Contenuto dell'articolo principale
Abstract
RIASSUNTO
Esistono in letteratura diverse definizioni di esiti sensibili alle cure infermieristiche. Van Der Bruggen e Groen, li hanno definiti come un aspetto osservabile e misurabile dell'individuo, gruppo o popolazione che deve essere obiettivo per clinici e ricercatori e soggettivo per il paziente e la famiglia. Johnson e Maas, come stati, comportamenti o percezioni variabili del paziente, della famiglia o del caregiver conseguenti ad interventi assistenziali. Per l'International Classification for Nursing Practice (ICNP), l'outcome infermieristico è lo status di una diagnosi infermieristica dopo un intervento assistenziale. Nell'Iowa Outcome Project, in cui è stato elaborato il sistema Nursing Outcomes Classification (NOC) l'esito assistenziale è una condizione, comportamento o percezione misurabile della persona o della sua famiglia, concettualizzata come variabile sensibile alle cure infermieristiche. Gli esiti individuati dal sistema NOC sono focalizzati sull'individuo, sulla famiglia e sulla comunití , e si riferiscono a stati, comportamenti o percezioni. Gli elementi da considerare nella definizione degli outcome infermieristici sono quattro: aspetti specifici dell'assistenza infermieristica, la patologia, aspetti generali dell'assistenza, la tipologia di paziente. E' importante pensare quali sistemi di valutazione degli esiti possono essere più appropriati in Italia, dove il campo d'azione dell'infermiere ha dei confini sfumati, con funzioni che si fondono e si confondono con altre figure professionali. Studi sull'effettiva possibilití di applicare la tassonomia NOC in Italia potrebbero essere una base di partenza per la definizione o l'adattamento di un sistema di valutazione degli esiti che consenta realmente la visibilití oggettiva del contributo che la figura infermieristica offre nel miglioramento globale della persona assistita
Parole chiave: Studi sugli esiti, misurazione degli esiti, processo di nursing, ricerca infermieristica
ABSTRACT
Literature reports several definitions of outcomes sensitive to nursing care. Van Der Bruggen & Groen defined nursing outcomes as observable and measurable aspects in individuals, groups and population that should be objective for clinicians and researchers and subjective for patients and families. Johnson & Maas defined nursing outcomes as variable behaviors or perceptions of family or caregiver after the caring intervention. According to the International Classification for Nursing Practice (ICNP), nursing outcomes are the status of a nursing diagnosis after the intervention. In the IowaOutcome Project, where Nursing Outcomes Classification (NOC) system has been elaborated, nursing outcome is a measurable condition, behavior or perception of the person or family conceptualized as sensitive variable to nursing care. Outcomes of NOC system are focused on individuals, families and community and refers to status, behavior or perceptions. Elements to be considered in nursing outcome definition are four: specific aspects of nursing care, the illness, general aspects of care, patient typology. It is important to identify which system for nursing evaluation outcomes are more suitable for Italy, where the field of action of nurses has faded edge with functions that mix and confuse with other professionals. Studies on the application of NOC taxonomy in Italy could be a starting point for defining and adapting an outcome evaluation system that will allow the objective visibility that nursing care gives to the global improvement of the cared person.
Key words: Outcome study, evaluation of outcome, nursing process, nursing research
Dettagli dell'articolo
Riferimenti
- Aydelotte, M. (1962). The use of patient welfare as a criterion measure. Nursing Research, 11, 10-14.
- Behrenbeck, J., Timm, J., Griebenow, L., & Demmer, K. (2005). Nursing Sensitive Outcome Reliability Testing in a Tertiary Care Setting. International Journal of Nursing Terminologies and Classifications, 16 (1), 14-20
- Brennan, P. (1995). Patient satisfaction and Normative Decision Theory. Journal of American Medical Informatics Association, 2, 250-259.
- Brown, D. (1992). A conceptual framework for the evaluation of service quality. Journal of Nursing Care Quality, 6, 66-74.
- Daubert, E. (1979). Patient classification and outcome criteria. Nursing Outlook, 27, 450-454.
- de Lima Lopes, J., Bottura Leite de Barros, A., & Michel, J. (2009). A Pilot Study to Validate the Priority Nursing Interventions Classification and Nursing Outcomes Classification Outcomes for the Nursing Diagnosis "Excess Fluid Volume" in Cardiac Patients. International Journal of Nursing Terminologies and Classifications, 20 (2), 76-88.
- Delaney, C., & Moorhead, S. (1995). The nursing minimum data set standardized language, and health care quality. Journal of Nursing Care Quality, 10 (1), 16-30.
- Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44, 166-206.
- Gillette, B., & Jenko, M. (1991). Major clinical functions: A unifying framework for measuring outcomes. Journal of Nursing Care Quality, 6, 20-24.
- Head, B., Aquilino, M., Johnson, M., Reed, D., Maas, M., & Moorehead, S. (2004). Content Validity and Nursing Sensitivity of Community-Level Outcomes From the Nursing Outcomes Classification (NOC). Journal of Nursing Scholarship, 36 (3), 251-259.
- Head, B., Maas, M., & Johnson, M. (2003). Validity and Community-Health-Nursing Sensitivity of Six Outcomes for Community Health Nursing with Older Clients. Public Health Nursing, 20 (5), 385-398.
- Horn, B., & Swain, M. (1978). Criterion measures of nursing care. Hayattsville, MD: National Center for Health Services Research.
- Hovenga, E. (1995). Performance measurement. In M. Clinton, & D. Scheiwe, Management in the Australian Healthcare Industry. Pymple NSW: Harper Educational.
- Hover, J., & Zimmer, M. (1978). Nursing quality assurance: The Wisconsin system. Nursing Outlook, 26, 242-248.
- Idvall, E., Rooke, L., & Hamrin, E. (1997). Quality Indicators in clinical nursing: a review of the literature. Journal of Advanced Nursing, 25, 6-17.
- Institute of Medicine. (2004). Keeping Patient Safe. Washington, DC: National Academy Press.
- Johnson, M., & Maas, M. (1997). Nursing outcomes classification. St. Louis: Mosby.
- Johnson, M., & Maas, M. (1999). Nursing-sensitive patient outcomes: Development and importance for use in assessing health care effectiveness. In E. Cohen, & V. DeBack, The outcomes mandate: Case management in health care today, 37-48. St.Louis: Mosby.
- Johnson, M., Bulechek, G., McCloskey Dochterman, J., Maas, M., & Moorhead, S. (2005). Diagnosi infermieristiche, Risultati, Interventi. Collegamenti NANDA, NIC, NOC. Milano: Ambrosiana.
- Lang, N., & Clinton, J. (1984). Assessment of quality in nursing care. Annual Review in Nursing Research, 2, 135-163.
- Lang, N., & Marek, K. (1990). The classification of patient outcomes. Journal of Professional Nursing, 6, 153-163.
- Lee, B. (2007). Identifying outcomes from the nursing outcomes classification as indicators of quality of care in Korea: A modified delphi study. International Journal of Nursing Studies, 44, 1021–1028.
- Lunney, M. (2006). Helping nurse use NANDA, NOC and NIC. Journal of Nursing Administration, 36 (3), 118-125.
- Marek, K. (1989). Outcomes measurement in nursing. Journal of Nursing Quality Assurance, 4, 1-9.
- Martin, K., & Scheet, N. (1993). Home Health Clients: Characteristics, Outcomes of care, and Nursing Interventions. American Journal of Public Health , 83, 1730-1734.
- McKormick, K. (1991). Future data needs for quality care monitoring, DRG considerations, reimbursement and outcome measurement. Image, 23, 29-32.
- Moen, A., Henry, S., & Warren, J. (1999). Representing Nursing Judgement in the Electronic Health Record. Journal of Advanced Nursing, 30 (4), 990-997.
- Moorhead, S., Johnson, M., & Maas, M. (2007). Classificazione NOC dei risultati infermieristici. Milano: Casa Editrice Ambrosiana.
- Nailor, M., Munro, B., & Brooten, D. (1991). Measuring the effectiveness of nursing practice. Clinical Nurse Specialist, 5, 210-215.
- Palese A., Beltrame, E.R., Bin, A., Borghi, G., Bottacin, M., Buchini, S, et al. (2008). Esiti sensibili alle cure infermieristiche: analisi critica della letteratura. Assistenza Infermieristica e Ricerca, 27 (1), 33-42.
- Ruland, C. (1999). Decision support for patient preference-based care planning: effects on nursing care and patient outcomes. Journal of American Medical Informatic Association, 6 (4): 304-12.
- Saba, V., & Zuckerman, A. (1992). A New Home Health Classification Method. Caring, 11 (10), 27-34.
- Scherb, C., Stevens, M., & Busman, C. (2007). Outcomes Related to Dehydration in the Pediatric Population. Journal of Pediatric Nursing, 22 (5), 376-382.
- Sovie, M. (1989). Clinical nursing practices and patient outcomes: evaluation, evolution, and revolution. Nursing Economics, 7, 79-85.
- Tarlov, A., Ware, J., Greenfield, S., Nelson, E., Perrin, E., & Zubkoff, M. (1989). The Medical Outcomes Study: An application of methods for monitoring the results of medical care. Journal of the American Medical Association, 262, 925-930.
- Van Der Bruggen, H., & Groen, M. (1997). Patient Outcome. Naar definiering en classificering van resultaten van verpleegkundige zorg. Verpleegkunde, 12 (2), 68-81.
- Zander, K. (1992). Quantifying, Managing, and Improving Quality, Part I: How CareMaps Link CQI to the Patient. The New Definition , 1 (2), 1-3.
Riferimenti
Aydelotte, M. (1962). The use of patient welfare as a criterion measure. Nursing Research, 11, 10-14.
Behrenbeck, J., Timm, J., Griebenow, L., & Demmer, K. (2005). Nursing Sensitive Outcome Reliability Testing in a Tertiary Care Setting. International Journal of Nursing Terminologies and Classifications, 16 (1), 14-20
Brennan, P. (1995). Patient satisfaction and Normative Decision Theory. Journal of American Medical Informatics Association, 2, 250-259.
Brown, D. (1992). A conceptual framework for the evaluation of service quality. Journal of Nursing Care Quality, 6, 66-74.
Daubert, E. (1979). Patient classification and outcome criteria. Nursing Outlook, 27, 450-454.
de Lima Lopes, J., Bottura Leite de Barros, A., & Michel, J. (2009). A Pilot Study to Validate the Priority Nursing Interventions Classification and Nursing Outcomes Classification Outcomes for the Nursing Diagnosis "Excess Fluid Volume" in Cardiac Patients. International Journal of Nursing Terminologies and Classifications, 20 (2), 76-88.
Delaney, C., & Moorhead, S. (1995). The nursing minimum data set standardized language, and health care quality. Journal of Nursing Care Quality, 10 (1), 16-30.
Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44, 166-206.
Gillette, B., & Jenko, M. (1991). Major clinical functions: A unifying framework for measuring outcomes. Journal of Nursing Care Quality, 6, 20-24.
Head, B., Aquilino, M., Johnson, M., Reed, D., Maas, M., & Moorehead, S. (2004). Content Validity and Nursing Sensitivity of Community-Level Outcomes From the Nursing Outcomes Classification (NOC). Journal of Nursing Scholarship, 36 (3), 251-259.
Head, B., Maas, M., & Johnson, M. (2003). Validity and Community-Health-Nursing Sensitivity of Six Outcomes for Community Health Nursing with Older Clients. Public Health Nursing, 20 (5), 385-398.
Horn, B., & Swain, M. (1978). Criterion measures of nursing care. Hayattsville, MD: National Center for Health Services Research.
Hovenga, E. (1995). Performance measurement. In M. Clinton, & D. Scheiwe, Management in the Australian Healthcare Industry. Pymple NSW: Harper Educational.
Hover, J., & Zimmer, M. (1978). Nursing quality assurance: The Wisconsin system. Nursing Outlook, 26, 242-248.
Idvall, E., Rooke, L., & Hamrin, E. (1997). Quality Indicators in clinical nursing: a review of the literature. Journal of Advanced Nursing, 25, 6-17.
Institute of Medicine. (2004). Keeping Patient Safe. Washington, DC: National Academy Press.
Johnson, M., & Maas, M. (1997). Nursing outcomes classification. St. Louis: Mosby.
Johnson, M., & Maas, M. (1999). Nursing-sensitive patient outcomes: Development and importance for use in assessing health care effectiveness. In E. Cohen, & V. DeBack, The outcomes mandate: Case management in health care today, 37-48. St.Louis: Mosby.
Johnson, M., Bulechek, G., McCloskey Dochterman, J., Maas, M., & Moorhead, S. (2005). Diagnosi infermieristiche, Risultati, Interventi. Collegamenti NANDA, NIC, NOC. Milano: Ambrosiana.
Lang, N., & Clinton, J. (1984). Assessment of quality in nursing care. Annual Review in Nursing Research, 2, 135-163.
Lang, N., & Marek, K. (1990). The classification of patient outcomes. Journal of Professional Nursing, 6, 153-163.
Lee, B. (2007). Identifying outcomes from the nursing outcomes classification as indicators of quality of care in Korea: A modified delphi study. International Journal of Nursing Studies, 44, 1021–1028.
Lunney, M. (2006). Helping nurse use NANDA, NOC and NIC. Journal of Nursing Administration, 36 (3), 118-125.
Marek, K. (1989). Outcomes measurement in nursing. Journal of Nursing Quality Assurance, 4, 1-9.
Martin, K., & Scheet, N. (1993). Home Health Clients: Characteristics, Outcomes of care, and Nursing Interventions. American Journal of Public Health , 83, 1730-1734.
McKormick, K. (1991). Future data needs for quality care monitoring, DRG considerations, reimbursement and outcome measurement. Image, 23, 29-32.
Moen, A., Henry, S., & Warren, J. (1999). Representing Nursing Judgement in the Electronic Health Record. Journal of Advanced Nursing, 30 (4), 990-997.
Moorhead, S., Johnson, M., & Maas, M. (2007). Classificazione NOC dei risultati infermieristici. Milano: Casa Editrice Ambrosiana.
Nailor, M., Munro, B., & Brooten, D. (1991). Measuring the effectiveness of nursing practice. Clinical Nurse Specialist, 5, 210-215.
Palese A., Beltrame, E.R., Bin, A., Borghi, G., Bottacin, M., Buchini, S, et al. (2008). Esiti sensibili alle cure infermieristiche: analisi critica della letteratura. Assistenza Infermieristica e Ricerca, 27 (1), 33-42.
Ruland, C. (1999). Decision support for patient preference-based care planning: effects on nursing care and patient outcomes. Journal of American Medical Informatic Association, 6 (4): 304-12.
Saba, V., & Zuckerman, A. (1992). A New Home Health Classification Method. Caring, 11 (10), 27-34.
Scherb, C., Stevens, M., & Busman, C. (2007). Outcomes Related to Dehydration in the Pediatric Population. Journal of Pediatric Nursing, 22 (5), 376-382.
Sovie, M. (1989). Clinical nursing practices and patient outcomes: evaluation, evolution, and revolution. Nursing Economics, 7, 79-85.
Tarlov, A., Ware, J., Greenfield, S., Nelson, E., Perrin, E., & Zubkoff, M. (1989). The Medical Outcomes Study: An application of methods for monitoring the results of medical care. Journal of the American Medical Association, 262, 925-930.
Van Der Bruggen, H., & Groen, M. (1997). Patient Outcome. Naar definiering en classificering van resultaten van verpleegkundige zorg. Verpleegkunde, 12 (2), 68-81.
Zander, K. (1992). Quantifying, Managing, and Improving Quality, Part I: How CareMaps Link CQI to the Patient. The New Definition , 1 (2), 1-3.