Testing the Q-DIO as an Instrument to Measure the Documented Quality of Nursing Diagnoses, Interventions, and Outcomes

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1744-618X.2007.00075.x Byline: Maria Muller-Staub (1), Margaret Lunney (2), Mary Ann Lavin (3), Ian Needham (4), Matthias Odenbreit (5), Theo van Achterberg (6) Keywords: Instrument testing; measurement instrument Q-DIO; nursing diagnoses; nursing interventions; nursing-sensitive patient outcomes Abstract: PURPOSE. To describe pilot testing of Quality of Diagnoses, Interventions and Outcomes (Q-DIO), an instrument to measure quality of nursing documentation. DESIGN. Instrument testing was performed using a random, stratified sample of 60 nursing documentations representing hospital nursing with and without implementation of standardized nursing language (30 for both strata) in a Swiss General Acute Hospital. METHODS. Internal consistency and intrarater and interrater reliabilities were tested. Through item analyses, the grades of difficulty and the discrimination validity of items were evaluated. FINDINGS. Internal consistency of nursing diagnoses as process produced Cronbach's alpha .83; nursing diagnoses as product .98; nursing interventions .90; and nursing-sensitive patient outcomes .99. With Kappas of .95, the intrarater and interrater reliabilities were good. Criteria for the grades of difficulty of items and discrimination validity were well met. The results of this study suggest that Q-DIO is a reliable instrument to measure the documentation quality of nursing diagnoses, interventions, and outcomes. Further testing of Q-DIO in other settings is recommended. Abstract: Zusammenfassung ZIEL. Die Beschreibung der Pilot-Testung von Q-DIO (Quality of Nursing Diagnoses, Interventions and Outcomes), eines Instruments zur Messung der Qualitat der Pflegedokumentation. DESIGN. Die Instrumenttestung wurde mittels einer zufallig gewahlten, stratifizierten Stichprobe von 60 Pflegedokumentationen vorgenommen, welche klinische Pflege mit und ohne Einfuhrung standardisierter Pflegefachsprache in einem Schweizer Akutspital reprasentierten (30 fur beide Strata). METHODE. Interne Konsistenz, Intrarater und Interrater-Reliabilitat wurden getestet. Mittels einer Itemanalyse wurden die Schwierigkeitsgrade und die Trennscharfe der Items evaluiert. ERGEBNISSE. Die interne Konsistenz der Subskala zu Pflegediagnosen als Prozess zeigte einen Crohnbach's alpha von 0.83; zu Pflegediagnosen als Produkt 0.98; zu Pflegeinterventionen 0.90 und zu pflegesensiblen Patientenergebnissen 0.99. Mit Kappa-Werten von 0.95 waren die Intra- und die Interrater-Reliabilitaten gut. Die Itemanalyse bestatigte die Erfullung der Kriterien zu Schwierigkeitsgrad und Trennscharfe der Items. SCHLUSSFOLGERUNGEN. Die Resultate beschreiben Q-DIO als zuverlassiges Instrument zur Messung der Qualitat von dokumentierten Pflegediagnosen, -interventionen und -ergebnissen. Studien zu weiteren Testungen von Q-DIO in anderen Settings werden empfohlen. Author Affiliation: (1)Head of Pflege PBS, Bern, Switzerland (2)College of Staten Island, The City University of New York Department of Nursing (3)Saint Louis University School of Nursing (4)Hochschule fur Angewandte Wissenschaften, Nursing Research Institute, St. Gallen, Switzerland (5)SoH Spital Solothurn, Solothurn, Switzerland (6)Nursing Science, Centre for Quality of Care Research, University Medical Center, St. Radboud, The Netherlands Article note: Author contact: muellerstaub@bluewin.ch