Exploring nurse‐sensitive patient outcomes in Dutch district nursing care: A survey study

Abstract

There is a lack of evidence to guide district nurses in using nurse‐sensitive patient outcomes as it is unclear how these outcomes are currently used in daily district nursing practice. Therefore, we aimed to explore (1) which nurse‐sensitive patient outcomes are measured and how these outcomes are measured, (2) how district nurses use the outcomes to learn from and improve current practice and (3) the barriers and facilitators to using outcomes in current district nursing practice. An exploratory cross‐sectional survey study was conducted. The survey was distributed online among nurses working for various district nursing care organisations across the Netherlands. The responses from 132 nurses were analysed, demonstrating that different instruments or questionnaires are available and used in district nursing care as outcome measures. The nurse‐sensitive patient outcomes most often measured with validated instruments are pain using the Numeric Rating Scale or Visual Analogue Scale, delirium using the Delirium Observation Scale, weight loss using the Short Nutritional Assessment Questionnaire and caregiver burden using the Caregiver Strain Index or a Dutch equivalent. Falls and client satisfaction with delivered care are most often measured using unvalidated outcome measures. The other nurse‐sensitive outcomes are measured in different ways. Outcomes are measured, reported and fed back to the nursing team multiple times and in various ways to learn from and improve current practice. In general, nurses have a positive attitude towards using nurse‐sensitive outcomes in practice, but there is a lack of facilitation to support them. Because insight into how nurses can and should be supported is still lacking, exploring their needs in further research is desirable. Additionally, due to the high variation in the utilisation of outcomes in current practice, it is recommended to create more uniformity by developing (inter)national guidelines on using nurse‐sensitive patient outcomes in district nursing care.

Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study

“…Such a demand can be identified in recent literature. A Dutch study that explored sensitive outcome use by nurses concluded that there is a lack of information on how nurses can and should be supported by outcome measurement tools ( 10 ) . In pediatric nursing, a literature review presented a total of 57 sensitive outcomes for use in the specialty ( 11 ) .…”

Contribuições da representação dos elementos da prática de enfermagem na norma ISO 18.104:2023: estudo teórico

“…Identifica-se, na literatura recente, tal demanda. Estudo holandês que explorou a utilização de resultados sensíveis por enfermeiras concluiu que falta informações sobre como as enfermeiras podem e devem ser apoiadas por instrumentos de medidas de resultados (10) . Na área da enfermagem pediátrica, revisão de literatura apresentou um total de 57 resultados sensíveis para uso na especialidade (11) .…”

Aportes de la representación de los elementos de la práctica de enfermería en la norma ISO 18.104:2023: estudio teórico

“…Esta demanda se identifica en la literatura reciente. Un estudio holandés que exploró el uso de resultados sensibles por parte de los enfermeros concluyó que falta información sobre cómo los enfermeros pueden y deben recibir apoyo de los instrumentos de medición de resultados (10) . En el área de enfermería pediátrica, una revisión de la literatura presentó un total de 57 resultados sensibles para su uso en la especialidad (11) .…”