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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Operationalising a modified Delphi study to progress quality care process nursing metrics for acute care.

Laserina O'Connor1, Eilish McAuliffe2, Mary Casey3

  • 1Professor, UCD School of Nursing Midwifery & Health Systems, University College Dublin, Ireland.

Journal of Research in Nursing : JRN
|November 21, 2022
PubMed
Summary

This study developed 11 quality care process metrics and 53 indicators for acute care nursing, aiming to make nurses' contributions visible. Challenges remain in objectively measuring patient experience and engagement.

Keywords:
acute careindicator developmentmodified Delphi techniquepatient experience quality care metric development

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Area of Science:

  • Nursing Quality Improvement
  • Healthcare Metrics
  • Patient Safety

Background:

  • Nursing practice complexity often renders nurses' contributions 'invisible' within healthcare.
  • Quality Care Metrics can quantify nursing care processes in complex clinical settings.

Purpose of the Study:

  • To develop an evidence-based metric system for measuring nursing care quality and clinical safety in Irish acute care settings.
  • To classify, agree upon, and prepare for the implementation of nursing care process metrics and indicators.

Main Methods:

  • A modified four-round Delphi study involving 422 nurses, patient representatives, stakeholders, and 26 expert nurse clinicians.
  • Surveys and consensus meetings were used to identify and refine metrics and indicators.

Main Results:

  • Consensus was reached on 11 quality care process nursing metrics and 53 corresponding indicators for acute care.
  • Concerns were raised regarding the subjective nature of metrics like 'patient experience' and 'patient engagement' due to a lack of objective measurement tools.

Conclusions:

  • The study operationalized a Delphi technique to establish key nursing quality care process metrics and indicators.
  • Implementation of these metrics is crucial to making nurses' contributions to patient-centered care tangible in acute care.