69), patient satisfaction (8±2.28) and time devoted to patient care (7.72±3.09) were determined as the indicators most associated with the quality of care. Conclusions and Suggestions: It was determined that the sample group of the research had opinions about the nursing-sensitive quality indicators and suggested additional indicators. it is recommended to evaluate the effectiveness of nursing care practices regularly in healthcare institutions.tives: The aim of this study was to determined the views of the nurses about “nursing-sensitive quality indicators”. Methods: This descriptive study were carried out in the internal and surgical units of a unıversity hospital with a state hospital located in the Middle Black Sea Region and with 144 nurses. Data were collected between the date of February 15 and May 15, 2018. Verbal consent of the nurses and written consent of the institution and ethics committee of institution was taken. Data were collected using a questionnaire developed by the researchers. Descriptive statistical methods (number, percentage, mean and standard deviation) were used to evaluate the data. Results: The average age of the nurses participating in the study is 35.3 ± 8 (min:22, max:58), 93.8% are female, 68.8% are undergraduate degree level. 59.7% of the nurses work in public hospitals, 57.6% in surgical unıts, 89.6% as clinical nurses and 53.5% in the profession for more than 10 years. It was determined that 46.4% of the nurses' definitions of care quality indicators are related to nursing, 38.1% of them are health institutions and 15.4% of them are related to the patient. In this research nursing-sensitive quality indicators, which are given the most five examples by nurses, are infection rate (20.3%), pressure injury rate (15.7%), patient fall rate (11.9%), patient satisfaction level (8.8%) and nurse satisfaction level (4.2%). Especially the approval level of educational level of nurses (8.09±2.69), patient satisfaction (8±2.28) and the allocated time for patient care (7.72±3.09) have ranked top three titles by having a high approval level. Conclusions and Suggestions: It was determined that the nurses in the sample group of the research had opinions about the nursing-sensitive quality indicators and suggested additional indicators. According to these results, it is recommended to evaluate the effectiveness of nursing care practices regularly in healthcare institutions and to include this issue in nursing undergraduate education and service training.

Anahtar Kelimeler

Nurse, Nursing care, Quality indicators

Kaynakça

• Acar, E. Ç. ve Fındık, Ü. Y. (2015). Ameliyathanede hastaların hemşirelik bakım kalitesi hakkında düşüncelerinin ve kaygı düzeylerinin değerlendirilmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 18(4), 268-273. Erişim adresi: https://dergipark.org.tr/en/pub/ataunihem/issue/45083/563102
• Blegen, M. A., Vaughn, T. E. & Goode, C. J. (2001). Nurse experience and education: effect on quality of care. JONA: The Journal of Nursing Administration, 31(1), 33-39. Erişim adresi: https://journals.lww.com/jonajournal/Fulltext/2001/01000/Job_Stages_of_Entry,_Mastery,_and_Disengagement.7.aspx
• Bolton, L. B, Aydin, C. E., Donaldson, N., Brown, D. S., Sandhu, M., Fridman, M. & Aronow, H. U. (2007). Mandated nurse staffing ratios in California: a comparison of staffing and nursing-sensitive outcomes pre-and post regulation. Policy, Politics, & Nursing Practice, 8(4), 238-250. https://doi.org/10.1177/1527154407312737
• Burston, S., Chaboyer, W. & Gillespie, B. (2014). Nurse sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues. Journal of Clinical Nursing, 23(13-14), 1785-1795. https://doi.org/10.1111/jocn.12337
• Çevik, K. ve Eşer, E. (2014). Nöroşirurji kliniğinde yatan hastaların bağımlılık düzeylerinin hemşirelik bakım kalitesini algılamalarına etkisi. Florence Nightingale Hemşirelik Dergisi, 22(2), 76-83. Erişim adresi: https://app.trdizin.gov.tr/makale/TVRVNU5EY3dNQT09/norosirurji-kliniginde-yatan-hastalarin-bagimlilik-duzeylerinin-hemsirelik-bakim-kalitesini-algilamalarina-etkisi
• Ekici, D. (2013). Sağlık hizmetinde toplam kalite yönetimi. (ss. 84-87). Ankara: Sim Matbaacılık
• Fındık, Ü. Y. ve Yeşilyurt, D. S. (2017). Cerrahi hastalarının ameliyat sonrası hemşirelik bakım kalitesi algısı. Journal of Anatolia Nursing and Health Sciences, 20(3), 195-200. Erişim adresi: https://dergipark.org.tr/tr/pub/ataunihem/issue/31360/292027#article_cite
• Gustafsson, S.R ve Eriksson, I. (2021). Quality indicators in telephone nursing–An integrative review. Nursing Open, 8(3), 1-13. https://doi.org/10.1002/nop2.747
• Heslop, L. ve Lu, S. (2014). Nursing sensitive indicators: A concept analysis. Journal of Advanced Nursing, 70 (11), 2469-2482. https://doi.org/10.1111/jan.12503
• Jeffs, L., Doran, D., Hayes, L., Mainville, C., Van De Velde-Coke, S., Lamont, L. & Boal, A. S. (2015). Implementation of the national nursing quality report initiative in Canada: Insights from pilot participants. Journal of Nursing Care Quality, 30(4), 9-16. https://doi.org/10.1097/NCQ.0000000000000122
• Kendall-Gallagher, D., Aiken, L., Sloane, D. & Cimiotti, J. (2011). Nurse specialty certification, inpatient mortality, and failure to rescue. Journal of Nursing Scholarship, 43(2), 188−194. https://doi.org/10.1111/j.1547-5069.2011.01391.x
• Köşgeroğlu N., Acat, M. B. & Karatepe, Ö. (2005). Kemoterapi hastalarında hemşirelik bakımı memnuniyet ölçeği. Anadolu Psikiyatri Dergisi, 6(2), 75-83. Erişim adresi: https://app.trdizin.gov.tr/makale/TmpFMk16SXk/kemoterapi-hastalarinda-hemsirelik-bakimi-memnuniyet-olcegi
• Kurşun, Ş. (2010). Genel Cerrahi servisinde hasta ve hemşireler tarafından hemşirelik bakım kalitesinin algılanması (Doktora tezi). Erişim adresi: https://tez.yok.gov.tr/UlusalTezMerkezi/tezDetay.jsp?id=aXgJqf3uQ6OJ7Ijqa1SgPg&no=whli_MwYOCqXSvT_Rj_OFw
• Lake, E. T. ve Cheung, R. B. (2006). Are patient falls and pressure ulcers sensitive to nurse staffing? Western Journal of Nursing Research, 28(6), 654-677. https://doi.org/10.1177/0193945906290323
• Lamberg, E., Salanterä, S. & Junttila, K. (2013). Evaluating perioperative nursing in Finland: An initial validation of perioperative nursing data set outcomes. AORN Journal, 98(2), 172-185. https://doi.org/10.1016/j.aorn.2013.06.011
• Matlock, A. M., Start, R., Aronow, H. & Brown, D. S. (2016). Ambulatory care nursing-sensitive indicators. Nursing Management, 47(6), 16-18. https://doi.org/10.1097/01.NUMA.0000483126.48107.cf
• Montalvo, I. (2007). The national database of nursing quality indicators TM (NDNQI®). OJIN: The Online Journal of Issues in Nursing, 12(3), 1-11. Erişim adresi: https://www.proquest.com/docview/229585708/fulltextPDF/D0CA04FD8DDA4A8DPQ/1?accountid=11054
• Özpekin, Ö. G. ve Erdim, A. (2016). Ameliyathane hemşirelerinin mesleki profesyonelliklerinin intraoperatif bakım kalitesine etkisinin değerlendirilmesi. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 8(4), 277-287. Erişim adresi: https://app.trdizin.gov.tr/publication/paper/detail/TWpZeE5EZzRPQT09
• Patrician, P. A., Loan, L., Mccarthy, M., Brosch, L. R. & Davey, K. S. (2010). Towards evidence-based management: creating an informative database of nursing-sensitive indicators. Journal of Nursing Scholarship, 42(4), 358-366. https://doi.org/10.1111/j.1547-5069.2010.01364.x
• Prezerakos, P.,Galanis, P. & Moisoglou, I. (2015). The work environment of haemodialysis nurses and its impact on patients’ outcomes. International Journal of Nursing Practice, 21(2), 132-140. https://doi.org/10.1111/ijn.12223
• Ribeiro, O. M. P. L., MMFPS, M., Sousa, P. A. F., Trindade, L. L., Forte, E. C. N., & Silva, J. M. A. V. (2020). Quality of nursing care: contributions from expert nurses in medical-surgical nursing. Revista da Rede de Enfermagem do Nordeste, 21(e43167), 1-9. https://doi.org/10.15253/2175-6783.20202143167
• Savitz, L. A., Jones, C. B., & Bernard, S. (2005). Quality indicators sensitive to nurse staffing in acute care settings. In: Henriksen, K., Battles, J. B., Marks, E. S., & Lewin, D. I. (Eds.), Advances in patient safety: From research to implementation volum 4 (pp.375-385). Agency for Healtcare Research and Quality.
• Sevin, K. (2018). Ortopedik cerrahi geçiren hastalarda perioperatif hemşirelik bakım kalitesinin değerlendirilmesi (Yüksek lisans tezi). Erişim adresi: https://hdl.handle.net/20.500.11782/1756
• Sim, J., Crookes, P., Walsh, K. & Halcomb, E. (2018). Measuring the outcomes of nursing practice: A Delphi study. Journal of Clinical Nursing, 27(1-2), 368–378. https://doi.org/10.1111/jocn.13971
• Stalpers, D., de Brouwer, B. J., Kaljouw, M. J. & Schuurmans, M. J. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature. International Journal of Nursing Studies, 52(4), 817-835. https://doi.org/10.1016/j.ijnurstu.2015.01.005
• Stalpers, D., Van Der Linden, D., Kaljouw, M. J. & Schuurmans, M. J. (2016). Using publicly reported nursing-sensitive screening indicators to measure hospital performance: the Netherlands experience in 2011. Nursing Research, 65(5), 362-370. https://doi.org/10.1097/NNR.0000000000000170
• Twigg, D. E., Pugh, J. D., Gelder, L. & Myers, H. (2016). Foundations of a nursing-sensitive outcome indicator suite for monitoring public patient safety in Western Australia. Collegian, 23(2), 167-181. https://doi.org/10.1016/j.colegn.2015.03.007
• Van den Heede, K., Sermeus, W., Diya, L., Clarke, S. P., Lesaffre, E., Vleugels, A. & Aiken, L. H. (2009). Nurse staffing and patient outcomes in Belgian acute hospitals: cross-sectional analysis of administrative data. International Journal of Nursing Studies, 46(7), 928-939. https://doi.org/10.1016/j.ijnurstu.2008.05.007
• Whitehead, L., Ghosh, M., Walker, D. K., Bloxsome, D., Vafeas, C. & Wilkinson, A. (2019). The relationship between specialty nurse certification and patient, nurse and organizational outcomes: A systematic review. International Journal of Nursing Studies, 93, 1-11. https://doi.org/10.1016/j.ijnurstu.2019.02.001
• Wu, Q., Huang, L. H., Xing, M. Y., Feng, Z. X., Shao, L. W., Zhang, M. Y. & Shao, R. Y. (2017). Establishing nursing-sensitive quality indicators for the operating room: A cross-sectional Delphi survey conducted in China. Australian Critical Care, 30(1), 44-52. https://doi.org/10.1016/j.aucc.2016.04.003
• Yavuz, M. (2013 Mart 11). Bakımın kalite göstergeleri. Medimagazin: Sağlık Profesyonellerinin Gazetesi. https://www.medimagazin.com.tr/authors/meryem-yavuz/tr-bakimin-kalite-gostergeleri-72-101-3399.html