護理品質線上題庫與評量系統 之開發與測試 報告人 : 徐南麗 慈濟大學護理學系教授 慈濟大學護研所所長

Development and Testing of a Computer-aided System on the Nursing Care Quality Nanly Hsu, ( 徐南麗 ) RN., PhD Director, Professor Department of Nursing Tzu Chi University

Outline  Introduction  Purpose  Literature Review  Conceptual Framework  Instrument Development  Computer Design Process  Scoring Methods  Results  Future Research

Introduction  Nursing staffs spend 30% of their working hours in recording and filing documents that are not directly related to their patient caring tasks. (Arnst, Hsu, 2004)

 There hasn’t been any formal nursing information system implemented to improve and assess nursing quality care for patients and nursing staffs in Taiwan.

Purpose  This study is to develop a nursing care quality information system and test the application of the system.

 Literature Review

 品=++ 質=斤+斤+貝 品=++ 質=斤+斤+貝 要斤斤計較產品的價格

Nursing Quality  The quality of service for patients  Nurses’ professional role

Theory of Nursing Quality Assurance Structure ProcessOutcome Donabedian, A.(1980).The definition of quality and approaches to its assessment.

Nursing Quality Assessment Method and Tools  Quality Assurance Cost Efficiency Risk Staff Model (QUACERS)  American Nurses’ Association (ANA)  Rush Medicus Tool-Monitoring the Quality of Nursing Care (RMT-MQNC )

 Conceptual  Framework

輸入 過程輸出 控 制控 制 護理標準護理品管 迴饋

Instrument Development  Translating RMT-MQNC into Chinese and then translated it back to English  Specialists examine the content and propose suggestions.  202 out of 368 items for medical and surgical Type 1-4 patients  There are 4 objectives and 25 sub-objectives

 Computer Design Process

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Patient Classification Items  Activity  Elimination  Nutrition  Cleaning and dressing  Vital signs

Patient Classification  Class I : Score 1~6  Class II : Score 7~11  Class III : Score 12~16  Class IV : Score 17~20

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Set up password Select patient classifying index Select patient basic data Classify Hospitalized patients Major objectives, standard and scores Select the major objective Select the standard Questions for nursing quality Questionnaire for different types of patients Select Items

Scoring Methods  1. Two answers: no and yes  2. Three answers: no, yes and not applicable  3. Four answers: no, yes-incomplete, yes-complete, not applicable

Scoring Methods  Two Answers Total score for quality= number who chose Yes/ (number with Yes answers + number with No answers)

品質得分 = 答是的總人數 /( 答是 + 答否的人數和 ) = [31/(31+1)]  100%= 分 1 個人記錄不完整 31 個人記錄完整 Two Answers

Scoring Methods  Three Answers Quality score = [2 x (number not completely recorded ) + 3 x (number completely recorded) ] /3 X (all the n applicable number )

22 個無記錄 17 個記錄完整 49 個不適用，不適用不計算 Three Answers

 品質得分 = 記錄完整的人數 / ( 無記錄 + 記錄完整人數 ) =[17/(17+22)]  100%= 分

0 位沒有記錄 88 位記錄不完整 3 位記錄完整 4 位不適用 Four Answers

 品質得分 =[2  ( 不完整的人數 )+ 3  ( 完整 的人數 )/ 3  ( 所有適用的人數 )] =[(2  88+3  3)/3  (0+3+88)]  100%=67.77 分

Results  To establish computerized nursing care criteria and index for evaluation.  To monitor the nursing care quality constantly.  To show the advantages and disadvantages of the nursing process.

Future Research  Testing and Evaluating of computer-aided system

Thanks for Your Attention