Aims: To identify indicators of nursing care performance by identifying structures, processes, and outcomes that are relevant, feasible and have the potential for benchmarking in Swiss acute hospitals.
Design: A modified Delphi-Consensus Technique.
Methods: We examined 19 indicators based on the current evidence and that were pre-selected by nursing scientists. Between August-October 2019, a consortium of experts (representatives of different cantons, hospitals, and healthcare roles in Switzerland) determined the relevance, feasibility, and suitability for benchmarking these indicators in two-round modus of digital survey. Consensus was defined a priori by at least 75% agreement on the highest level of a 3-point Likert-type scale.
Results: The response rate was 70.4% in the first and 68.4% in the second round. In round one consensus was reached for three indicators on relevance but for none of the indicators regarding feasibility or potential for benchmarking. For round two, the experts suggested two additional indicators (new total of 21 indicators). Of 21 indicators, consensus was reached on twelve regarding relevance, seven regarding feasibility, and two regarding the potential for benchmarking.
Conclusion: A national expert consortium defined 12 of 21 nursing care indicators as relevant. Feasibility, however, was estimated only among seven indicators and a consensus on suitability for benchmarking was reached for two nursing-sensitive indicators.
Impact: The results show how the indicators to evaluate nursing care performance, which have been identified as priority by Canadian nursing scientists, are assessed in a different setting. There are many overlaps, but also some differences in the assessment of the indicators between the different settings. Different health systems prioritize the indicators to evaluate nursing care performance differently, which is why national surveys are important for the compilation of their own (priority) indicator sets.
目的: 识别相关、可行且在瑞士急症医院中具有标杆性的结构、过程和结果,从而确定护理绩效的指标。 设计: 经改进的德尔菲法技术。 方法: 根据当前证据,对护理科学家预先选定的19项指标进行研究。在2019年8月至10月间设立一个专家(瑞士不同州、医院和医疗机构的代表)联盟,展开两轮数字调查,依此确定上述指标的相关性、可行性和适用性。处于李·克特式三点量表的最高水平时,至少有75%的人同意预先定义共识。 结果: 第一轮的有效率为70.4%,而第二轮的有效率为68.4%。第一轮,就三项相关性指标达成共识,但没有一项指标与标杆的可行性或潜力相关。第二轮,专家建议增加两个指标(新增后,总计21个指标)。21项指标中,12项涉及相关性,7项涉及可行性,2项涉及标杆潜力,并已就此达成共识。 结论: 全国性专家联合会将21项护理指标中的12项定义为相关指标。然而,仅对7项指标的可行性进行评估,此外,现已就两项护理敏感指标的适用性达成共识。 影响: 研究结果显示在不同的环境条件下评估被加拿大护理科学家确定为优先事项的护理绩效指标的具体方法。不同设置时,指标评估可能大范围重叠,但也可能存在部分差异。不同健康系统的护理绩效指标评估顺序不同,因此,国家调查内容对于其自身(优先)指标集的确定极为重要。.
Keywords: benchmarking; modified Delphi; nursing; nursing-sensitive indicators; nursing-sensitive outcomes; quality.
© 2020 John Wiley & Sons Ltd.