The Patient Intensity for Nursing Index: a validity assessment

Area of Science:

• Nursing
• Healthcare Management
• Psychometrics

Background:

• Assessing nursing intensity is crucial for effective patient care and resource allocation.
• Existing measures may not fully capture the multifaceted nature of nursing workload.
• The Patient Intensity for Nursing Index (PINI) was developed to address these limitations.

Purpose of the Study:

• To report the psychometric assessment of the Patient Intensity for Nursing Index (PINI).
• To evaluate the reliability and validity of the PINI in measuring nursing intensity.
• To determine the relationship between PINI scores and various patient and hospital characteristics.

Main Methods:

• A purposive sample of 6,445 patients from five hospitals was assessed by 487 registered nurses (RNs).
• The PINI, a 10-item, 5-point ordinal scale measure, assesses four dimensions: severity of illness, dependency, complexity of care, and time.
• Psychometric testing included interrater reliability, confirmatory factor analysis, hypothesis-testing, contrasted groups, and an observational time study.

Main Results:

• The PINI demonstrated substantial interrater reliability.
• Confirmatory factor analysis supported the four dimensions of nursing intensity, with time loading on all factors.
• PINI scores significantly correlated with medical severity, length of stay, discharge disposition, secondary diagnoses, specialty consults, hospital classification systems, and DRG intensity.
• Observed nursing time correlated significantly with PINI time estimates.

Conclusions:

• The PINI is a psychometrically sound measure of nursing intensity.
• The PINI effectively captures key dimensions of nursing workload.
• The PINI has significant potential for use in clinical practice, research, and healthcare management for staffing and resource allocation.