Nurse-sensitive outcome indicators for adult intensive care units in the South African context

Abstract

Background: Quality nursing care is associated with positive patient outcomes. Nurse-Sensitive Indicators are quality measures of patient care directly affected by nursing activities. There is currently no endorsed set of approved Nurse-Sensitive Indicators for use in adult intensive care units (ICUs) in South Africa.Aim: The aim of this research project was to develop Nurse-Sensitive Indicators for monitoring quality of nursing care in adult intensive care units in South Africa.Methodology: A quantitative research approach, based on the Donabedian Conceptual Framework and the Intensive Care Nurse Workload Conceptual Framework, was used to conduct this three-phased research project across four selected hospitals; two public and two private hospitals. Phase 1, included three objectives: 1.) A survey of all adult intensive care unit (ICU) nurses (N=350) using a combination of the Intensive critical care nurse competency scale (ICCNC-S),Response to stressful experiences scale (RSES) and the ICU nurse-physician collaboration scale (ICU-N-P-Q-S) to measure nurse self-assessed and reflective level of ICU nurse competency, ICU nurse resilience, and ICU nurse-physician collaboration respectively. 2.) A survey of critical care family needs inventory (CCFNI) of critical care patient family needs and the Consumer Quality Index of critical care patient family Members perceptions of the Intensive Care Unit (CQI-R-ICU) Scale to determine the family perception of ICU care (N=150). 3.) A retrospective review of critical care patients’ clinical records over a seven-day period to determine the intensive care nurse workload using the Therapeutic Intervention Scoring System-28 (TISS-28).