This study was done to develope a computer program for the evaluation of quality of nurisng care. Because the professional nursing care should be evaluated consistantly, computer program for the measurement of quality of nursing care is necessary for the effective and efficient management of nursing quality. In this study, a computer program for gastrointestinal surgery patients was developed as a module. Visual basic 4.0 was used as a basic program for the development of this program, and Access 7.0 was used for the data base construction of the program. The systems of evaluation criteria were hierarchical. and the titles of the hierarchical criteria were evaluation area-evaluation item-indicator. Each evaluation area contained several items and each evaluation item contained several indicators. The numbers of the evaluation criteria for gastrointestinal surgery patients were 7 evaluation areas, 32 evaluation items. and 71 indicators. Content validity of the evaluation criteria(in this case, 32 evaluation items) was .95. Scoring could be possible with the evaluation items. For the scoring types of this program were two. norm-referenced type(option 1) and criterion-referenced type(option 2), the user can choose the type according to the purpose of the evaluation. With this computer program. accurate and consistant evaluation of the quality of nursing care could be expected. Also. by the rapid feedback to nursing care practice. quality of nursing practice could be improved rapidly. and the systems of the evaluation criteria developed in this study could be used for the development of other moduls for various kinds of patient groups. Because this computer program was developed only for the purpose of research, it is necessary to be refined commercially to be used in real nursing situation.
Background : Quality of professional nursing care is the most essential factor for survival and growth of nursing profession. Then, nursing professionals have responsibility for the evaluation of quality of professional nursing care. The purpose of this study was to develope an evaluation tool of nursing care for patients received gastrointestinal surgery with general anesthesia. This study was a primary work for the developement of a computer program for the evaluation of nursing care. Methods : This study was done through some consecutive steps. They were (1) Developement of items for the tool (2) Developement of an evaluation tool of nursing care quality for the G-I surgery patient (3) Test of reliability and validity of the tool. Two groups of experts and expert pannels who had much experience of the QA and the care of G-I surgery patients participated for developement of the items. 85 nursing records were used for the test of reliability and validity of the developed tool. The evaluation tools were developed with two types of scoring, norm-referenced tool and criterion-referenced tool. Results The system of items for tool was evaluation area evaluation item-indicator. There were 7evaluation areas which contained 32evaluation items which contained 7lindicators. Evaluation areas 1, 2, 3, 4 were for the evaluation of process and 5, 6, 7 were for the evaluation of outcome of nursing care for G-I surgery patient. For the test of interrator reliability, correlation coefficients of each scores of items and intragroup correlation coefficients were calculated. The average correlation coefficients between two rators were 0.65, 0.54 and the intragroup correlation coefficient were 0.99 and 1.00 by the types of scoring. The Cronbach alpha coefficients of the tools were 0.54 and 0.46 by the types of scoring. The average content validity index of the items was 0.95 from 4 pairs of experts. Because there were significant differences between some scores of quality of nursing care of 3 general hospitals regardless of the types of scoring, the tools could be thought to have some construct validity. And also, there were significant correlations between some scores of quality of nursing care and admission days and admission days after surgery regardless of the types of scoring, the tools could be thought to have predictive validity. Conclusion In this study, the evaluation tool of nursing care was developed for the very specified group of patient, G-I surgery patient. And the items were developed and tested by the experts of nursing practice. Because of these reasons, it was supposed that the tool could be used effectively in nursing pratice. And the procedures for the development and the test of the evaluation tool of nursing care in this study were supposed to be used for the developement of other tools.
We need to continuously evaluate for nursing quality and the outcome to reflect nursing, to repair and improve of nursing. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. We need a system for quality assurance evaluation that is, development and framework of evaluation tool for nursing care quality. The purpose of this study was attempted to develop an evaluation tool for the quality of nursing care in musculoskeletal disorder patients. The approach method of nursing quality for the development of the tool in this study was process evaluation framework. The study were devided dvelopment process and reliability, validity verification process. The subjects of development process of this tool are three nursing export groups, and the subject of reliability, validity verification process are 20 samples of two university hospital in seoul, who were within discharge 3 months after admission treatment in musculo-skeletal disorder. Data for this study was collected from March 10 to April 13, 1995. The development process of the tool were as follows : 1. Make preliminary list of the tool by focal group were constituted 12 clinical nurses. 2. Modify and add preliminary list by 4 nursing expert panel. 3. Calculate content validity of the tool by 25 nursing expert panel of judge. 4. Verify reliability and validity of the tool. 5. Finalize an evaluation tool for the quality of the nursing care in musculo-skeletal disorder. The results of this study were as follows : 1) Development an evaluation tool for the quality of nursing care in musculo-skeletal disorder. (1) The evalution tool of this study was developed 5 standards, 33 criterias and 133 indicators. (2) 5 standards were divided according to Nursing Process. from standard 1 to standard 5, involved criterias were each 6(18%), 3(9%), 3(9%), 15(46%), 6(18%). 2) Verify reliability and validity of the tool. (1) Score of adequate degree for content validity of 33 criterias and 133 indicators were every average 2.82. (2) Inter-rater reliabilities(consentaneity score) of the tool by pearson correlation coefficient between three raters were : r=.7506, r=.8934, r=.6695. and Inter-rater reliabilities by single-facet crossed design were : r=.7464. (3) The alpha coefficient relating to internal consistency was .8524 over all 30 items of 33 criterias of developed tool. (4) Score of the quality of nursing care following to generaal characteristics of this study subjects were stastically significant differences according to educational level (F=2.93, p=.029)and diagnosing classification (F=2.50, p=.042). Through this study, I'm sure that the developed tool for the quality of patient care in musculo-skeletal disorder will show the way of more improvement of the quality of nursing care and effective nursing interventions.
Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.
Purpose: The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. Methods: A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's ${\alpha}$ and Cohen's Kappa. Results: Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's ${\alpha}$=.95. Conclusion: The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.
Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.
Purpose: The aim of this study was to develop service quality indicators to evaluate structure and process of the nursing home service. Method: On the basis of literature review and analysis of existing quality indicators, the researcher made a preliminary service quality indicators and verified content validity twice. The final service quality indicators were applied in 30 nursing homes. Results: Preliminarily, 3 domains, 24 sub-domains, and 156 indicators were generated. Through two content validity testings, the indicators scoring over .80 CVI for each testing were adopted and modified by discussion with a panel of experts. The final indicators consisted of 3 domains, 15 sub-domains, and 128 indicators. These indicators were applied in 30 nursing homes. The result showed that they were easily applicable and suitable for a evaluation of service quality in nursing home. Conclusion: This 'service quality indicators in nursing home' was verified by the content validity. This tool will be able to be used for evaluation and improvement of nursing home service quality. However, repeated researches are needed for further validity and reliability.
To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.
Purpose: The objective of this study was to identify relationships among the perception of quality assurance and national hospital evaluation program and nursing performance of hospital nurses. Method: The participants were 401 nurses who worked at the A medical center. The data were collected from 25 April to 9 May. 2008. The cross-sectional descriptive survey was done using a structured questionnaire. Result: The perception of the quality assurance correlated significantly with nursing performance. Also, the perception of national hospital program correlated significantly with nursing performance. However, the scores of perception of quality assurance & national evaluation program of hospital nurses is relatively low. Conclusions: These results means positive perception of quality assurance of nurses can produce good nursing performance. It suggests that nurses need more education and training for quality assurance. And the incentives will be needed to enhance the perception of quality assurance. Moreover, the detailed nursing performance indicators should be developed to measure the quality of nursing performance properly.
Purpose : this study was to examine the effect of using a nursing standards for the quality of nursing care in musculo-skeletal patients. Method : The approach to nursing quality assurance evaluation was selected process-outcome framework. The subjects ware 100 case of musculo-skeletal patients in orthopedic surgery nursing care unit of E. university hospital in seoul. The data of a control group were collected from 23 December 2001 to 20 March 2002 and an experimental group were collected from 1 June to 25 August 2002. The instruments used for this study were a nursing care standards in musculo-skeletal disorder patients developed by the investigator and an evaluation tool for the quality of nursing care in orthopedic surgery patients developed by soon-ook Choi in 1995. It's reliability is Cronbach alpha=.8628. The data were analyzed by means of $x^1$-test, t-test, ANOVA with SPSS program. Results : This study are as fellows : 1. Scores of the quality of nursing care in standard 1 in the experimental group were higher than those of the control group with no significant difference(t=-8.793, p=.000), scores of the quality of nursing care in standard 2 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000) and standard 3 in the experimental group were higher than those of the control group with significant difference(t=-10.550, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with no significant difference(t=-1.833, p=.070). 2. Scores of the quality of nursing care in criteria 28 of 33 criteria in the experimental group were higher than those of the control group with significant difference in 12 criteria(p<.05 ). 3. Scores of the quality of nursing care in standard 1 to standard 4(process evaluation); the experimental group were higher than those of the control group with significant difference(t=-10.704, p=.000). scores of the quality of nursing care in standard 5(outcome evaluation); the experimental group were higher than those of the control group. but no significant difference(t=-1.833, p=.070). 4. Scores of the quality of nursing care in experimental group were higher than those of the control group with significant difference(t=-10.794, p=.000). Conclusion : Through this study, I'm sure that using a nursing care standards in musculo-skeletal disorder patients improve quality of nursing care and nursing care standards are effective nursing care.
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