Co-Producing Peritoneal Dialysis Nursing Sensitive Indicators for Quality Care: A Multinational Consensus Building Design

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2025-01-28 DOI:10.1111/jorc.70008

Jessica Baillie, Ann Bonner, Sonia Guillouet, Cornelia Mikut, Sally Punzalan, Anna Kaczmarek, Lawrence Climaco Wenzyl, Jeanette Finderup

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引用次数: 0

Abstract

Background

Nursing sensitive indicators are a way of measuring aspects of patient care that are most affected by the actions of the nurse. Despite the existence of nursing sensitive indicators, these are largely not suitable to measure peritoneal dialysis nursing practice.

Objective

This project aimed to co-develop a set of peritoneal dialysis nursing-sensitive indicators.

Design

Informed by the Donabedian quality framework (structure, process, outcome), a multinational co-production consensus design was used.

Participants and Measurements

First, an expert panel of seven professionals proposed potential indicators from clinical expertise and examining peer-reviewed articles and clinical guidelines. Next, the expert panel undertook a consensus building process involving face-to-face meetings and online discussion to refine the indicators. Lastly indicator confirmation was undertaken using a 5-point rating scale involving delegates at a major conference.

Results

The initial indicator proposal, based on evidence and clinical experience, identified 65 potential indicators (20 structural, 22 process and 23 outcome). The consensus process involved discussion and negotiation to reduce the potential indicators to 28 (eight structural, 12 process and eight outcome). Confirmation involved 25 nurses with all 28 indicators supported (all > 3.5/5). Indicators highly supported were patient satisfaction, fluid balance assessment, peritoneal dialysis catheter exit-site, clinical signs measurement, peritonitis investigation, peritoneal dialysis catheter complications referral and infection rates.

Conclusion

Following further validity, reliability and feasibility testing, these nursing sensitive indicators can be used to measure the quality of peritoneal dialysis nursing care provided for patients and families.

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联合生产腹膜透析护理敏感指标的质量护理：多国共识建设设计。

背景：护理敏感指标是一种衡量病人护理中最受护士行为影响的方面的方法。尽管存在护理敏感指标，但这些指标在很大程度上不适合衡量腹膜透析护理实践。目的：本项目旨在共同开发一套腹膜透析护理敏感指标。设计：根据Donabedian质量框架（结构、过程、结果），采用多国合作生产共识设计。参与者和测量：首先，由7名专业人士组成的专家小组从临床专业知识和审查同行评审的文章和临床指南中提出了潜在的指标。接下来，专家小组开展了建立共识的过程，包括面对面会议和在线讨论，以完善指标。最后，采用一项涉及一次主要会议代表的5点评分表进行指标确认。结果：初步指标提案基于证据和临床经验，确定了65个潜在指标（20个结构指标，22个过程指标和23个结果指标）。协商一致进程涉及讨论和谈判，以将潜在指标减少到28项（8项结构性指标、12项进程指标和8项结果指标）。确认涉及25名护士，所有28项指标均得到支持（均为bb0 3.5/5）。患者满意度、体液平衡评估、腹膜透析导管退出部位、临床体征测量、腹膜炎调查、腹膜透析导管并发症转诊和感染率均得到高度支持。结论：这些护理敏感指标经过进一步的效度、信度和可行性检验，可用于衡量腹膜透析患者及家属护理质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.