QUALITY OF NURSING CARE AS MEASURED BY IMPLICIT REVIEW

此应用程序的目的是开发，实施和评估 护理服务质量的隐性评价方法 给急性病住院的医保病人隐性医疗审查 记录描述了基于健康护理的护理质量评估， 专业人士自己的判断。 相对较少的科学研究专门关注 通过隐性护理评审确定护理质量 注意，也不是关于护理，医生护理， 适当使用服务和患者结果。的具体目标 该项目旨在： 1.回顾有关护理记录和护理质量的护理文献 在乎 2.召集一个护士小组，帮助设计结构化的隐性审查 反映护理优先事项和单独确定护理的表格 质量，短期护理结果，护士评定的医生质量，以及 其他医院服务的质量。 3.衡量一个国家接受的护理质量 充血性心脏病住院患者的代表性样本 失败和脑血管意外，采用护士结构化内隐 审查表（由护士审查员申请）和现有的国家 医疗记录的代表性样本。 4.评定护士结构化内隐量表的信度和效度 审查形式与评价过程质量之间的联系 护理和护理的结果，包括症状的减少，30和180 白天死亡和再次入院 5.评估护理记录类型和护理质量的变化 跨地理区域、医院类型和时间段的护理。 6.分析同一医疗器械的不同评价之间的差异 记录 这项研究将提供一个重要的方法步骤， 了解护理流程及其对患者的影响 结果。

The purpose of this application is to develop, implement, and evaluate an implicit review method for measuring the quality of nursing care delivered to acutely ill, hospitalized Medicare patients. Implicit review of medical records describes the assessment of quality of care based on a health care professional's own judgement. Relatively little scientific research has focused specifically on determining the quality of nursing care through implicit review of nursing notes, nor on the relationships between nursing care, physician care, appropriate use of service, and patient outcomes. The specific aims of this project are to: 1. Review the nursing literature regarding nursing notes and quality of care. 2. Convene a panel of nurses to help design structured implicit review forms that reflect nursing priorities and that separately identify nursing quality, short term nursing outcomes, nurse-rated physician quality, and the quality of other hospital services. 3. Measure the quality of nursing care received by a nationally representative sample of patients hospitalized with congestive heart failure and cerebrovascular accident, using the nurse structured implicit review form (applied by nurse reviewers) and an existing nationally representative sample of medical records. 4. Assess the reliability and validity of the nurse structured implicit review form and evaluate the link between the quality of the process of care and the outcomes of care including reduction in symptoms, 30 and 180 day death, and hospital readmissions. 5. Assess the variations in types of nursing notes and in nursing quality of care across geographic regions, types of hospitals, and time period. 6. Analyze discrepancies between different reviews of the same medical records. This study will provide an important methodological step towards improved understanding of the nursing process and its influence on patient outcomes.