PURPOSE: This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality. METHODS: The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility. RESULTS: The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over .80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable. CONCLUSION: In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.
Humans ; Nursing Evaluation Research ; Nursing Homes/*standards ; Nursing Services/*standards ; *Quality Indicators, Health Care ; Reproducibility of Results

PURPOSE: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). METHOD: This study was a methodological study. The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. RESULTS: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. CONCLUSIONS: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.
*Quality Indicators, Health Care ; Nursing Staff, Hospital/*standards ; Nursing Care/*standards ; Humans

PURPOSE: The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. METHODS: A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's alpha and Cohen's Kappa. RESULTS: Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's alpha=.95. CONCLUSION: The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.
Humans ; Interviews as Topic ; Nursing Evaluation Research ; *Nursing Homes/standards ; Program Development ; Quality of Health Care/*standards ; Questionnaires

PURPOSE: This study was done to develop standards for dementia care as a baseline for professional nurses to provide a framework for dementia care evaluation. METHODS: The dementia care standards were developed through a literature review and focus group discussions. According to the Delphi method, the data analysis was conducted using the Content Validity Index (CVI). RESULTS: The final set of 18 standards on dementia care was developed through one round of CVI. The standards included four structural standards: 'Organization of nursing system', 'Operating system', 'Management of human resources', 'Management of material resources', 13 procedural standards: 'Advanced assessment', 'Nursing diagnosis', 'Nursing plan', 'Advanced nursing implementation', 'Evaluation', 'Education', 'Research', 'Consultation', 'Counseling and cooperation', 'Development of specialty', 'Utilizing resources', 'Nursing quality assurance', 'Ethics', and one standard concerning outcome ('Evaluation of nursing tasks in care of patients with dementia'). The final set of 55 criteria on care of patients with dementia was confirmed through two rounds of CVI. The final 171 indicators were confirmed through four rounds of CVI. CONCLUSION: These dementia care standards provides a framework that allows registered nurses to clarify their roles and tasks in the care of patients with dementia and provides evaluation criteria.
Dementia/*nursing ; Humans ; Nursing Care/*standards ; Program Evaluation ; Questionnaires ; Standard of Care

INTRODUCTIONVentilator-associated pneumonia (VAP) is a common risk among critically ill ventilated patients. This study aimed to investigate the effects of nurse-led education on: (a) knowledge of and compliance with ventilator care bundle (VCB) practices among intensive care unit (ICU) nurses; and (b) reduction in the rates of VAP post intervention.

METHODSA quasi-experimental design with pretest-posttest evaluation and observation was used to investigate nurses' knowledge of and compliance with VCB practices, and the incidence of VAP. The study was conducted among 71 nurses, and the intervention involved structured education on VAP and its prevention using VCB in an ICU setting. Data were analysed using descriptive and inferential statistics.

RESULTSNurse-led education significantly increased nurses' knowledge of (t[70] = -36.19; p < 0.001) and compliance with (t[65] = -21.41; p < 0.001) VCB practices. The incidence of VAP, which was 39 per 1,000 ventilator days during the two-month period before intervention, dropped to 15 per 1,000 ventilator days during the two-month period following intervention.

CONCLUSIONOur findings show that nurse-led education on VAP and VCB significantly increased knowledge of and compliance with VCB practices among ICU nurses, and was associated with a reduction in the incidence of VAP among intubated and mechanically ventilated ICU patients. Inclusion of recent knowledge and evidence-based VCB guidelines for VAP prevention when educating anaesthetists, nurses, physiotherapists and other healthcare providers in the critical care setting is recommended.

Adult ; Clinical Competence ; Critical Care ; methods ; standards ; Critical Illness ; Education, Nursing ; Education, Nursing, Continuing ; methods ; Female ; Humans ; Intensive Care Units ; standards ; statistics & numerical data ; Male ; Nursing ; standards ; Pneumonia, Ventilator-Associated ; prevention & control ; Respiration, Artificial ; standards ; Ventilators, Mechanical ; standards ; Young Adult

PURPOSE: To develop and psychometrically test the Korean version of the Cultural Competence Scale for Nurses (K-CCSN). METHODS: A multi-phase questionnaire development method was used to develop the scale from November 2012 to April 2013. The item pool was generated based on literature review, existing scales and in-depth interviews. The content validity was evaluated twice by an expert panel. The scale validation was conducted with a convenience sample of 456 general hospital nurses recruited from five general hospitals and a nursing college in the Seoul Metropolitan Area of South Korea. The construct-related and criterion-related validity and internal consistency reliability of the scale were tested. RESULTS: The 33-item K-CCSN comprised four subscalesdcultural awareness, cultural knowledge, cultural sensitivity and cultural skillsdexplaining 53.96% of the total variance. The criterion-related validity was supported by a known-group comparison. The reliability analysis showed an acceptable-to-high Cronbach's alpha in total and for subscales ranging from .879 to .932. CONCLUSION: This preliminary evaluation of psychometric scale properties demonstrated acceptable validity and reliability. The K-CCSN is able to provide scientific and empirical data regarding the cultural competence of clinical nurses. However, further studies are needed to test the applicability of the scale in different settings and contexts.
Adult ; *Cultural Competency ; Culturally Competent Care/*standards ; Humans ; *Nursing Staff, Hospital ; Psychometrics/*standards ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; *Students, Nursing

PURPOSE: This paper is a report of a concept analysis of 'quality of pediatric nursing care'. METHODS: Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care. RESULTS: Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.' CONCLUSION: 'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.
Child ; Humans ; Nurse-Patient Relations ; Nurses/psychology ; Pediatric Nursing/*standards ; Professional Competence ; *Quality of Health Care

PURPOSE: This study was conducted to investigate the clear concept of patient safety and obtain theoretical evidences. METHODS: Research was conducted using Walker & Avant's conceptual analysis process. RESULTS: Patient safety was defined as an activity that minimizes and removes possible errors and injuries to patients. It includes a basic desire to secure the patient's right to safety, and the legal regulations and duties of medical teams. The results of the establishment of a safety culture are patient-centered medical treatment and caring. Antecedents were found to be open and clear communications, continuous education and training for health care personnel, sufficient allocation of qualified personnel, cooperation among departments, improvements in the recognition of patient safety. Consequences were found to be the provision of high quality medical care and treatment, and increase in patient satisfaction. CONCLUSION: Patient safety as defined by the results of this study will contribute to the foundation of institutionalization of the pursuit of patient safety and creation of a hospital culture focusing on patient safety as a first priority.
Health Personnel/education ; Humans ; Models, Theoretical ; Nursing Care ; *Patients ; Safety Management/*standards

Female ; Humans ; Male ; Mouth ; injuries ; Mouth Diseases ; chemically induced ; nursing ; Paraquat ; poisoning ; Patient Care ; standards

PURPOSE: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. METHOD: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. RESULT: SaO2 was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. CONCLUSION: CES prevented VAP, was cost effective, and a safe suctioning system. CES ncan be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.
Adult ; Cross Infection/*etiology ; Female ; Humans ; Intubation, Intratracheal/*adverse effects/methods/nursing ; Male ; Middle Aged ; Nursing Care/standards ; Pneumonia/*etiology ; Respiration, Artificial/*adverse effects/nursing