J Nurs Acad Soc.  1977 Dec;7(2):11-21.

A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care

• Yoo JS

Abstract

Many in nursing look back on Nursing Reserch history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows; 1 ) To develop the instrument to be used in evaluating the quality of nusring care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital. 2 ) To evaluate the quality of nursing care in the clinical area. 3 ) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the ivestigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows; 1) Maintenance of airway 2) Maintenance of fluid & electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro-Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X2-test, T-test, F test and Correlation. The results of the study were as follows ; 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into 5 categories such as "excellent", "good", "moderate", "incomplete", and "poor" based upon the investigator's personal judgement. a. The nusring index of maintaining airway showed that 78 % of the patients fell wthin the "excellent" and 22 % of the patients. Fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 35 % of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100 % of the patients fell within she "excellent" category. d. The nursing index of personal hygitene revealed that 49 % of the patients fell within the "excellent" and 51 % of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63 % of the patients fell within the "excellent" and 32 % of the patients Fell within the "good" and 5 % of patients fell withnn the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients tell within the "excellent" category. g. The nursing index of emotional care revealed that 27 % of the patients fell within the "excellent", 24 % of the patients fell within the "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8. 73, D. F. =100. P<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2 . Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t = 0.084. D. F.=12. P>0.05), Age(F=0.1251, D. F. =3.18, P>0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, P>0.09, levels of consciousness (F=0. 31. D. F. =3. 18. P >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing iddex of maintaining airway (r = -0. 5449, P<0.01) and personal hygiene(r= -0. 4075, P<0.01) There was positive correlation between the levels of consciousness and the nursing iddex of opitmum activitity {r=0. 3936, P <0.01) and emotional care (r = 0.7819, P(0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3458, 0, 01

0.05) and preventing accidents (r =0.1441, P>0.05).

MeSH Terms

Consciousness
Humans
Hygiene
Nursing Care*
Nursing Research
Nursing*
Water-Electrolyte Balance