ADVERSE PATIENT OCCURRENCES AS A MEASURE OF NURSING-CARE QUALITY

Objective: The purpose of this study was to describe relationships amo ng adverse patient occurrences aggregated at the unit level of measure ment. Relationships between adverse occurrences and a patient acuity m easure were also described. Background: Adverse patient occurrence dat a have been traditionally a major indicator of quality care in hospita ls; however, few studies have examined relationships among these indic ators or the usefulness of these indicators for assessing the quality of nursing care. Methods: A correlational design was used to examine a nd describe patterns of relationships among inpatient units in a terti ary care hospital. The results demonstrated positive correlations betw een medication error rates and patient falls; these adverse occurrence s correlated negatively with. pressure ulcers, infections, patient com plaints, and death. Pressure ulcers, infections, patient complaints an d death intercorrelated positively and also related positively to pati ent acuity levels. Results: An examination of these same rates for a s ubset of units with similar patient acuity levels revealed that most o f the interrelationships among the entire set of adverse occurrence in dicators were positive. When patient acuity was taken into account, th ese adverse outcomes appeared to indicate some common underlying chara cteristic of the units, such as quality of nursing care. Conclusions: This study suggests a relationship between the adverse occurrences tha t were correlated (pressure ulcers, patient complaints, infection, and death) and the severity of patient illness. Medication error rates an d patient fall rates were not correlated with patient acuity and are m ore likely to indicate quality of nursing care across all types of uni ts.