Nutrition Care Process Quality Evaluation and Standardization Tool: The Next Frontier in Quality Evaluation of Documentation
Nutrition Care Process Quality Evaluation and Standardization Tool: The Next Frontier in Quality Evaluation of Documentation
复制标题
DOI：
10.1016/j.jand.2021.07.004
复制
发表时间：
2022-02-18
影响因子：
4.8
通讯作者：
Papoutsakis, Constantina
中科院分区：
文献类型：
--
作者：
Lewis, Sherri L.;Miranda, Leslie S.;Papoutsakis, Constantina
文件对于有资格的营养和饮食从业者与其他医疗保健提供者之间沟通护理至关重要。目前缺乏一种经过验证的工具，可以评估营养护理过程 (NCP) 的质量记录，包括结果进展情况。 NCP 质量评估和标准化工具 (QUEST) 验证研究的目的是修订现有的 NCP 审核工具，并在美国退伍军人事务部在所有临床护理环境中使用时对其进行评估。六名注册营养师修订了现有的 NCP 审计工具。对修订后的工具（NCP-QUEST）进行了清晰度、相关性和可靠性分析。我们从 8 个退伍军人事务志愿者站点收到了 85 份文档说明（44 份是初次的，41 份是重新评估的）。六名注册营养师中有五名参加了互评者可靠性测试，不知道彼此的评级；两名注册营养师参加了内部评级可靠性评估，六周后对相同的注释进行了审查，而对原始评级不知情。结果显示，参与者间可靠性具有中等程度的一致性（所有项目的 Krippendorff α = 0.62，总分 0.66，质量类别评级 0.52）。所有项目的评估者内信度都非常出色（所有项目的 alpha = 0.86 至 0.87；总分为 0.91 至 0.94；质量类别评级为 0.74 至 0.89）。经过两个周期的内容有效性审核后，NCP-QUEST 具有较高的内容效度（项目级别的内容效度指数 = 0.78，量表级别的内容效度指数 = 0.9）。该工具可以促进批判性思维，改善 NCP 链的链接，是高质量数据收集和结果管理的必要基础。 NCP-QUEST 工具可以提高制图的准确性和置信度。
Documentation is essential for communicating care between credentialed nutrition and dietetics practitioners and other health care providers. A validated tool that can evaluate quality documentation of the Nutrition Care Process (NCP) encounter, including progress on outcomes is lacking. The aim of the NCP Quality Evaluation and Standardization Tool (QUEST) validation study is to revise an existing NCP audit tool and evaluate it when used within US Veterans Affairs in all clinical care settings. Six registered dietitian nutritionists revised an existing NCP audit tool. The revised tool (NCP-QUEST) was analyzed for clarity, relevance, and reliability. Eighty-five documentation notes (44 initial, 41 reassessment) were received from eight volunteer Veterans Affairs sites. Five of six registered dietitian nutritionists participated in the interrater reliability testing blinded to each other's ratings; and two registered dietitian nutritionists participated in intrarater reliability reviewing the same notes 6 weeks later blinded to the original ratings. Results showed moderate levels of agreement in interrater reliability (Krippendorff's alpha = .62 for all items, .66 for total score, and .52 for quality category rating). Intrarater reliability was excellent for all items (alpha = .86 to .87 for all items; .91 to .94 for total score and.74 to .89 for quality category rating). The NCP-QUEST has high content validity (Content Validity Index = 0.78 for item level, and 0.9 for scale level) after two cycles of content validity review. The tool can facilitate critical thinking, improved linking of NCP chains, and is a necessary foundation for quality data collection and outcomes management. The NCP-QUEST tool can improve accuracy and confidence in charting.