The development of Nursing Quality Care Process Metrics and Indicators for use in Older Persons Care Settings: A Delphi‐Consensus Study

Aim To develop a suite of nursing quality care process metrics and indicators for older persons care settings in Ireland. Background Regulatory investigations of health system failures highlight non‐adherence to clinical guidelines and standards resulting in deficiencies in nursing care delivery. Limited attention has been paid to measuring nursing care processes particularly in the care of older people. Quality care process metrics can facilitate measurement of nurse‐sensitive measures of care. Design A scoping literature review and modified Delphi‐Consensus Technique. Methods A scoping review of literature published between January 2007 – January 2017 was conducted to identify nursing process metrics and indicators. The Delphi Consensus phase incorporated a four‐round electronic survey of 404 nurses and a consensus meeting with 13 stakeholders working in Older Persons Care Settings in Ireland. Findings From the review, 33 potential metrics were identified. After all Delphi survey rounds, 20 metrics and 90 associated indicators were selected by the nurses. Following the consensus meeting, 19 metrics and 80 indicators were included in the final suite of nursing quality care process metrics and indicators. Conclusion Developing this suite of nursing quality care process metrics and indicators for use in older persons care settings provided consensus on what nursing processes should be measured to improve the quality and safety of care delivery. Impact The nursing processes identified, provide a framework for future research and educational programmes in the care of older persons. Although conducted in the Irish healthcare system, there is potential for adoption or adaption in other healthcare settings. 目的 为爱尔兰的老年人护理机构制定一套护理质量护理过程度量和指标。 背景 对卫生系统故障的监管调查突出了对临床指南和标准的不遵守,从而导致护理提供方面的缺陷。护理过程的测量(特别是老年人护理过程中的测量)受到的关注有限。质量护理过程度量标准可以促进护士敏感型护理措施的测量。 设计 界定的文献综述和经修订的德尔福共识技术。 方法 对2007年1月至2017年1月期间发表的文献进行了范围审查,以确定护理过程的度量标准和指标。德尔福共识阶段包括对404名护士进行4轮电子调查并与爱尔兰老年人护理机构工作的13名利益相关者召开共识会议。 发现 从审查中,确定了33个潜在的度量标准。在所有德尔福问卷调查结束后,护士选择了20项度量标准和90项相关指标。共识会议后,19项度量标准和80个指标被纳入护理质量护理过程度量标准和指标的最终套件。 结论 制定这套护理质量护理过程度量标准和指标,供老年人护理机构使用,就应衡量哪些护理过程以提高护理质量和安全性方面提供了共识。 影响 确定了护理过程,为今后在老年人护理方面的研究和教育方案提供了框架。虽然在爱尔兰医疗系统中进行,但在其他医疗环境中也有采用或适应的潜力。