Effectieve excellentie in de verpleegkunde
Het overbruggen van de kloof tussen het meten van de kwaliteit van verpleegkundige zorg en klinische realiteit
Summary
Effective excellence in nursing: bridging the gap between measurement of quality of nursing care and clinical reality
Dewi Stalpers
AIM: To assess the value of nurse-sensitive indicators as measures to evaluate quality of nursing care and to determine contributing factors in nurses’ work environment.
METHOD: A series of studies were performed, including a systematic review of literature, two cross-sectional studies, an observational study in intensive care units (ICUs), and a survey study.
FINDINGS: Nurse-sensitive indicators are potentially valid and useful quality measures. The applicability of indicators in daily nursing practice and the continuity in monitoring proved to be important challenges. Nurses’ educational level and the work environment characteristics of nurse staffing, autonomy, patient-centered values and professional relationships are related to the quality of care provided. The mediating factor of proactivity seems to be the hidden force in care processes, connecting nurse characteristics and their work environment (nurse level) to job performance and patient outcomes in hospitals (organizational level).
CONCLUSIONS: Bridging the gap between measurement of quality and clinical reality involves the necessity that organizational entities continuously assess the value and stimulate nurses’ intrinsic motivation to use nursesensitive indicators appropriately. At nurses’ level, nurse managers have to create healthy work environments and allow individual nurses to optimize their own performances by means of continuous education and maintenance of competences.
Key words: Hospitals, nurses, performance indicators, quality of care, work environment