QUALITY OF NURSING CARE AS MEASURED BY IMPLICIT REVIEW

此应用程序的目的是开发、实现和评估 隐性回顾法在护理服务质量测量中的应用 给病情危重的住院医疗保险患者。对医学的隐性审查 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于 用护理内隐回顾确定护理质量 笔记，也没有关于护理，医生护理， 适当地使用服务，以及患者的结果。的具体目标 该项目的目的是： 1.查阅有关护理笔记和护理质量的护理文献 关心。 2.召集一个护士小组，帮助设计结构化的隐性审查 反映护理优先顺序的表格，以及分别标识护理的表格 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 有代表性的充血性心脏病住院患者样本 心力衰竭与脑血管意外，采用结构化隐性护理 审查表(由护士审查员使用)和现有的全国性 有代表性的病历样本。 4.评定护士结构内隐的信度和效度 评审表格和评价过程质量之间的联系 护理和护理的结果，包括症状减轻，30和180 日间死亡和重新入院治疗。 5.评估护理记录类型和护理质量的差异 不同地理区域、不同医院类型和不同时间段的医疗服务。 6.分析同一医疗项目的不同评审之间的差异 唱片。 这项研究将提供重要的方法论步骤，以改进 对护理流程的理解及其对患者的影响 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.