While the provision of quality care to patients is clearly a professional obligation of nurses, it is considerably less clear how quality care should be evaluated, or who should be involved in the evaluation. The assertion that quality care has occurred must include data representing a variety of inputs including those of the patient, her/his health status, the nurse, the setting of the care, and the patient outcomes from the care. The primary goal of the proposed study is to further test a measure of the patient's perspective on quality nursing care to provide documentation of its utility as a quality of care measure. The long term goal of this project is to make available to acute-care setting administrators, researchers, and clinicians a measure of the patient's perspective on quality nursing care that will provide a means to assess the quality of care delivered and to identify how variations or changes in the delivery of care affect the quality of that care. The instrument to be used in this study is the Patient's Perception of Quality Scale (PPQS), a tool derived from the qualitative interviews of patients and tested using explicit instrument construction criteria. There are four aims for this study--evaluating the weighting, structure and reliability of the PPQS with a larger, more diverse sample; examining the construct validity of the scale; exploring the possibility o demographic group differences on the PPQS and, if present, developing group norms for the scale; and estimating the costs of an institution-wide patient's perception of nursing care quality assessment program using the PPQS. A descriptive design will be used to explore the reliability, validity and cost implications of the PPQS. Thirty-nine medical-surgical patient units in six institutions will serve as the settings for the study. All nurses employed on these units (n = 957) will be asked to participate in the study as will a convenience sample of 5,897 patients over the two years of data collection. Test-retest samples of half of the nurses and 10% of the patient sample will also be obtained. The patient test-retest sample will also serve as a follow-up sample used to ascertain selected validation variables. Analyses to be conducted include factor analysis, reliability estimation, correlating the PPQS subscales with measures predicted to covary with patient's perceptions of the care (e.g., compliance with and discharge care regimens), relating the PPQS scales to measures of the context of nursing, and using ANOVA to assess the ability of the PPQS to differentiate between units with more and less expert nurses. Costs of implementing an institution-wide patient satisfaction assessment program will be estimated.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR003606-03
Application #
2416216
Study Section
Nursing Research Study Section (NURS)
Program Officer
Helmers, Karin F
Project Start
1995-05-01
Project End
1999-04-30
Budget Start
1997-05-01
Budget End
1999-04-30
Support Year
3
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Miscellaneous
Type
Schools of Nursing
DUNS #
078861598
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Lynn, Mary R; McMillen, Bradley J; Sidani, Souraya (2007) Including the provider in the assessment of quality care: development and testing of the Nurses'Assessment of Quality Scale - acute care version. J Nurs Care Qual 22:328-36
Lynn, Mary R; McMillen, Bradley J; Sidani, Souraya (2007) Understanding and measuring patients'assessment of the quality of nursing care. Nurs Res 56:159-66
Lynn, Mary R; McMillen, Bradley J (2004) The scale product technique as a means of enhancing the measurement of patient satisfaction. Can J Nurs Res 36:66-81
Lynn, M R; McMillen, B J (1999) Do nurses know what patients think is important in nursing care? J Nurs Care Qual 13:65-74
Moore, K; Lynn, M R; McMillen, B J et al. (1999) Implementation of the ANA report card. J Nurs Adm 29:48-54
Lynn, M R; Moore, K (1997) Research utilization by nurse managers: current practices and future directions. Semin Nurse Manag 5:217-23
Lynn, M R; Moore, K (1997) Relationship between traditional quality indicators and perceptions of care. Semin Nurse Manag 5:187-93