Abstract
PURPOSE
To describe the NOC outcomes most relevant for specialty nursing practice and in selected field sites representing the continuum of care; to assess the adequacy of measures (reliability, validity, sensitivity, specificity, practicality); and to describe the linkages among nursing diagnoses, interventions, and outcomes in clinical decision making.
METHODS
Data were collected on 434 patients during the 12-month data collection period at a tertiary care center: cardiac surgery intensive care (n= 76), cardiac transplant unit (n= 153), and medical unit (n= 205). Medical diagnoses of patients on the two cardiac units were related to cardiac disease. Medical diagnoses of patients on the medical unit were extremely varied (ranging from e.g., gout to pneumonia). Data were collected on 65 separate outcome labels for a total of 633 ratings.
FINDINGS
In the cardiac transplant ICU, data were collected on 42 outcomes: 30 had an average interrater reliability of ≥85%, and 16 had an absolute agreement interrater reliability of ≥85%. In the cardiac surgery ICU, data were collected on 30 outcomes: 25 had an average interrater reliabilty of ≥85%, 6 had an absolute agreement interrater of ≥85%. In the medical unit, data were collected on 45 outcomes: 41 had an average interrater reliability of ≥85%, 14 had an absolute agreement interrater reliability of ≥85%. Four outcomes have been implemented into the documentation system for all patients: Tissue Integrity: Skin and Mucous Membranes, Mobility Level, Knowledge: Disease Process, and Coping.
CONCLUSIONS
Overall, nursing staff were very positive about having the opportunity to participate in nursing research. Staff were able to think about the relative status of their patient and how nursing care contributes to the patient's recovery. They appreciated the opportunity to discuss this with a colleague during the interrater exercise. Increased familiarity with NOC allows staff members to determine which outcomes comprise core nursing-sensitive outcomes for their clinical setting.
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