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Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review
Matteo Danielis1, Adele Castellano1, Elisa Mattiussi1
1Department of Medical Sciences, School of Nursing, University of Udine, Viale Ungheria 20, 33100 Udine, Italy.
Insights
This study maps nursing-sensitive outcomes (NSOs) in pediatric intensive care units (PICUs), identifying 46 NSOs. Clinical, safety, and functional outcomes were most reported, with few validated tools used.
Area of Science:
- Pediatric critical care nursing research
- Nursing-sensitive outcomes (NSOs) measurement
- Evidence-based practice in pediatric intensive care units (PICUs)
Background:
- Measuring nursing intervention effectiveness is crucial in intensive care units.
- Limited research exists on nursing-sensitive outcomes (NSOs) specifically for pediatric populations.
- Understanding NSOs in pediatric intensive care units (PICUs) is essential for quality improvement.
Purpose of the Study:
- To map the current scientific understanding of nursing-sensitive outcomes (NSOs) in pediatric intensive care units (PICUs).
- To identify and describe all documented NSOs and their metrics within the PICU setting.
- To highlight areas for future research, such as perceptual outcomes.
Main Methods:
- A comprehensive scoping review was performed, adhering to the Arksey and O'Malley framework.
- Fifty-eight relevant articles were included in the analysis.
- Data extraction focused on identifying NSOs, their domains (clinical, safety, functional, perceptual), and measurement metrics.
Main Results:
- A total of 46 nursing-sensitive outcomes (NSOs) were identified in the pediatric intensive care unit (PICU) literature.
- The most frequently reported NSOs belonged to the clinical (83 instances), safety (41 instances), and functional (18 instances) domains.
- NSOs were predominantly measured using single quantitative occurrences, with limited use of validated tools; no perceptual outcomes were reported.
Conclusions:
- Nursing care in pediatric intensive care units (PICUs) addresses clinical performance, patient safety, and fundamental care needs.
- The current measurement of nursing-sensitive outcomes (NSOs) in PICUs relies heavily on simple quantitative metrics.
- Further exploration and development of methods to measure perceptual nursing-sensitive outcomes (NSOs) in critically ill children are warranted.
Abstract:
Measuring the effectiveness of nursing interventions in intensive care units has been established as a priority. However, little is reported about the paediatric population. The aims of this study were (a) to map the state of the art of the science in the field of nursing-sensitive outcomes (NSOs) in paediatric intensive care units (PICUs) and (b) to identify all reported NSOs documented to date in PICUs by also describing their metrics. A scoping review was conducted by following the framework proposed by Arksey and O'Malley. Fifty-eight articles were included. Publications were mainly authored in the United States and Canada (n = 28, 48.3%), and the majority (n = 30, 51.7%) had an observational design. A total of 46 NSOs were documented. The most reported were related to the clinical (n = 83), followed by safety (n = 41) and functional (n = 18) domains. Regarding their metrics, the majority of NSOs were measured in their occurrence using quantitative single measures, and a few validated tools were used to a lesser extent. No NSOs were reported in the perceptual domain. Nursing care of critically ill children encompasses three levels: improvement in clinical performance, as measured by clinical outcomes; assurance of patient care safety, as measured by safety outcomes; and promotion of fundamental care needs, as measured by functional outcomes. Perceptual outcomes deserve to be explored.
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