• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.157-174
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• 2010

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.107-118
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• 1997

This study was designed to obtain basic data for development of evaluation tool which would be needed to measure the outcome of general quality nursing care of individual patient. The purpose of this study was to analyze and classify the outcome indicators of quality nursing care. The 29 articles of quality nursing care and outcome measures were selected coveniently, and analyzed to classify the outcome indicators of quality nursing care using open coding method. The results of this study were as follows: 1. Quality nursing care was defined as level of excellence of nursing care to achieve good patient outcome. 2. The 6 domains of which were health status, satisfaction, self care, patient progress and prognosis, and compliance were identified in outcome indicators of quality nursing care 3. Seven indicators of health status domain which were perceived health status, quality of life, well-being, daily activities, physical-physiological status, psychoemotional status, and social role functioning were identified. 4. Two indicators of satifaction domain which were patient satisfaction and family satisfaction were identified. 5. Three indicators of self care domain which were skill, knowledge, and home management were identified. 6. Seven indicators of patient progress and prognosis domain which were change of clinical status, resolution of nursing diagnosis and problem, days of stay, dicahrge state, recovery state, survival were identified. 7. compliance with therapeutic direction compliance was identified as an indicator of compliance domain. 8. It was sugested that studies for development of evaluation tools for outcomes of quality nursing the results of this study could be executed

• Korean Journal of Adult Nursing
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• v.15 no.1
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• pp.88-93
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• 2003

Purpose: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients. Method: focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed. Result: 12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested. Conclusion: This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.

• Journal of Korean Academy of Nursing
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• v.33 no.5
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• pp.625-632
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• 2003

Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of four nursing sensitive nursing outcomes selected from the Nursing Outcomes Classification (NOC). Outcomes for this study were 'Knowledge: Diet', 'Knowledge: Disease Process', 'Knowledge: Energy Conservation', and 'Knowledge: Health Behaviors'. Method: Data were collected from 183 nurses working in 2 university hospitals. Fehring method was used to estimate outcome and indicators' content and sensitivity validity. Multiple and stepwise regression were used to evaluate relationships between each outcome and its indicators. Result: Results confirmed the importance and nursing sensitivity of outcomes and their indicators. Key indicators of each outcomes were found by multiple regression. 'Knowledge: Diet' was suggested for adding new indicators because the variance explained by indicators was relatively low. Not all of the indicators selected for stepwise regression model were rated for highly in Fehring method. The R² statistics of the stepwise regression models were between 18 and 63% in importance by selected indicators and between 34 and 68% in contribution by selected indicators. Conclusion: This study refined what outcomes and indicators will be useful in clinical practice. Further research will be required for the revision of outcome and indicators of NOC. However, this study refined what outcomes and indicators will be useful in clinical practice.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.2
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• pp.189-201
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• 2012

Purpose: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). Method: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and $x^2$ test. Result: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. Conclusions: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.523-531
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• 2002

Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of six sensitive nursing outcomes selected from the Nursing Outcomes Classification. The outcomes in this study were Self-Care: Activities of Daily Living, Self-Care: Instrumental Activities of Daily Living, Treatment Behavior: Illness or Injury, Knowledge: Health Promotion, Caregiver Performance: Direct Care, and Caregiver Physical Health. Method: Data were collected from 97 visiting nurses working in public health centers located in a province and a capital city. The Fehring method was used to estimate outcomes and indicators for content validity. Simultaneous multiple regression and stepwise regression were used to evaluate relationships between each outcome and its indicators. Results: Results confirmed the importance and nursing sensitivity of the outcomes and their indicators. Multiple regression revealed key indicators of each outcome. Self-Care: Instrumental Activity of Daily Living needed to be revised. Neither all of the indicators nor the indicators showing the highest importance and contribution ratio were selected as independent variables for the stepwise regression model. The R2 of the regression models ranged from 29 to 56% in importance by selected indicators and from 56 to 83% in contribution. Conclusion: Further research is needed for the revision of outcomes and their indicators.

• Korean Journal of Adult Nursing
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• v.20 no.3
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• pp.489-499
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• 2008

Purpose: The purpose of this study was to assess the importance and contribution of 9 nursing outcomes and their indicators that could be applied to cerebrovascular patients. Methods: Data were collected from 175 neurosurgical nurses working at two university affiliated hospitals and five secondary hospitals located in Gwang-ju. The Fehring method was used to estimate outcome content validity(OCV) and outcome sensitivity validity(OSV) of nursing outcomes and their indicators. Stepwise regression was used to evaluate relationship between outcome and its indicators. Results: The core outcomes identified by the OCV were Tissue Perfusion: Cerebral, Nutritional Status, Neurological Status, and Wound Healing: Primary Intention, whereas highly supportive outcomes identified by the OSV were Oral Health, Self-Care: ADL, and Nutritional Status. All the critical indicators selected for Fehring method were not included in stepwise regression model. By stepwise regression analysis, the indicators explained outcomes from 19% to 52% in importance and from 21% to 45% in contribution. Conclusion: This study identified core and supportive outcomes and their indicators which could be useful to assess the physical status of cerebrovascular patients. Further research is needed for the revision and development of nursing outcomes and their indicators at neurological nursing area.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.17-25
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• 1998

This study was done to evaluate the quality of clinical nursing care using the variables of structure, process, and outcome and to analyze the relationship between the variables. This study also explored which variables are validating indicators to evaluate the quality of nursing care. The results analyzed by multiple regression showed that, generally structural variables did not contribute to the variance in outcome scores, but process variables of nursing care contributed significantly to the outcome variable of patient satisfaction. A combination of structure and process variables explained outcome variables more than structural variables alone. Also, patient satisfaction and hospital preference were significantly related to each other. Therefore, if nursing quality evaluation relies solely upon on structural variables such as number of available nurses and workload, it would be inaccurate because process variables of nursing care are strongly related to outcome variables and the two categories of structure and process variables helped to strengthen the relationships. Thus, it is important to focus on variables of structure, process, ant outcome together in evaluating nursing care quality.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.110-118
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• 2010

Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.1
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• pp.106-117
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• 2012

Purpose: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. Methods: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. Results: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. Conclusion: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.