医療施設における高齢者看護の質評価指標の検討

Quality Indicators of Geriatric Nursing in Hospital Settings

抄録

　本研究では，医療施設における高齢者看護の質評価指標について検討を行った．17領域80項目の質指標候補について，RAND/UCLA適切性評価法により専門家パネルとして9人の老人専門看護師を対象に，郵送法による2回の質問紙調査を行った．各項目について9段階評価を行った結果，1回目評価では中央値7以上の適切が80項目中78項目，4〜6の中間が2項目，1〜3の不適切は認められなかった．2回目評価についても同様に17領域80項目について評価を行ったところ80項目すべてにおいて適切であった．また，7以上の割合が多かった領域として褥瘡予防，包括的アセスメント，疼痛マネジメント，せん妄，身体抑制，退院支援が挙げられた．

　This study was conducted to examine quality indicators of geriatric nursing in hospital settings. Quality indicators of 17 categories and 80 items were made. Nine gerontological certified nurse specialists evaluated the items by RAND/UCLA appropriateness method. Questionnaires were mailed twice to the nurses. Each quality indicator was assessed on 9-point Likert-type scales: 78 of 80 items were rated as “appropriate” with a median of over 7 points, 2 items were rated as “intermediate” with a median of 4-6 points, and no items were rated as “inappropriate” at the first round evaluation. Second round evaluation was conducted using the same 80 items, and all of the 80 items were rated as appropriate. Additionally, categories such as prevention of pressure ulcer, comprehensive geriatric assessment, pain management, delirium prevention and management, physical restraint reduction and management, and discharge planning were rated as “high” with a median of over 7 points.