Nursing Quality Outcome Indicators

Abstract

The purpose of this study was to assess the feasibility and conduct a pilot study of the ANA Nursing Care Report Card Study in one state. Clinical indicators studied include agency data, skin integrity, patient falls, and nurse (n = 217) and patient (n = 924) satisfaction. Patients were well satisfied with their care. Nurses were less satisfied, with a significant difference between what was important to their satisfaction and their current level of satisfaction. Important information is included for hospital and nursing service administrators, as well as for nurses.

Caracterização das quedas de pacientes segundo notificação em boletins de eventos adversos

“…A related publication about 181 patients with a history of falls refers to falls from bed (49%), while walking (43%) and falls from chair (8%) (8) . In another study, carried out during one year at 42 intensive nursing care units, 64 falls were reported, in which 80% of patients were walking alone or with help, while 20% were bedridden (7) . It is also mentioned that 30% of falls occur when patients get out of bed and go to the bathroom (9) .…”

“…Hence, knowing what patients face greater risks of falls, specific prevention and safety measures can be put in practice, so as to preserve patients' health and care quality (6) . A study in the United States found that only 4.8% of patients assessed without risk of falls upon admission actually fell during hospitalization (7) .…”

“…In the present research, the fact that units with higher fall frequencies did not have beds with grates and wheel locks may have contributed to falls too. Authors of a North American study mention that, in 31% of 64 patient falls from bed, the grates were down (7) .…”

“…With regard to the relation between adverse event rates and the hospital unit's care level, it was observed that units with more severe patients displayed less fall events; at those units, due to their health condition, patients did not walk, which probably decreased the risk of falls (7) . The larger number of nurses at intensive care units may have contributed to lower fall rates as well (7) . In a study published in 1994, 27.3% of falls were attributed to environmental factors, including nursing staff (12) .…”

“…In a study published in 1994, 27.3% of falls were attributed to environmental factors, including nursing staff (12) . In this respect, higher fall frequencies were reported at hospital units with a higher number of secondary-education nursing (7) than at units where more professionals were nurses (13) .…”