Mixed‐method research protocol: defining and operationalizing patient‐related complexity of nursing care in acute care hospitals

“…Due to the duration of the overall research programme, we updated the literature with a second theoretical phase in 2018 and finished with a final analytical phase. A study protocol and further results have been published (5,25,(39)(40)(41)(42)(43).…”

Section: Designmentioning

confidence: 99%

Patient‐related complexity of nursing care in acute care hospitals – an updated concept

Huber

Kleinknecht-Dolf

Kugler

et al. 2020

Scandinavian Caring Sciences

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Patient-related complexity of nursing care in acute care hospitalsan updated concept Rational: The interest in complexity of nursing care has grown in science and practice in recent years because of changed patient profiles and higher average levels of patient acuity in acute care hospitals. Aim: The aim of this study was to redefine the concept of patient-related 'complexity of nursing care' in acute care hospitals. Design: The hybrid model for concept development was chosen. Methods: In a first theoretical phase, we performed a narrative literature review regarding defining elements of patient-related 'complexity of nursing care' and developed a working definition. In the fieldwork phase, we investigated collective case studies representing 12 nursing care situations. The theoretical phase was updated before all findings were synthesised, and in the final analytical phase, the preliminary working definition was refined. Ethics: An ethical committee judged the study as unproblematic (waiver no. 82/14 from 5 December 2014). Results: The concept was redefined confirming previous understandings of patient-related 'complexity of nursing care' as a dynamic, relational concept characterised by the instability, variability and uncertainty that exist. The extent of complexity was determined by multifaceted patient problems and resources as well as extensive knowledge, experience, attention and caring skills of registered nurses interacting with each other. Limitations: The study did not include organisation-related complexity of nursing care. Conclusions: The redefinition of the concept may support a common understanding of patient-related demands on nursing care among practitioners, managers and politicians which is important regarding patient safety and health nursing staff.

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“…We applied an embedded mixed‐methods design with a leading quantitative study section (Creswell, ). The research protocol for this study was published elsewhere (Huber, Kleinknecht‐Dolf, Müller, Kugler, & Spirig, ).…”

Section: The Studymentioning

confidence: 99%

Validation of the instrument “Complexity of Nursing Care”—A mixed‐methods study

et al. 2019

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AimsThis study aimed to psychometrically test the instrument “Complexity of Nursing Care” and to broaden the understanding of the instrument's psychometrics and applicability.DesignEmbedded mixed‐methods design.MethodsWe performed a cross‐sectional study assessing all stationary patients of five Swiss hospitals daily for up to 5 days with the instrument “Complexity of Nursing Care” over a 1–month period in 2015. The scale's psychometrics were analysed using partial least square structural equation modelling. In the qualitative study section, we completed 12 case studies and analysed them case‐wise and across cases. Quantitative and qualitative results were synthesized in tables.ResultsStructural equation modelling confirmed a reflective‐formative second‐order model of the instrument with good psychometric properties leading to a formula for the calculation of a complexity score. Qualitative results evolved descriptions of low and high extent of complexity. Narrative considerations of two raters deepened the understanding of the inter‐rater reliability.

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Mixed‐method research protocol: defining and operationalizing patient‐related complexity of nursing care in acute care hospitals

Abstract: Following the phases of the hybrid model and using an embedded mixed-methods design can reach an in-depth understanding of patient-related complexity of nursing care in acute care hospitals, a final version of the questionnaire and an acknowledged definition of the concept.

Cited by 11 publications

References 54 publications

Implementation of a new patient education programme for renal transplant recipients

Implementation of a new patient education programme for renal transplant recipients

Patient‐related complexity of nursing care in acute care hospitals – an updated concept

Validation of the instrument “Complexity of Nursing Care”—A mixed‐methods study

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