Nursing-Sensitive Outcomes Data Collection in
Acute Care and Long-Term-Care Settings
Diane M. Doran 4 Margaret B. Harrison 4 Heather S. Laschinger 4 John P. Hirdes 4 Ellen Rukholm
Souraya Sidani 4 Linda McGillis Hall 4 Ann E. Tourangeau
Editor’s Note
Additional information provided by the authors expanding this article is
on the Editor’s Website at http://www.nursing-research-editor.com.
b Background: Most administrative databases do not contain
good information about nursing-sensitive outcomes.
b Objectives: To determine (a) the reliability of the instruments
measuring nursing-sensitive outcomes, (b) whether the out-
come measures are sensitive to changes in patients’ health,
and (c) whether the outcome measures are associated with
nursing interventions.
b Methods: The sample consisted of 890 patients from acute
care hospitals and long-term-care facilities. A repeated
measures design was used. Functional status was
assessed on admission and discharge using Minimum Data
Set 2.0 items. Symptom (pain, nausea, dyspnea, fatigue)
frequency and severity were assessed with 4-point and 11-
point numeric scales, respectively. Therapeutic self-care
was assessed on discharge from acute care. Nursing
interventions were assessed by documentation review.
b Results: The outcome measures demonstrated very good
interrater reliability with weighted Kappa ranging from .64
to .93. The internal consistency reliability was high for
functional status and therapeutic self-care. The outcome
tools were sensitive to change in patient condition. Select
nursing interventions were related to functional status,
therapeutic self-care, and symptom outcomes.
b Discussion: The findings suggest that nurses are able to
collect data on nursing-sensitive patient outcomes in a
reliable and valid way.
b Key Words: functional status
&
nursing intervention
&
nursing-
sensitive outcomes
&
self-care
I
n terms of patient contact, nurses provide the most care
in all sectors of the healthcare system; however, very
little information about the impact of nursing care is
recorded in administrative databases (Pringle & Doran,
2003). With the increasing demand for professional and
financial accountability in healthcare, health databases
need to be updated to provide information about one of
the most significant components of care, the individual and
collective contributions of nurses.
Historically, an interest in clinical end points such as
mortality and morbidity (iatrogenic complications) has
Nursing Research
.
March/April 2006
.
Vol 55, No 2S, S75–S81
Nursing Research March/April 2006 Vol 55, No 2S S75
Diane M. Doran, PhD, RN, FCAHS, is Professor, Associate Dean
of Research and International Relations, Faculty of Nursing,
University of Toronto; Nursing Health Services Research Unit,
Ontario, Canada.
Margaret B. Harrison, PhD, RN, is Associate Professor, School
of Nursing, Faculty of Health Sciences, Queen’s University,
Kingston, Ontario, Canada.
Heather S. Laschinger, PhD, RN, is Professor, Associate Director
of Research, School of Nursing, University of Western Ontario,
London; Nursing Health Services Research Unit, University of
Toronto, Ontario, Canada.
John P. Hirdes, PhD, is Professor, Department of Health Studies
and Gerontology, University of Waterloo; and Scientific Director,
Homewood Research Institute, Ontario, Canada.
Ellen Rukholm, PhD, RN, FCAHS, is Professor and Director,
School of Nursing, Laurentian University; and Faculty member,
Centre for Rural and Northern Health, Sudbury, Ontario,
Canada.
Souraya Sidani, PhD, is Professor, Faculty of Nursing, University
of Toronto; Nursing Health Services Research Unit, Ontario,
Canada.
Linda McGillis Hall, PhD, RN, is Associate Professor, Faculty of
Nursing, University of Toronto; Nursing Health Services Research
Unit, New Investigator, Canadian Institutes of Health Research,
Ontario, Canada.
Ann E. Tourangeau, PhD, RN, is Assistant Professor, Faculty of
Nursing, University of Toronto; Adjunct Scientist, Institute for
Clinical Evaluative Sciences in Ontario; Co-investigator, Nursing
Health Services Research Unit; Career Scientist, Ontario Ministry
of Health and Long-Term Care, Ontario, Canada.
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