Background: Nurse-sensitive indicators and nurses’ satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. Methods: To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores of the publicly reported nurse-sensitive indicators: screening of delirium, screening of malnutrition, and pain assessments, were averaged (2011). Nurse-perceived quality ratings were obtained from staff nurses working in the same hospitals by the Dutch Essentials of Magnetism II survey (2010). Concordance between the quality measures was analyzed using Spearman’s rank correlation. Results: The mean screening performances ranged from 63 % to 93 % across the six hospitals. Nurse-perceived quality of care differed significantly between the hospitals, also after adjusting for nursing experience, educational level, and regularity of shifts. The hospitals with high-levels of nurse-perceived quality were also high-performing hospitals according to nurse-sensitive indicators. The relationship was true for high-performing as well as lower-performing hospitals, with strong correlations between the two quality measures (r S = 0.943, p = 0.005). Conclusions: Our findings showed that there is a significant positive association between objectively measured nurse sensitive screening indicators and subjectively measured perception of quality. Moreover, the two indicators of quality of nursing care provide corresponding quality rankings. This implies that improving factors that are associated with nurses’ perception of what they believe to be quality of care may also lead to better screening processes. Although convergent validity seems to be established, we emphasize that different kinds of quality measures could be used to complement each other, because various stakeholders may assign different values to the quality of nursing care.
Staffing practices in long-term care lack a clear evidence base and often seem to be guided by opinions instead of evidence. While stakeholders believe intuitively that there is a positive relationship between staffing levels and quality in nursing homes, the research literature is contradictory (1). In this editorial we consider the evidence found in a literature study that we conducted for the Dutch Ministry of Health, Welfare and Sports (VWS). The aim of this study was to summarize all available evidence on the relationship between staffing and quality in nursing homes. Specifically, we focused on the quantity and the educational background of staff and quality in nursing homes. The literature study has contributed to the recent Dutch quality framework for nursing homes (Kwaliteitskader verpleeghuiszorg in Dutch) of the National Health Care Institute. This quality framework was published in January 2017 and provides norms – among other quality aspects – for nursing home staffing. As well as a description of the main findings of the literature study, we present implications for different stakeholders charged with staffing issues in nursing homes.
This report is the second in a series of three reports named Value Added Planning, consisting of three unique, but interconnected tools, namely the Green Credit Tool, the Workbench Method and Value Added Planning, These tools have been developed and/or tested in the context of the European INTERREG programme: VALUE (INTERREG IVB North West Europe - Valuing Attractive Landscapes in the Urban Economy), in which the municipality of Amersfoort is involved. Aim of this programme is to understand how green space in urban centres can become more competitive with other urban functions. In this context, the municipality of Amersfoort has introduced the interactive method named Workbench Spatial Quality (Werkbank Ruimtelijke Kwaliteit in Dutch) in their spatial design in several areas in their municipality. The Workbench Spatial Quality (to be referred to as Workbench) has been applied on two cases in Amersfoort: Park Randenbroek and Vathorst NW. In this report the Workbench as applied in Amersfoort is evaluated. Research was done on the basis of literature research, case-material and interviews performed with several experts. Furthermore, research was done by students at the Wageningen University and Research Centre (WUR). Part of the evaluation in this report makes use of a quick scan of 19 Dutch cases. The question addressed in this report is: 1.How was the Workbench Spatial Quality applied in Amersfoort? 2.Can the Workbench contribute to sustainable spatial planning?
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