Year: 2010
Type: article
Abstract: Despite rich data on the association between nurse staffing and patient outcomes, evidence regarding the number and combination of nursing resources that optimize patient outcomes is lacking.One method of determining nurse staffing is patient acuity measurements, but inconsistencies exist in how acuity is defined and measured.The purpose of this study was to clarify the concept of acuity, recommend a standardized definition of acuity, and assess the psychometric properties of the Oncology Acuity Tool (OAT), a patient acuity tool currently in use on an inpatient oncology unit.Procedures included assessing inter-rater reliability (IRR), surveying expert oncology nurses for content validity, using a visual analog scale for concurrent validity, and assessing whether acuity scores predicted one of two acute events, patient falls and rapid response team consults, for predictive validity.Results demonstrated high interrater reliability (ICC=0.953,CI 0.914, 0.977; p<0.001), moderately strong concurrent validity (r=0.578,p=0.01), high content validity (70% of acuity items had an I-CVI > 0.78; S-CVI=0.82;84% of items had kappa statistics (k*) of good [k*=0.6-0.74] or excellent [k*>0.74]).Acuity scores during the shift of the acute event were significant predictors of rapid response team consults (OR=2.25,CI 1.45, 3.48; p<0.001), as were acuity scores during the shift prior to the acute event (OR=1.75,CI 1.21, 2.54; p=0.003).These data indicate that the OAT is a psychometrically sound instrument that demonstrates high reliability and validity for measuring acuity prospectively in the xii oncology inpatient population.These findings can be used in future research in oncology populations to test acuity as a structure and process variable in studies that examine the relationship between acuity-based staffing and patient outcomes.The methodology used in this study can be applied to the development of acuity tools in other populations and tests of the relationship between acuity-based staffing decisions and better patient outcomes.
Author: Caitlin W. Brennan
Institution: Case Western Reserve University
Language: English
Subfield: Research and Theory
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W167176978