Nurse-sensitive outcomes in district nursing care: A Delphi study.

<h4>Objectives</h4>To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses' scope and domain of practice and that are influenced by nursing inputs and...

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Main Authors: Jessica D Veldhuizen, Anne O E van den Bulck, Arianne M J Elissen, Misja C Mikkers, Marieke J Schuurmans, Nienke Bleijenberg
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0251546
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author Jessica D Veldhuizen
Anne O E van den Bulck
Arianne M J Elissen
Misja C Mikkers
Marieke J Schuurmans
Nienke Bleijenberg
author_facet Jessica D Veldhuizen
Anne O E van den Bulck
Arianne M J Elissen
Misja C Mikkers
Marieke J Schuurmans
Nienke Bleijenberg
author_sort Jessica D Veldhuizen
collection DOAJ
description <h4>Objectives</h4>To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses' scope and domain of practice and that are influenced by nursing inputs and interventions.<h4>Design</h4>A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection.<h4>Setting</h4>District nursing care in the community care setting in the Netherlands.<h4>Participants</h4>Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing.<h4>Main outcome measures</h4>Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement.<h4>Results</h4>In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient's autonomy, the patient's ability to make decisions regarding the provision of care, the patient's satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care.<h4>Conclusions</h4>This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.
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spelling doaj.art-ef32711f7bdb4101accd1df40b73759a2022-12-21T23:38:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025154610.1371/journal.pone.0251546Nurse-sensitive outcomes in district nursing care: A Delphi study.Jessica D VeldhuizenAnne O E van den BulckArianne M J ElissenMisja C MikkersMarieke J SchuurmansNienke Bleijenberg<h4>Objectives</h4>To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses' scope and domain of practice and that are influenced by nursing inputs and interventions.<h4>Design</h4>A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection.<h4>Setting</h4>District nursing care in the community care setting in the Netherlands.<h4>Participants</h4>Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing.<h4>Main outcome measures</h4>Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement.<h4>Results</h4>In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient's autonomy, the patient's ability to make decisions regarding the provision of care, the patient's satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care.<h4>Conclusions</h4>This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.https://doi.org/10.1371/journal.pone.0251546
spellingShingle Jessica D Veldhuizen
Anne O E van den Bulck
Arianne M J Elissen
Misja C Mikkers
Marieke J Schuurmans
Nienke Bleijenberg
Nurse-sensitive outcomes in district nursing care: A Delphi study.
PLoS ONE
title Nurse-sensitive outcomes in district nursing care: A Delphi study.
title_full Nurse-sensitive outcomes in district nursing care: A Delphi study.
title_fullStr Nurse-sensitive outcomes in district nursing care: A Delphi study.
title_full_unstemmed Nurse-sensitive outcomes in district nursing care: A Delphi study.
title_short Nurse-sensitive outcomes in district nursing care: A Delphi study.
title_sort nurse sensitive outcomes in district nursing care a delphi study
url https://doi.org/10.1371/journal.pone.0251546
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