Development and Application of Nursing Service Quality Indicators in Nursing Homes

노인요양시설의 간호서비스 질 평가 지표 개발 및 적용

  • Published : 2007.04.30

Abstract

Purpose: This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality. Methods: The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility. Results: The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over.80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of 7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable. Conclusion: In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.

References

  1. Arling, G., Kane, R. L., Lewis, T., Mueller, C. (2005). Future development of nursing home quality indicators. Gerontologist, 45(2), 147-156 https://doi.org/10.1093/geront/45.2.147
  2. Arling, G., Karon, S. L., Sainfort, F., Zimmerman, D. R., Ross, R. (1997). Risk adjustment of nursing home quality indicators. Gerontologist, 37(6), 757-766 https://doi.org/10.1093/geront/37.6.757
  3. Berlowitz, D. R., Brandeis, G. H., Anderson, J. J., Ash, A. S., Kader, B., Morris, J. N., Moskowitz, M. A. (2001). Evaluation of a risk-adjustment model for pressure ulcer development using the minimum data set. J Am Geriatr Soc, 49, 872-876 https://doi.org/10.1046/j.1532-5415.2001.49176.x
  4. Center for Health Systems Research and Analysis (1999, January). Quality indicators for implementation. Retrieved June 20, 2005, from the CHSRA Web site: http://www.chsra.wisc.edu/chsra/qi/
  5. Cho, H. S. (2005). Development of quality management index in Korean nursing homes. Unpublished doctoral dissertation, Korea University, Seoul
  6. CMS (2002). Minimum Data Set Version 2.0., Retrieved July 6, 2005, from the Centers for Medicare and Medicaid Services Web site: http://www.cms.hhs.gov/NursingHomeQualityInits
  7. Gordon, M. (1994). Nursing diagnosis. Process and application. 3rd. Missouri: Mosby
  8. Hillman, J. L., & Stricker, G. (1994). A linkage of knowledge and attitudes toward elderly sexuality: Not necessarily a uniform relationship. Gerontologist, 34(2), 256-260 https://doi.org/10.1093/geront/34.2.256
  9. interRAI (2000). RAI-HC assessment manual version 2.0. Marblehead, USA: Opus Communications
  10. Jensdottir, A. B., Rantz, A., Hjaltadottir, I., Guomundsdottir, H., Rook, M., Grando, V. (2003). International comparison of quality indicators in United States, Icelandic and Canadian nursing facilities. Int Nurs Rev, 50(2), 79-84 https://doi.org/10.1046/j.1466-7657.2003.00163.x
  11. Kane, R. L. (1988). Assessing quality in nursing homes. Clin Geriatr Med, 4(3), 655-666
  12. Kane, R. L. (1995). Improving the quality of long-term care. JAMA, 273(17), 1376-1380 https://doi.org/10.1001/jama.273.17.1376
  13. Kang, S. M. (2000). Development of nursing assessment tools for elderly patients with dementia. Unpublished master's thesis, Yonsei University, Seoul
  14. Karon, S. L., & Zimmerman, D. R. (1996). Using indicators to structure quality improvement initiatives in long-term care. Qual Manag Health Care, 4, 54-66 https://doi.org/10.1097/00019514-199604030-00008
  15. Kim, K. A. (2001). A study on nursing service quality of the elderly facilities. Unpublished master's thesis, Dankook University, Seoul
  16. Kovner, C., Mezey, M., & Harrington, C. (2000). Research priorities for staffing, case mix, and quality of care in U. S. Nursing Homes. J Nurs Scholarsh, 32(1), 77-80 https://doi.org/10.1111/j.1547-5069.2000.00077.x
  17. Lee, S. H. (2006). The determinants of nursing home quality indicators: A multilevel analysis. J Korean Acad Nurs Adm, 12(3), 473-481
  18. Lynn, M. R. (1986). Determination and quantification of content validity. Nurs Res, 35(6), 382-385
  19. Ministry of Health and Social Welfare (2006). A review of senior citizens welfare institutions. http://www.mohw.go.kr
  20. Muller, C., & Karon, S. L. (2004). ANA nurse sensitive quality indicators for long-term care facilities. J Nurs Care Qual, 19(1), 39-47 https://doi.org/10.1097/00001786-200401000-00009
  21. OECD (2005, March). Policy brief Ensuring quality long-term care for older people. Retrieved October 10, 2005, from the OECD Web site: http://www.oecd.org/dataoecd/53/4/34585571.pdf
  22. Rantz, M. J., Mehr, D. R., Petroski, G. F., Madsen, R. W., Popejoy, L. L., Hicks, L. L., Conn, V. S., Grando, V. T., Wipke-Tevis, D. D., Bostick, J., Porter, R., Zwygart-Staffacher, M., Maas, M. (2000). Initial field testing of an instrument to measure: Observable indicators of nursing home care quality. J Nurs Care Qual, 14(3), 1-12
  23. ANA (1998). Standard of clinical nursing practice (2nd ed.). American Nurses Association
  24. Steinke, E. E. (1997). Sexuality in aging: Implications for nursing facility staff. J Contin Educ Nurs, 28(2), 59-63
  25. Simmons, S. F., Cadogan, M. P., Cabrera, G. R., AI-Samarrai, N. R., Jorge, J. S., Levy-Storms, L., Osterweil, D., & Schnelle, J. F. (2004). The minimum data set depression quality indicator: Does it reflect differences in care processes? Gerontologist, 44(4), 554-564 https://doi.org/10.1093/geront/44.4.554
  26. Thomson, R., Taber, S., Lally, J., & Kazandjian, V. (2004). UK quality indicator project and the UK independent health care sector: A new development. Int J Qual Health Care, 16(1), 51-56 https://doi.org/10.1093/intqhc/mzh008
  27. Wagner, C., Van der Wal, G., Groenewegen, P. P., & Bakker, D. H. (2001). The effectiveness of quality systems in nursing homes: A review. Qual Health Care, 10(4), 211-217 https://doi.org/10.1136/qhc.0100211..
  28. Wipke-Tevis, D. D., Williams, D. A., Rantz, M. J., Popejoy, L. L., Madsen, R. W., Petroski, G. F., & Vogelsmeier, A. A. (2004). Nursing home quality and pressure ulcer prevention and management practices. J Am Geriatr Soc, 52(4), 583-588 https://doi.org/10.1111/j.1532-5415.2004.52166.x
  29. Zimmerman, D. R. (2003). Improving nursing home quality of care through outcomes data: The MDS quality indicators. Int J Geriatr Psychiatry, 18(3), 250-257 https://doi.org/10.1002/gps.820