A tentative model for developing strategic and clinical nursing quality indicators: Postoperative pain management

Abstract

The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.

Patient assessment of postoperative pain management – Orthopaedic patients compared to other surgical patients

“…For each item in the SCQIPP instrument, a mean score that exceeds 4.5 (scale range 1-5) has been suggested as the level required for high quality of care (Idvall et al, 2002b). The items have been validated as essential for the quality of care, realistic to carry out, and possible for nurses to influence management (Idvall et al, 1999(Idvall et al, , 2001, and therefore a high threshold has been set. In this study, low quality of care was set at a mean score <4.0 to facilitate comparison of different patient outcomes in other studies.…”

“…Development of this instrument started with a qualitative approach using interviews (Idvall and Rooke, 1998) and a literature review (Idvall et al, 1999) that led to the items tested for content validity (Idvall et al, 2001). Content validity and psychometric properties gave initial support for the instrument with a Cronbach's alpha of 0.84 and inter-item correlation of 0.32 (Idvall et al, 2002a).…”

Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management

“…The tentative model consists of 15 categories in two dimensions, i.e. elements of performance and prerequisites, and was used for designing strategic and clinical quality indicators in postoperative pain management in a study by Idvall et al . (1999) (Table 1).…”

The assesment of the quality of postoperative pain management in patients with maxillofacial injury

“…In regards to the subscales, the minimal score (as recommended by the authors of the original version) was not reached as well. 5,12,18,21,22 In the communication subscale the lowest score applied to the statement concerning information about possible methods of pain relief was 2.87 points (range 1-5). The majority of the respondents (54.1%) ranked those aspects negatively giving them 1 or 2 points.…”