This application seeks funding for Phase II of a three-phase program of research to identify, classify, and test nursing sensitive patient outcomes and their indicators for use in standardized language development, practice, research, and education. The purposes of the research are to: 1) identify, label, validate, and classify nursing sensitive patient outcomes and indicators, 2) evaluate the validity and usefulness of the classification in clinical field testing, and 3) define and test measurement procedures for the outcomes and indicators. The classification is expected to contain patient outcomes, indicators, and measurement activities at three to four levels of abstraction and to identify those patient outcomes most influenced by nursing. The research uses both inductive and deductive approaches. An inductive approach will be used to extract outcomes, indicators, and measures from current nursing literature and instruments. A combined inductive and deductive approach will be used to label outcomes, specify indicators for the outcomes, and group the outcomes in broad categories based on the Medical Outcomes framework and categories identified by nurses. Delphi techniques and surveys of random samples of masters prepared nurses will be used to validate the outcomes and indicators prior to field testing the outcomes and indicators in four sites, a tertiary care hospital, a community hospital, a nursing home, and a community agency. Hierarchical clustering techniques and nonmetric scaling analysis will be used to develop the classification of nursing sensitive patient outcomes and a survey of nurse experts will be used for initial validation of the classification.
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