Development of an evaluation tool for the quality of nursing care in abdominal surgery patients

복부수술 환자간호의 질평가 도구 개발

The purpose of this study was to develop an evaluation tool for the quality of nursing care in abdominal surgery patient. The target subjects of the tool were adult patients having abdominal surgery under general anesthesia. Process-outcome framework was selected for the development of the tool in this study. The results were as follows. 1. Nine standards. 40 criteria and 88 indicators were developed. A standard was summary statement of the ideal level of excellencein a dimension of quality of nursing care. which could be evaluated by criteria. Several criteria indicated a specific standard and each criterion could be measured by observable and measurable indicators. 2. The standards were divided into two dimensions. One was process dimension which contained four standards(23 criteria), the other was outcome dimension which contatined five standards(17 criteria). 3. Average CVI was .985 at 9 standards. .947 at 40 criteria. and .987 at 88 indicators. 4. The evaluation tool for the quality of nursing care in abdminal surgery patients was a criterion-referenced tool. And data collection methods of the tool were investigation of patient's record and interview( or questionnaire) with the patients. 5. Interrater reliabilities of the tool were ; r= .7572 (agreement between two raters), and pI=.8487 (intraclass correlation between five raters who rated the 84 patients). 6. Internal consistency reliability ${\alpha}$ was .6194, which was obtained from 32 criteria. Eight criteria were missed in the analyzing process because of data omission. 7. Scores of the process and the outcome dimensions showed significant. but low correlation(r= .3759, p < .001). 8. There were significant differences in total scores between the hospitals and the departments of surgery(F = 15.233. p .0001). There was also significant interaction effect between hospitals and departments to total score(F = 8.396. p = .0001). Construct validity of the toool was verified by the known-group method. these kinds of difference were expected by the nursing experts participated in the study. From these results, more specific patient classification is suggested for the development of evaluation tool of the quallity of nursing care. And indicators to be used for objective measurement for the quality of nursing care must be developed.